What You Don’t Say to Patients (and Why This Matters..) | Nitin 360

What You Don’t Say to Patients (and Why This Matters..)

For those who watched the first Presidential debate last night, there were some interesting non-verbal cues from the candidates. They conveyed a message (beyond the spoken word) to the 40 million viewers.

When you are interacting with a patient, it’s the things you don’t say that are as valuable (if not more) than the things you do. For starters, your body language must convey the comfort, trust and warmth that the patient is seeking.

In an excellent news segment that analyzes verbal cues of Presidents and Presidential candidates on CNN, host Anderson Cooper refers to former President Bill Clinton as the ‘master of warmth’. Along with Amy Cuddy, Cooper takes a closer look at body language in a short video I can only describe as “Body Language 101″.

Cooper describes Clinton, as the former President conveys “I feel your pain without even saying it” without uttering those words. Watch the video to see exactly what I am talking about.

CNN Video – Debate Body Language Speaks Volumes

The body language of every staff member has important implications for the perception of, and success of your practice. The video consists of several classic moments, including a couple of BIG body language gaffes from former Presidential nominees Al Gore and John McCaine. A must-see if you want to use body language to grow your practice.

It’s Not Just What You Say, It’s What You Don’t Say

There are several things going on in the patient’s mind during each interaction with you. For example, arm crossing and watching the clock is a sign of disinterest. The patient is constantly asking himself / herself:

  • Can the therapist really help me get better?
  • Should I come back for the next visit?
  • Why should I refer my friends and family to this therapist?
Often, it’s the things you don’t do (or say) that have the biggest impact. Here are the things that the patient observes, almost at an unconscious level, that you should be aware of:
  • Is your posture open and upright?
  • Are you maintaining eye contact?
  • Are you using purposeful, deliberate gestures to convey your opinion?
  • Are you smiling and leaning towards the patient, giving the patient your full attention?
  • Are you using voice modulation? Is your voice moderate to low tone?
It’s Not Just What You Say, It’s How You Say It
Voice modulation is a lost art, it’s something that professional actors are trained to do. Outside of body language, it is the most effective way to convey a message and persuade individuals (patients, staff, even your own kids) to take the desired action. Advanced techniques in voice modulation include:
  • Lowering your voice to demonstrate compassion and empathy.
  • Pausing between sentences and nodding your head to encourage compliance.
  • Stretching out certain words (almost like singers do) to get the listener’s attention.
  • Raising your voice just as you are about to end the sentence to emphasize a point.
When body language is combined with voice modulation, you have a powerful communication tool, and an outstanding manager. At the end of the day, what you don’t say is the most important thing that needs to be said. This will help you inside (and outside) your clinic.


  • James Charleston PT says:

    Great stuff Nitin! It's something that all of us should be doing as private practice owners

  • Larry DelTorro says:

    The video was great. Food for thought. One thing we do in our clinic is to that the therapist puts his hand on the patients shoulder at the end of the visit and says "We hope you had a good session. We'll see you soon". It works well to encourage compliance and makes the patient feel more comfortable.

  • ACruz says:

    Great post Nitin. Thanks for sharing.

  • NIck says:

    Yes I agree with the others it is excellent. Although I believe one should be careful about pretending to be nice, i.e. having a script, or pretending to be interested. I think the lady being interviewed kept on stressing that disingenuine behaviour can have a counterproductive outcome. I know as I can do this myself! However, I like to say this as I really find it hard when someone treats me with disingenuine behaviour. Thus I think yes being warm, looking into someone's eyes is great, but like the lady said it has to be genuine. Therefore I think the best way is to be yourself, and even if your having a crappy day, or are not interested in the patients complaints, acknowledge these feelings and thoughts which can then allow one to be present again. Actually an old mentor of mine use to say something like, every time you open the treatment room door, only have one thing in mind-an open heart! I know i have been a bit controversial here, but I think it is such a good source for your business, but insincere behaviour can be a really good way to loose patients as well.
    Thanks Nitin

  • Dr Akshay Mehta says:

    I agree with Nick. "First be true to yourself". Very nice to hear "when you open the door, open your heart". In my practice I have almost never had to 'feign' or 'show' interest. Being in the shoes of a patient is good enough to make yourself genuinely interested. Of course once you are genuine, what Nitin says is perfectly true. Very nice suggestions. Akshay

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