The evolving science of interpersonal neurophysiology gives us insights into how the relationship between a healthcare provider and the patient can change the outcome. Part of this science is about the words we use and how we use them create an experience that can either facilitate or hinder your treatment.  Although this seems obvious to some, many organizations fail to integrate these essential skills into the patient experience.  

The human brain is a complex meaning machine designed to “make sense” of the experience.  Humans are social beings and have evolved in the context of social groups and psychological constructs that have enabled tremendous advancements.  This “socialness” is possible with a brain that is designed to connect with others, interpret intentions and “feel” the emotions of others. These neural mechanisms are the foundation of successful human interaction.  

As part of precision language training, one can learn the power of presuppositional language.  Presuppositional language is a linguistic proposition that employs a pre-existing belief to infer an unspoken truth.  In other words, the language we use in the sentence assumes a condition is already existing. We see this kind of language frequently but you may not recognize it unless you really listen for it.  

As an example:  “How hungry are you?”

This sentence presupposes that you are hungry, and depending upon the context of the discussion, but also primes the receiver’s brain in a way that sensitizes them to  and the degree to which they are hungry.  

One language set I often use in the clinic is “What questions do you have?”  When I use this with patients, I am intentionally communicating that I am assuming they have questions and it is a good time to ask them.  Contrast this question with “Do you have any questions?”.  The first question is more likely to get the questions rolling, especially if I use a body language that communicates I am interested and willing to ensure they are comfortable with the instructions I have provided. 

A short story: My wife had arthroscopic knee surgery awhile back.  She woke up in the recovery room and the well intended nurse entered the room eager to help.  The first thing she asked, without even looking at my wife was, “How bad is your pain?” I was in the corner of the room thinking “NOooooo!”.  And before my wife could answer, the nurse said, “honey, I’ll give you some pain meds but it’s gonna make you nauseous.” And sure enough, first the pain and then the nausea! 

There are ways to use this language skill in the clinic to “prime” the patient’s brain toward the desired state for a successful treatment.  As an example, instead of first asking the patient “how is your pain today?”, you can ask “What progress have you noticed since your last visit?”  The latter invites the patient to “search their minds” for examples of progress, whereas the former brings them right to the pain experience. Try it!

In summary, words create an experience!

• When healthcare providers understand this concept, they recognize that what they communicate (words, tone of voice, body language) all contribute to the patient’s experience, and strive to learn the necessary communication skills to connect with patients. 
• When healthcare leaders understand this concept, they recognize the need to engage with colleagues in a manner that inspires performance to meet organizational and personal goals.
• When healthcare organizations understand this concept, they design cultures and systems designed to engage all members of the organization in a process of alignment to the organization’s Values and Mission. 

As the Healthcare System rapidly shifts toward a value-based reimbursement model, providers and organizations must find innovative ways to engage patients to actively participate in their own care.  This will require that all healthcare providers learn the skills that connect with patients, their teams and the desired outcome.

It is time!