By Adam Widdison, author of The Expert Clinician
The words we use help shape the conversation.
In my previous post, The Art of Conversation, I explored why the consultation is a purposeful exchange rather than a simple transfer of information. Here I examine how the choice and delivery of our words can determine whether that exchange succeeds.
Patients respond not only to the medical content of what we say, but also to the words we choose and the way we deliver them. This can feel unsettling, yet it reflects a basic human truth: perception shapes experience.
Words Have Power
Language conveys more than facts. It can reveal beliefs, assumptions and values. Meaning is shaped by context, tone, volume, facial expression and body language. Often, the meaning that reaches the patient extends beyond our original intent.
It is what is heard that matters, not simply what is said.
The wrong word—or the right word delivered poorly—can create misunderstanding, undermine confidence, reveal bias or erode trust.
As Rudyard Kipling observed: “Words are the most powerful drug used by mankind.”
An Illustrative Moment
A 45-year-old woman saw a rheumatologist with increasingly severe wrist and elbow pain that sometimes left her unable to use her arms.
The rheumatologist concluded that she was spending too much time in the gym and that excessive gripping was the problem. He advised her to stop all gripping exercises and gave her a steroid injection.
The advice was devastating.
Exercise was not merely fitness for her; it was her daily stress relief and mental reset. The injection site later became infected. She never returned.
A technically plausible explanation, delivered without regard for what the words would mean to her, destroyed trust.
She did not book a follow-up appointment.
The clinician may have believed he had addressed the problem. The patient experienced something very different.
Read the Room
From the moment the patient arrives, mutual evaluation begins. A brief, genuine human connection, learning something about the person, their life, values, and concerns, signals respect and gives early relational cues that should influence the words, pace, and tone that follow.
The introductory conversation is more than “small talk”; it is an opportunity to understand something about the person sitting in front of us.
A healthcare practitioner (HCP) who appears calm, confident and attentive is more likely to be perceived as competent and caring. Small gestures matter: a warm greeting, proper introductions, eye contact, a sincere smile and unhurried attention. Conversely, appearing rushed, distracted or dismissive can erode trust even when the medical content is sound.
First impressions are hard to reverse.
Often, it is not simply what is said that matters, but
How it is said, when it is said, what is left unsaid and the surrounding context.
Speak clearly and face the patient. Avoid turning away or speaking from behind a screen. Give them time to think and respond. Avoid jargon they are unlikely to understand.
If a patient has difficulty with the local language, you may need an independent interpreter. When someone cannot hold a meaningful conversation—for example because of dementia or acute confusion—appropriate support from a guardian or advocate may also be necessary.
Language matters. Preferred terms shift over time and can vary between individuals and cultures.
Person-first phrasing, such as “a person with a disability”, is generally safer than labels that define someone solely by a condition. Avoid clearly pejorative or outdated terms, and be cautious with everyday idioms that may sound dismissive or unintentionally offensive.
When uncertain, simpler language is usually better, and asking someone how they prefer to be described is better still.
Why This Matters
Patients and HCPs care about both what is said and how it is said.
The same information can be experienced very differently depending on the language used, the circumstances in which it is delivered and the relationship between the people involved.
Understanding and perception are filtered through the lens of our lives, our mood, previous experiences, education, culture, disability and other personal circumstances.
HCPs bring their own filters too. The risk of misunderstanding therefore runs in both directions.
We cannot completely control how our words are received. A phrase intended to reassure may sound dismissive; an attempt to be direct may be perceived as insensitive. What matters is recognising that communication is not simply about transmitting information; it is about creating understanding.
When we are unsure how something has been received, we should not rely on assumption. A simple check can prevent a misunderstanding from becoming a barrier to the consultation.
Take-Home Message
Words do more than convey information; they convey opinion, beliefs, feelings and meaning.
Choose words carefully. They last.
Consider the context in which they are delivered. Use language the patient can understand, and be alert to the possibility that your intended message may not be the message they receive.
We cannot fully control how our words are received, but we can be intentional about the message, the manner of delivery and the experience we create.
Turning clinical science into language the patient understands, and knowing which words to use, when and how, is an art.
Patients want to know you care and that you will do what you say you will.
I’d be interested to hear your thoughts.
Have you ever experienced a situation where an HCP’s words changed how you understood or experienced your care?
Have you ever had to rethink the way you communicate something because you realised it was not being received as you intended?
Knowing how to ask a question is not the same as knowing which question to ask, when to ask it, and what you will do with the answer.
In my next post, “The Art of the Question,” I show how the right question—asked with purpose, empathy and genuine attention—can uncover hidden concerns, reshape the consultation and focus care on the person, not just the problem.
Discover why silence, timing and the “question behind the question” matter as much as clinical technique, and how a simple question can have a lasting impact.
Read this post and transform the way you guide every conversation.
These ideas are explored further in The Expert Clinician: Bridging the Clinical Divide. If you’re interested in developing a more adaptive, patient-centred approach, you can read more here:
Thoughts? Join the conversation…..