Abstract
Introduction
Communication plays an integral role in every service context. Language is how service agents talk to customers, salespeople talk to prospects, and chatbots talk to consumers.
But as Danaher, Berry, Howard, Moore, and Attai (2023) note, given healthcare’s impact on quality of life, it’s a particularly important domain to study effective communication. How doctors, nurses, physician’s assistants, and other clinicians communicate impacts everything from patient understanding to medical adherence, with implications for physical, mental, and financial health. Consequently, helping clinicians communicate with patients more effectively is vital, and understanding this high stakes context should help service scholars think about their own research settings in new ways.
Danaher et al. (2023) provide a stellar review and framework in this regard. They integrate work from a variety of disciplines to discuss how verbal communication, nonverbal communication, and listening shape patient responses. This framework should help medical professionals to help improve patient interactions, and encourage future research.
That said, one paper can only cover so much ground, and there are several additional areas that deserve further attention. Building on this framework, we offer some additional areas for future work. Hopefully these suggestions will further encourage others to build on Danaher et al.’s framework, deepening understanding in healthcare services and beyond.
Using Language to Better Understand Patients
Danaher et al. (2023) highlight how clinician language impacts patients, but language serves a dual role. Not only does it impact the audience (e.g., patients) that is exposed to it, but it also reflects things about the communicators that produce it (Berger et al., 2022). Consequently, just as listening is a central channel through which clinicians can improve communication, one area that deserves further attention is patients’ words. Patient language can provide insight into who they are, and how likely they are to engage in particular actions in the future.
Beyond their literal meaning, for example, words are a valuable marker of people’s mental or physical states, commitment, and motivation (Berger and Packard 2022). People who refer to the self (e.g., I, me, or my) a lot, for example, are more likely to be feeling anxious or depressed (Guntuku et al. 2019), and using lots of anger words (e.g., hate, mad, frustrated) predicts heart disease above and beyond traditional risk factors (e.g., obesity and diabetes; Eichstaedt et al. 2015). Beyond health contexts, the language people use in loan applications predicts how likely they are to default and Airbnb hosts’ language reveals whether they are more motivated by financial or interpersonal factors, which drives how likely they were to stay engaged with the service.
Along these lines, subtle patient language cues should provide information about how best to serve them, and what types of treatments they may benefit from and adhere to. Language captured at intake could be used as a segmentation tool, for example, identifying groups of patients that talk similarly, and thus may have similar needs or ways of conceptualizing their conditions. Certain patients may use more agentic language, for example, suggesting they see themselves as in control of their medical journey, whereas others may use more tentative language (e.g., guess, maybe, seem), indicating they need a clinician to take a more active role. Patient language can also be used to help predict which patients may be less likely to adhere to medical advice, and thus benefit from clinician follow-up.
Patient language may also be used for diagnosis, helping identify issues that might be challenging to identify, or that patients might be less willing to disclose. Clinicians could also be trained to attend to the words researchers have revealed as diagnostic of a range of mental states and motivations (cf. Packard and Berger 2024). By listening for the sometimes subtle, hidden meanings in patients’ words, healthcare workers can better serve them in response.
How Mediums Shape Language
The mediums health professionals communicate through also deserve more attention. Patients and healthcare professionals can speak to one another face to face or over the phone, write back and forth through email or online portals, and use PCs, smartphones, and a range of other devices to share thoughts and information. Indeed, modality (e.g., speaking or writing), communication channels (e.g., face to face, phone, charting notes, or patient portals) and devices (e.g., smartphones, PCs, or smartwatches) are the mediums through which communications occur.
While these mediums may seem incidental, they actually have an important impact on what gets communicated (see Oba and Berger 2024 for a review). Compared to speaking, for example, writing leads communicators to use less emotional language (Berger, Rocklage, and Packard 2022). Similarly, content produced on smartphones tends to be shorter, less focused on specific details, more emotional, and more self-disclosing (Melumad et al. 2019).
Consequently, mediums have important implications for both studying communication, and influencing it. First, when collecting data, it’s important to recognize how the medium through which it was produced might shape the message. The content of clinician-patient communication, for example, may look very different depending on whether it was spoken or written.
Second, when trying to improve healthcare communication, the mediums used to communicate will shape the content produced. If the goal is to encourage patients to reveal potentially embarrassing information, for example, encouraging them to speak (rather than write) and do so into a smartphone (rather than face to face with a doctor) may be more effective (i.e., because it should encourage disclosure and emotional language). Similarly, clinicians may want to choose different communication mediums based on their goals. If the goal is patient understanding, for example, speaking face to face may not be ideal because spoken language is often ephemeral (i.e., disappears after it is uttered). Written communications (e.g., brochures or discharge plans) that patients can process at their own pace may be helpful.
Language for Different Communication Goals
Work might also examine how to effectively tailor communication for different communication goals. Doctors often feel like their job is to diagnose the problem and impart medical information, but changing health outcomes often requires several additional steps. People don’t like being told what to do, for example, so medical advice may engender psychological reactance. Consequently, asking questions rather than making statements, or talking patients down a path without making them feel forced, may be important for getting them to take desired actions. Similarly, using concrete language should help healthcare professionals show patients they are listening (Packard and Berger 2021), which should increase patient satisfaction and medical adherence over time.
In addition, if patients don’t remember what doctors said weeks later when it comes to take action, they may not take their medication, or do so incorrectly. Consequently, making sure what is said sticks, and is triggered by the environment near the time of action (Berger 2013), are vital for medical adherence.
Overall, thinking about communication goals, and which outcomes are important when, should help clinicians improve patient outcomes and help researchers identify new areas for further research.
Conclusion
Healthcare communication is central to patient satisfaction, medical adherence, and health outcomes. Danaher et al.’s (2023) framework should encourage more research in this space, and help practitioners further improve these outcomes.
As Danaher and colleagues (2023) note, given their frequent use by clinicians, metaphors, labels, and jargon are key. That said, using language to understand patients, thinking about how mediums shape what language is produced, and thinking about the right language to achieve different goals represent additional opportunities to enhance theory and practice. Scholars could start by building on the variety of communication features and language processing tools considered in consumer, social, and personality psychology (Berger and Packard 2022) to build new knowledge on service communications in medical settings and beyond.
That said, new knowledge is not enough. While healthcare professionals often receive a great deal of instruction about medicine, and how to deliver it, there is less training on communication, and how to use language effectively (Kee et al. 2018). Medical schools and continuing education efforts should consider a stronger focus on effective communication. By better understanding the insights on effective communication offered by Danaher et al. (2023) and the psychology of language, hopefully healthcare professionals can improve patient satisfaction, and health.
Footnotes
Declaration of Conflicting Interests
Funding
ORCID iD
