Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

“Don’t Worry”


General reassurances are often ineffective when they don’t address patients’ true concerns.

In primary care, we often have to debrief with patients about their experiences in other medical settings. I was puzzled when my longtime patient with diabetes told me about his recent visit to urgent care. He went there on a weekend with a small foot wound and was told to apply topical antibiotic ointment and, “Don’t worry, everything will be fine.” Yet he looked very upset. 


The problem was, as it turns out, that he wasn’t sure why he shouldn’t worry, as he knew that foot wounds can sometimes cause severe infection or even limb loss in patients with diabetes. His story highlights how reassurances can be ineffective if clinicians don’t clearly explain why they don’t think an issue is serious. It’s also critical to understand and address the patient’s true underlying concern. 


When explaining clinical impressions to patients: 


1. Ask, “What are you most worried about?” and directly address their concerns.


2. Be precise and avoid vague consolations.


3. Encourage patients to always self-advocate and voice their true concerns, even if the clinician doesn’t ask about them.






This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.