Takeaway
When a patient’s fears and misinformation create barriers to care, start with listening and validating concerns rather than beginning with facts. Shifting the conversation to what matters to them builds trust and can open the door to effective treatment.
Connecting with Patients | July 2, 2025 | 2 min read
By Edana Mann, MD, Johns Hopkins Medicine
“I just want antibiotics.”
A patient came into the ED with a productive cough, shortness of breath, and a fever. He had hypertension, obesity, diabetes, and looked pretty sick. I told him we needed a chest X-ray and some labs to see what was going on. Pneumonia? COVID? Something else?
He shook his head. “I don’t want any of that,” he said. “I read online that those tests are how they track you. Just give me antibiotics—I know my body.”
It stopped me cold. He clearly needed care, but his fear and his belief in misinformation were in the way. And in that moment, I had a choice. I could try to win an argument, or I could try to build trust.
Don’t lead with facts
I’ve learned that leading with facts rarely helps when someone’s scared. Instead, I asked, “Can you tell me more about what you’re worried about?”
That opened things up. He told me his friend had gone to the hospital for COVID testing and ended up in the ICU. He didn’t trust hospitals. He thought if we ran tests, we’d find something and keep him against his will.
His fear wasn’t just about the test. It was about control, safety, and what had happened to people he knew. So, I didn’t correct him. I just said, “That makes sense. I’m not here to trap you. I just want to help you feel better and get home safely.”
It’s not always about changing the plan
We still did the X-ray and labs. But the difference was in how we got there. Once I shifted the conversation from what we needed to what he needed, he was on board. It turned out he had early COVID. We treated him and discharged him safely.
That moment stuck with me, not because it was dramatic, but because it could have gone differently. Exceptional care isn’t just about being clinically right. It’s about slowing down just enough to connect with someone who’s scared and engaging with their beliefs.
Here are a few things I’ve learned that you may find helpful:
1. Ask before advising.
A simple “What have you heard?” goes a long way.
2. Acknowledge fear.
You can validate feelings without validating misinformation.
3. Keep it simple.
Plain, honest language builds more trust than stats or protocols.
4. Step back when needed.
Not every conversation needs to be solved in one breath.
5. Show up as a person.
More than anything, people want to feel safe with you.
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This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.