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6 Things Never to Say to Patients

Research shows the risk of a lawsuit is directly linked to a physician’s inability to effectively communicate and develop relationships with patients.

senior patient talking to doctor
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Every physician knows the importance of the doctor-patient relationship. Without trust and honest communication, outcomes can be worse and caring for patients may be extremely difficult. However, many doctors overestimate their ability to connect with those in their care.

One study found 84% of doctors surveyed believed their discussions with patients were satisfactory, but just 67% of patients surveyed agreed. When a patient doesn’t feel heard, or doesn’t understand what their physician has explained, this can lead to poor health outcomes—and also potential malpractice litigation.

In order to provide the best care for your patients and protect yourself from litigation, be intentional when communicating with patients—and stay away from the following statements.

1. “I don’t know.”

Although you might mean that medical science has yet to find an answer to the patient’s specific question, saying a simple “I don’t know” makes it seem like you’re not qualified to care for her. Instead, say “I don’t know at the moment, but I will find out for you” or use a broader “we,” for example, “we don’t always know what causes medical problems.” Then, suggest she seek a second opinion. Encouraging a second opinion shows patients you can put your ego aside and prioritize their health, which will make them feel more comfortable and confident in your care.

2. “You should have come in to see me sooner.”

Statements like this may make the patient feel blamed and shamed about something they can’t go back and change. Instead, recognize the patient’s barriers to treatment. Patients are busy and many of them must take time off work or arrange childcare to go to the doctor. Depending on their insurance plan, appointments can be expensive and patients may try to avoid coming in if not absolutely necessary. If a patient repeatedly doesn’t come in even when it’s necessary, consider using telehealth, speaking over the phone, or sending messages via a patient portal.

3. “The Internet isn’t your doctor, I am.”

More than half of Americans use the internet to search for health information. What's more alarming is that one in 10 Americans are now using social media as a source of health information. It can be tempting to immediately dismiss their online findings. However, this can come across as haughty and make the patient feel that you don’t want her participation in the decision-making process.

Instead, tell her you appreciate her taking the time to learn about her condition. Initiate a discussion about what concerns her from her online research. Find gentle ways to explain if some of her conclusions are unlikely. Use the experience to strengthen your relationship with the patient, demonstrating that you take her seriously and value her opinion, and emphasizing that she can feel comfortable discussing her condition and her worries with you.

4. “Don’t worry about that right now.”

Telling a patient not to worry “right now” implies that he has much larger issues to be concerned with, which can be scary and overwhelming to hear. It also minimizes his concerns and can make him feel uncomfortable sharing important information with you moving forward. Additionally, the simple act of telling someone not to worry can increase their stress and anxiety, as most of us have trouble controlling what we’re worried about. To avoid this anxiety, be as transparent as possible with the patient. Explain to him that his concerns are important, but together, you’ll need to focus on other, more urgent issues before you can turn elsewhere. Discuss how his concerns might be addressed in the future, so he knows you’re listening and already thinking ahead.

5. “Do you understand?”

No one wants to look uneducated or unintelligent, and most patients won’t want to admit they don’t understand something. That means you’ll likely get a “yes” even if the patient needs more information. Instead, express that you want to make sure you’ve explained yourself clearly and ask the patient if he can tell you in his own words what you just discussed. Alternatively, ask him what questions he has for you and encourage him to reach out via a patient portal or phone call if questions occur to him at a later date.

6. “This won’t hurt at all.”

Everyone has a different pain threshold, so it’s unwise to suggest anyone will completely avoid pain during a given procedure. Instead, explain that most people find the procedure to be painless, but if the patient is worried about dealing with potential pain, there are pain management options available.

Just as important as what you say is how you say it. Even if you’re feeling rushed, do your best to speak calmly, slowly, and clearly, avoiding medical jargon. Show your patients you’re listening closely by staying silent as they speak and try not to interrupt them. Don’t stare at your computer screen or tablet for the entire conversation; even if you need to take notes as you go, make sure to look at the patient more than your device. It can be challenging at times to practice these skills consistently, but the rewards are worth the effort.

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  1. More than half of American households used internet for health related activities. https://ntia.gov/blog/2020/more-half-american-households-used-internet-health-related-activities-2019-ntia-data-show
  2. 1 in 10 Americans Turn to Social Media for Health Information, New Survey Shows. https://www.forbes.com/sites/debgordon/2021/10/06/1-in-10-americans-turn-to-social-media-for-health-information-new-survey-shows
  3. Evaluating patient and medical staff satisfaction from doctor-patient communication. https://www.emerald.com/insight/content/doi/10.1108/IJHCQA-03-2022-0033/full/html
  4. 10 Worst Things Physicians Say to Patients. MD Mag. https://www.mdmag.com/contributor/ryan-gray-md/2016/06/10-worst-things-physicians-say-to-patients
  5. Eleven Things to Never Say to Patients. Physicians Practice. https://www.physicianspractice.com/patient-confidentiality/eleven-things-never-say-patients
  6. Hickson GB, Jenkins AD. Identifying and Addressing Communication Failures as a Means of Reducing Unnecessary Malpractice Claims. North Carolina Medical Journal. 2007;68(5): 362-364. https://www.researchgate.net/profile/Mike_Newton-Ward/publication/5666203_Increasing_the_public's_awareness_the_importance_of_patient-practitioner_communication/links/0a85e537b89d0cfc3f000000.pdf#page=68
  7. Tan SSL, Goonawardene N. Internet Health Information Seeking and the Patient-Physician Relationship: A Systematic Review. Journal of Medical Internet Research. 2017;19(1):e9.  https://www.jmir.org/2017/1/e9/
  8. Tongue JR, Epps HR, Forese LL. Communications Skills for Patient-Centered Care. Research-Based, Easily Learned Techniques for Medical Interviews That Benefit Orthopaedic Surgeons and Their Patients. The Journal of Bone and Joint Surgery. 2005;87:652-658. https://npos.memberclicks.net/assets/tongueetalarticle.pdf
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.