When a Physician's Words Do More Harm Than Good

Learning how you as a patient can form a collaborative, working relationship is essential.

Jul 21, 2026

Physician speaking with a patient — Image: Pexels/Cottonbro

Years ago, my preterm newborn was discharged without a NICU stay, but was later readmitted due to hypothermia.

The physicians could not identify the reason for his low body temperature. At one point, the pediatric resident explained that since they couldn’t find a cause, the situation was ominous.

Ominous? What do you mean by OMINOUS?!

After he saw my reaction, he explained that they couldn’t figure out why my son’s temperature was so low. But the impact on my psyche did its damage.

The word he used was not only distressing, but also inaccurate. Perplexing, confusing, a conundrum — any of these word choices would have been fine. In need of a few more tests or observation would have been even better.

Later, he returned and actually apologized for claiming the situation was ominous and admitted that he used an inappropriate word. Good for him. Even though he had jarred my already stressed-out senses, his humility and willingness to apologize were heartening. (And most importantly, my son rapidly recovered from whatever caused his low body weight after a few days!)

The medical system: A love-hate relationship

Like many of you, I have had a love-hate relationship with medical professionals — as a patient, a parent, and a family member advocating for a loved one’s medical care.

I have also worked as a psychologist in behavioral medicine programs and still collaborate routinely with physicians regarding patient care. I have counseled physicians in my psychotherapy practice and witnessed their own frustrations with healthcare systems that place enormous and sometimes unreasonable demands.

Physicians, of course, are people too. Many are stressed out, burned out, frustrated with the system, and struggling just to keep up. They endure devastating loss, confusing diagnoses, and sometimes, hostile patients. And they bring their own insecurities, stressful personal lives, and even prejudices to the exam room.

As their patients, though, we can meet this challenge head-on by understanding the power of empathy, the importance of a collaborative doctor-patient relationship, and what to do when things go awry (see more below).

What goes wrong

Most physicians enter medical school training with high hopes. They want to serve, to help patients thrive, to right the wrongs in a medical system that bristles with inequity.

They know the path will be difficult and exhausting, but they are up for the challenge.

Then reality hits.

Often saddled with exorbitant student loans, relentless work demands, and even higher expectations from the corporations they work for, many doctors, nurses and other healthcare professionals struggle to balance a personal life with the harsh demands of their jobs.

Yet, they are expected to contain and sometimes ignore their emotions.

Some retain long-standing PTSD-like symptoms stemming from brutal medical school and residency training. Others feel overwhelmed in the face of so much suffering and pain, and experience vicarious trauma from what they witness on a daily basis.

Recent changes in health care delivery –- electronic medical records, hospital mergers, restrictions on how much time with patients is “permitted,” reductions in insurance reimbursement –- add to already stressful work conditions. And this stress ultimately trickles down to patients.

Under such challenging conditions, empathy and careful communication can take a back seat.

How empathy affects patient care

In my work as a psychologist, I have heard many stories of patients’ encounters with medical professionals. Similar to my own personal experiences, their tales range from heartwarming to infuriating. They have described astonishing displays of caring, bored indifference, and patronizing disdain.

The physician’s actual words have a profound impact and sometimes remain embedded in patients’ memories for years.

“Clinical empathy is an important element in the quality of medical care,” wrote behavioral neuroscience researcher Jean Decety. “Physicians who try to understand what their patients feel, express interest, and show concern have a more positive impact on the relationship.”

Empathy not only enhances the physician-patient relationship, but also contributes to improved medical outcomes.

Decety cited studies supporting the physiological impact of a physician’s empathetic behavior, including a reduction in the duration and severity of flu symptoms, and improved glucose and cholesterol levels among patients with diabetes.

In another study, patients treated for low back pain by physicians rated as very empathetic had significantly better one-year treatment outcomes (related to pain, function, and self-reported quality of life) than those treated by physicians viewed as only slightly empathetic, reported medical researcher John Licciardone.

“Physician empathy,” according to Licciardone, “was more strongly associated with favorable outcomes than were nonpharmacological treatments, opioid therapy, and lumbar spine surgery.”

First, do no harm: Why communication is so important

In the past, some physicians talked “down” to patients, with a figurative pat on the hand and little explanation.

Nowadays, many take the opposite approach, offering an uncensored litany of possible diagnoses and rule-outs to perplexed patients, wide-eyed with fear.

Attempts at openness and transparency can backfire without carefully choosing the right words. Some medical terms are downright scary or need clarification and at least some context.

In fact, the medical creed, “first, do no harm,” could start with the right choice of words.

Clear and compassionate communication is essential to the physician’s role as healer. Research has shown that trust-building interactions and a caring communication style improve patient encounters.

Patients remember their physician’s kindness and helpful words long after their pain has subsided and the wounds have healed.

What can you do?

1. First, identify what you need and want from the doctor-patient encounter.

Are you seeking specific advice, comfort and reassurance, greater clarification, or an exploration of other directions to consider?

If you are clearly aware of what you need, it may be easier to remain grounded in your priorities and move the conversation in the right direction.

Come prepared with a list of questions. Stick with symptoms or concerns that are priorities and ask for explanations. Write it down or ask for a written summary from the online chart. If you are feeling overwhelmed or in physical pain, have a friend, family member, or other advocate accompany you.

If a physician encounter leaves you feeling uncomfortable or misunderstood, trust your instincts and consider finding a different health care professional. Even in those circumstances where you have little choice, like a hospital stay, you may be able to request a second opinion or communicate with other hospital staff as much as possible.

2. “You catch more flies with honey than with vinegar.”

Physicians are human. They have bad days. They get burned out. And like most people, they respond well to kindness and collaborative respect. In addition to bringing an attitude of general friendliness into your encounter, pay attention to their cues and demeanor.

Assert yourself by clearly, tactfully, and concisely expressing your questions and concerns.

If your doctor seems rushed, you might consider saving additional questions for a later time. Show respect for their time crunch and ask if it would be better if you set up another appointment or message them through email or the online portal. If they are avoiding eye contact, asking a very specific question may engage their attention and distract them from note-taking.

And if you feel blindsided by a poorly phrased comment (as I did with my newborn child), ask for immediate clarification in as calm a manner as possible.

You might be upset and angry. But try to stick with the facts and gather the information you need. If you feel you have been treated poorly or personally disrespected, let them know directly.

I have done this a few times. It wasn’t pleasant, but it was necessary.

3. Communication involves respect on both sides.

Hold up your end of the bargain.

Show up on time for regular appointments. Refrain from middle-of-the-night calls unless it is an emergency. Treat office staff respectfully.

If you feel there is a misunderstanding, ask for clarification and an explanation of what they meant. If a prescription is not covered by your insurance, for example, don’t blame the physician, but instead, ask for an alternative. If office staff do not return phone calls, let your doctor know. But don’t chastise the doctor for this oversight.

A little kindness and respect for their tough job goes a long way.

4. Advocate for systemic change.

Physicians enter this demanding field to be healers — not insurance advocates or cogs in an administrative wheel. They want to deliver high-quality care, but are stymied by demands that have little to do with you as the patient.

Rather than berating your doctor for their limited availability, for example, voice your complaints to office managers (who often control their schedules). Consider reaching out to hospital administration, insurance companies, donors, shareholders, or your human resources department (who may hold contracts with insurance companies) with complaints about systemic impediments to patient care.

You also might appeal to stakeholders on hospital and medical school boards to prioritize physician training that emphasizes empathy and communication skills. And insist on systemic change that could address unrealistic demands on the physician’s time, excessive work hours, and unnecessary paperwork.

You can learn more about advocacy through organizations that lobby for change, such as the American College of Physicians, the Center for Medicare Advocacy (since most private insurance companies follow their lead), and the Patient Advocate Foundation,

The burden of a healthcare system riddled with problems affects physicians every day. Their frustrations can trickle down to interactions that might leave you feeling angry, alone, and misunderstood.

Consider your role as patient — what you need, what you can prioritize, and what bothers you most — and find channels for expressing yourself.

You are not just a passive recipient. What you bring to the physician-patient relationship can shape the encounter and lead to clarity, greater trust, and better treatment outcomes.

This article is similar to an article published on Medium.

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Gail Post, PhD: A Psychologist's Perspective

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