Young doctor smiling at patient
Photo credit: Mercy Health | CC

Here’s a recent interview I did with Nancy Freimark, Ph.D., an Adopt One! Challenge Advisory Board Member. Nancy is a strategic communications consultant currently working in telehealth. She is the former Director of Communications & Regional Director of Market Research for Kaiser Permanente in the Northwest where she worked for 15 years.


Q: What is the big deal with physician-patient communications? Why is it so important?

A: “What’s the big deal?” That is often the first question that comes up in healthcare strategic planning sessions when the conversation turns to patient-physician communications. Senior leaders—impatient for results and schooled in Six Sigma process improvement techniques—will suggest the solution is quite simple. “Just tell the docs to smile more.” Then, the discussion turns to activities that can be measured and managed such as throughput, performance, and optimizing Medicare reimbursement rates.

The big deal with patient-physician communications is the fact that doing it well can be both measured and managed because its downstream effects are observable and impressive. Patient-centered communications are the lynch pin that holds together every other success in the healthcare environment. Communications is essential for establishing trust during the patient experience, encouraging adherence to a treatment plan, and generating positive clinical outcomes.

The argument has been made that patient-physician communications skills are already high in the United States. A quick look at the various third party rating systems like HEDIS and HCAHPS indicate that most physicians are rated at 95% or better on patient communications. But these scores are a bit of statistical illusion because everyone can’t be in the top five percent of anything unless they live in Lake Wobegon where everything is above average.

More objective measures of the patient experience tell a different story. Deficiencies in communications lead to longer hospital stays, lack of compliance with treatment plans, less than optimal clinical outcomes, and a majority of patients not understanding what they were told by their doctor. In addition, nearly half of all Americans have health literacy problems including not being able to read or follow written instructions. From a stone cold business perspective, less than stellar performance in patient-physician communications results in patient churn (patients leaving to find another physician or medical group) and reputation management issues.



Q: How do think busy physicians and their teams might potentially benefit from participating in the Adopt One! Challenge?

A: Pursuing excellence in patient-physician communications is the new reality of healthcare. Gone are the days of medical paternalism where the physician issued directives and the patient did what they were told. Today’s healthcare consumers, aka patients, are their own advocates and expect to partner with their physician. They want to share knowledge, be respected for their opinions, and, most importantly, they want to be heard.


Q: There are those who would make the case that information technology can do the same or better job of engaging and activating patients as the in-person office visit. What do you see the role of health information technology being in relation to clinicians when it comes to physician-patient communication before, during, and between visits?

A: Healthcare technology can help improve the depth, breadth, and speed of patient-physician communications by improving the sharing of knowledge and connectivity but technology is best used to enhance an already effective relationship. Without first mastering patient-physician communications, no advancement in technology will increase productivity or engagement.


Q: If you could make a recommendation to your physician, what one patient communication skill would you suggest they pick to work on and why?

A: Continual improvement in communications is the success formula for any customer facing enterprise, healthcare included. A great place for any physician to start is to focus on “Sharing the Why.” Too often, physicians and other medical staff assume the patient understands the “why” of an intervention (ie. It’s for your health, for your safety…), a recommendation, or a course of action. The specifics of the “why” are left unstated with the blank to be filled in by the unknowing patient. Critically important for improved patient-physician communications, therefore, is to prioritize the “why”. Encourage understanding. Ask probing questions. Leave time for information to be processed. Check for true understanding. Then check again.

The social contract between the patient and physician is evolving and that change requires everyone in the healthcare industry to learn how to be 21st Century partners. The most essential skill to leveraging an effective partnership is to embrace patient-centered communications. It is the key to improved patient satisfaction, outcomes, retention, and revenue generation—all things that can be measured and managed.


More about Nancy Freimark, Ph.D.

She has extensive experience leading customer-focused communications and market research strategies in the healthcare, government, and advertising/marketing industries.

First Posted at Mind the Gap on 9/16/2013.

Stephen Wilkins
Principal and Founder, Mind The Gap Academy, a thought leader, research, and solution provider company specializing in physician-patient communications, patient engagement, and patient-centered/relationship-centered care. Steve has over 25+ years of professional health care experience working in and consulting with hospitals, health plans, physician groups and solution vendors. The balance of his experience has been in working with provider organizations in the areas of applied consumer health behavior.


  1. Today I followed a cardiologist’s advice. When I got home, I found a new PCP. My thyroid was out for 6 months, and 3 months of acute strep during the same time period.

    Patient-doctor communications—-REMEMBER MED 101; Sore throat complaint = strep test. Things like that- and don’t lump patients into categories. Sure I’m an old woman, but I still caught strep.

    Tolerate stories or notions by old people or from other cultures. I was at a church pot luck in the 60s. A family was making fun of their granny because she refused to eat cheese. I asked if they knew how cheese was made into the 1940s. I told them that they put horse manure in a wood trough, poured or packed in the cheese curds, and covered that with more manure. Then they covered it with burlap and kept it damp. They asked how I came up with that. My father helped the local butcher make cured cheese when he was a kid, and my maternal grandmother made her own cheese. Then I related how that applied to modern cheese. They scraped all of the cheese off of their plates.


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