December 8, 2024

Using PEARLS to talk with and help your patients.

What is PEARLS?

Not to be confused with pearls in medicine (small bits of information), PEARLS is a method that doctors can use to communicate with patients.

While there are different approaches to speaking with and guiding patients, PEARLS offers a framework that:

  • A addresses patient feelings and emotions
  • B addresses the patient-doctor relationship

 

PEARLS is an acronym that means

P Partnership

E Empathy

A Apology/Acknowledgment

R Respect

L Legitimation

S Support

As you can see, all are areas that are important when interacting with patients.

Let’s get into each area in detail.

P for Partnership

What does partnership mean?

According to the Miriam-Webster Dictionary, a partnership is “the state of being a partner; participation.”

In another sense, it is a working relationship where both parties are participating and being involved with each other.

Partnership in terms of patient care shows the willingness to work with the patient in all areas of diagnosis, treatment and after care.

It is important to communicate to the patient that you – as their medical care provider – are there to help them to overcome the condition they are facing.

Not only this, but it is imperative to establish a working relationship with honest, clear communication.

Building a partnership with a patient is vital to patient recovery and care.  PEARLS is all about the partnership with the patient.

What it is not

Telling that patient what you – as the doctor – will do without any input from the patient or even consent from the patient.

Not being clear about the possible and actual diagnoses, prognoses and treatment options.  Taking the “I’m a doctor, you are the patient so I know what is better” approach is this way.

Ways to build partnership

There are several ways to build partnership with a patient.

Among them are being honest, being direct and using the right language.

Being honest

It is important to be honest with a patient. There may be times when you want to sugar-coat something – probably bad news. 

It is important to be direct with your language from the start.  

Being honest helps the patient with expectations; the patient can learn to trust you when he or she knows you are telling him or her the truth.

Being direct

Saying things directly is also key; it goes hand-in-hand with being honest.

Direct language is important because it sets up the tone and direction of the relationship. 

You are there to help the patient – through all parts of the patient’s medical problem.  Being able to speak to the point will ensure that the patient understands what is going on.

Being direct should not be confused with being rude and not caring about the patient. 

That is not what PEARLS is about.

Rather, it is about showing care when speaking.

Using the right language

This is connected with both being honest and being direct.

The language you use can make a difference. 

As stated above, being direct can be misunderstood as being rude. No one wants that.

It is important to think before speaking. Planning on what you want to say and how you want to say it can make the difference between the patient accepting what you say and the patient deciding to get a second opinion.

There are, of course, phrases that you can use to lead the conversation. 

Phrases that might help

I’ll be taking care of you today.  

 

Please feel free to tell me anything and everything that is going on with you, okay? What you say is confidential.

 

I will do everything I can to find out what is wrong with you, okay?

 

What do you think is going on with you?

 

How do you want me to help you?

 

Let’s come up with some ways to improve your health. How’s that?

 

If you have trouble with following this, what do you think you can do?

 

Where can these be used?

Partnership should be established early as possible – at the start of your first meeting with a patient.  

It should always be continued throughout the relationship, whether it is short term or long term.

Rapport

Establishing a partnership helps with building rapport. 

Rapport is a friendly and harmonious relationship, one that is characterized by agreement, mutual understanding or empathy. (Miriam Webster)

With rapport, it is easy to make a relationship grow – the partnership can be solid and dependable.

Case Study

Let us look at the following case study.

  • A 52-year old male visits your office or hospital for the first time.
  • He has some lower back pain, frequent urination and some tingling in his feet. 
  • At first thought, it could be signs of early diabetes; of course, it could be one of any medical condition that causes the same symptoms.
  • Instead of thinking it is automatically diabetes, it would be important here to build the relationship from the start.

Here are some possible sentences and directions that could happen.

Tell me about your social habits. This is so I can understand what is going on in your life better.

 

What do you think is going on with your body?

 

What are your expectations for yourself and for me after we finish meeting here today?

 

Okay, I have a good idea of what is going on with you. Before I go on, I want you to know that I am going to do my best to help you through this. Please always tell me what you are feeling and what you are worried about. 

 

What do you think the doctor can do?

PEARLS Assignment Practice

Each patient has his or her own goals, problems, fears and expectations.

Sometimes you have to consider building a relationship with not only the patient, but also with the family – as in the case of a child and parent.

For you, please think about how to build a relationship with each of the following patients using P in PEARLS:

  • A 21-year old female with trouble sleeping
  • A 64-year old male with arthritis and joint pain
  • A 47-year old female with hyperthyroidism

As you will see, each patient will need a different approach. PEARLS is all about building and continuing the relationship with patients. It is important for both you and your patient.

This article is not about medical treatment. It is about communicating with patients in English. It is an explanation about the PEARLS concept, and is not an opinion of the company and the author.

 

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