Using PEARLS to talk with and help your patients

Respect

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:

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

PEARLS, used in a communication sense, is:

Partnership

Empathy

Apology/Acknowledgment

Respect

Legitimation

Support

Following apology/acknowledge, we will take a look at respect. Respect is crucial when meeting with and treating your patients.

What is Respect

Respect is honoring another person.  It is recognizing that the other person is a human being that has values, needs, dreams, and goals.  When we have respect for someone, it shows that we are equals – we know you are important.

In a clinical setting, showing respect to your patient is absolutely necessary.

Using the patient’s name is the first and perhaps most important step.

You can ask them how they want to be addressed if you are not sure what to call her or him.  This is true with cultures that rely on several different given names and surnames.

Of course, all rules about confidentiality and privacy must be respected. Without them, the patient will not willingly cooperate.

More importantly, showing that you respect the patient and respecting their fears and concerns makes for a solid, successful working experience.

Like all parts of PEARLS, respect is connected to the way you – as the physician – communicate with the patient.  If you do so respectfully, it makes an easier experience for all people involved.

What it is not

There is a feeling that doctors are a bit proud. After all, you go through a lot of education and training to get to where you want to be.  You might be at the top of your field – which is great!  The thing to remember is that the patient is there to see you for help with their current problems or conditions.

Do not expect your patient to be in awe of you because you are a doctor.

It might some trivial and unimportant, but it is something that people can pick up on.

Respect is being careful about what you say and how you say it.

Respect is expecting people to respect you, but not in the way you want them to – with unnecessary deference or hesitation.

If you expect your patient to be in awe of you, to use polite language all the time, it will not work out in the long term.

Both you and the patient will realize the relationship is not working out, and this could lead to lack of enthusiasm on the patient’s part – not taking medicine as prescribed, for example.

This is not to say that a patient should be rude or offensive in any way.  It is important to note that respect works both ways, and that with patient-centered care, thinking before speaking is crucial.

Ways to Show Respect

There are different ways to show respect. Listening, repeating, and using polite and/or appropriate language are all ways to ensure you are respectful.

Listening

It is important to listen to your patients. If you listen, you can understand what the person wants you to know about her or him. I

If the patient is not talkative, it is important to recognize that and not necessarily work on ‘bringing out’ the patient by chatting.

It also allows you a chance to hear what is not said or shared.  That itself can be a clue as to how the patient is thinking.

Repeating

Repeating – or summarizing – is another way to show respect. How? Because if you repeat what you heard, it shows that you are listening.

Many times, the patient just wants someone to listen to them – not a family member or friend, but someone who is on his or her side.

Polite/Appropriate Language

While you do not have to be extremely formal, polite words go a long way.

The language you use can make an impact on someone. They could feel intimidated or put on the spot. It is important to remember this and use the write words and phrases.

This can also be connected to intonation. Using a friendly tone and manner makes everyone feel good and relaxed. A relaxed person is more likely to cooperate.

A good idea is to see how a patient reacts to you, what language they use with you. That is a clue as to how to approach.

Sullen patients require less talking, but that does not mean you should not be respectful.  Using a moderate tone and the right wording can make things run smoothly.

Phrases That Might Help

Here are some phrases that you can use that are respectful in tone.

Greetings

Thank you for waiting, ___. It’s nice to meet you, _____.

How would you like to be addressed? How would you like to be called?

General conversation

Okay. Just to make sure I am clear, you ______.

Thanks for sharing that with me.

I appreciate it that you shared that with me.

Confidentiality

Everything you say today is confidential, okay?

Everything you tell me will not be shared with anyone, okay?

All the information I will ask/am asking is so that I can better treat you and help you.

Filler words

I see. Okay. I understand. Right. Uh huh.

What are some other phrases you can come up with?

Case Study

For this case, please think about how you can use respect to address the patient and the patient’s concerns.

Patient: 26 year old female worried about having a baby.  She was pregnant 6 years earlier, but lost the baby (miscarriage). She is not sure if she wants a child, but her spouse has talked about it recently.  She is not sure if she can do that again.

PEARLS Assignment Practice

Respect can take many different forms. It will depend on the patient and the exact situation and context.

Please think of all

• A mother with a 12-year old boy starting puberty.
• A 46-year old male with an occasional cough.
• A 75-year old female who often forgets important things.

Respect is a cornerstone of every human relationship. In your dealings with patients, it is paramount to show respect.

In this series: Part 1, Part 2, Part 3, Part 5, Part 6

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.