Opening Insight
Patients do not always tell you exactly what they are thinking. They may say they want to “think about it,” ask whether the treatment is really necessary, or mention that they need to speak to a spouse first. These words deserve attention—but often, the real conversation is happening beneath them.
The most skilled communicators learn to hear both what is said and what remains unspoken.
The Principle
Every patient conversation has two layers. The first is the spoken message. The second is the emotion, concern, or uncertainty that gives those words meaning.
A question about cost may reflect uncertainty rather than affordability.
A request for more time may indicate fear rather than indecision.
Silence may signal confusion rather than agreement.
When clinicians respond only to the words, they often miss the real issue. When they listen for the meaning behind the words, conversations become more productive and patients feel genuinely understood.
The goal is not to make assumptions, but to remain curious enough to explore what lies beneath the surface.
From the Practice
Some of the most rewarding conversations in my practice began with a simple follow-up question.
When a patient said, “I’d like to think about it,” I learned not to end the conversation there. Instead, I might gently ask:
“Of course. May I ask what you’d like to think about?”
That one question often revealed concerns about fear, finances, previous experiences, or uncertainty about the treatment itself.
Patients rarely object to being understood. They appreciate having the opportunity to express what they were hesitant to say in the first place.
Key Takeaway
The words patients choose tell part of the story. Their emotions often tell the rest.
Dr Kaplan’s Perspective
The longer I practised, the more I realised that successful consultations depended less on having the perfect explanation and more on recognising the concern that had not yet been voiced. Listening beyond the words became one of the most valuable skills I ever developed.
Reflection
During your next patient conversation, ask yourself: What might this patient be trying to tell me that they haven’t yet found the words to express?