Special challenges

• Health literacy. Use simple, concrete words rather than medical jargon. Know that a person’s language level and reading skills may not match their intelligence.

• Income. Try not to assume a person can afford the treatment, diet, or medicine you’re recommending. If you have any doubts, ask.

• Motivation. Know that you may have to motivate, as well as educate, someone about some health behaviors.

• English proficiency. Provide language assistance services such as bilingual staff and interpreter services at all points of contact for people with limited English proficiency. To adhere to patient confidentiality, don't use family members as translators unless the person agrees. Permission should be asked when family members are not present.

• Online medical visits. If the patient encounter is on a mobile or online device, be sure to establish rapport with the person. Adequately explain the reasons for any decisions you've made in this unfamiliar setting. Don't rush the visit or multitask. Always ask the person if they have questions or concerns before ending the visit. Respond in a timely fashion if the online visit isn't live (asynchronous).

Body language

Position yourself, whenever possible, at eye level with your patients. Healthcare providers who sit are perceived to spend more time with their patients than providers who stand for the same amount of time. Try to maintain eye contact with people while they’re talking, rather than writing or looking in a chart, computer screen, or tablet. Don't check your phone or read text messages when you're with a patient. Listen to the person’s tone of voice and watch their body language. These may not match with what they're saying.

Active listening

Nod. Ask questions or comment on a patient’s efforts to change a health behavior. Repeat back what a person says to check your understanding.

Cultural diversity

Some people have cultural beliefs that can affect compliance with treatment. They may be trying alternative therapies, such as herbal medicine. In fact, current estimates suggest that as many as 1/3 of Americans use at least 1 herbal remedy. Or they may view the role of a healthcare provider less as final authority and more of a consultant when it comes to adhering to their care.

Get to know the cultures in your community. Try to keep an open mind with your patients so they’ll feel comfortable telling you about other treatments they’re trying or problems they’re having in adhering to your recommended care. Try to take advantage of elements of the person's cultural background to reach outcomes that you both desire.

The patient’s perspective

Ask for patients’ ideas about the cause of their conditions. This can uncover critical clues to their attitudes and beliefs about health, such as other treatments they’re trying. It also gives you a chance to show you respect their opinions and awareness.

Empathy

Try to make 1 empathetic statement during each visit. For instance, such as acknowledging a difficult emotion with, “That has to be painful.” Hold emotional, difficult, or personal conversations in private.