Takeaway
Asking patients “What are you most worried about?” may help you to understand their priorities. This can lead to the creation of a shared plan aligned with their values.
Connecting with Patients | November 6, 2025 | 2 min read
By Navin Sampathkumar, MD, Johns Hopkins Observership Program, with Sonal Gandhi, MD, Johns Hopkins Medicine
I observed a family meeting for a patient at the end of life on our hospitalist service. Three physicians—a hospitalist, a palliative care specialist, and a geriatrician—sat with the family to talk about goals of care. Early on, a family member asked, “Are you saying this because the hospital needs beds?” The hospitalist took a breath, let the room settle, and answered gently: “This is a hard time. Questions and doubts are normal. What are you most worried about?” That invitation changed everything.
What followed was a model of giving excellent care. The team listened first and acknowledged emotions before moving to facts. They then explained the medical reality in clear language: the patient’s appetite had faded; even water led to coughing; heart function was severely weakened; mobility and cognition had declined; and a recent blood clot meant it was very unlikely the patient would return to prior health. When someone said, “You’re the experts—decide what’s best,” the team reaffirmed patient autonomy and shared decision-making: “Let’s decide together based on what she would want.”
At one point, a family member whispered, “I just can’t think right now.” The team didn’t rush. They let silence do the work—sitting with the family in stillness as grief surfaced. Later, when another relative said, “She wouldn’t want to suffer,” the palliative physician described comfort-focused options and explained hospice at home. The family then chose care that matched their loved one’s values.
Moments like these remind us that exceptional care isn’t about saying more—it’s about hearing more. When we ask about patient and family worries and fears, speak plainly about reality, families can make decisions that honor the person they love.
What made the difference in this encounter:
1. A deliberate pause before responding
2. An open question: “What are you most worried about?”
3. Plain-language explanations of medical facts
4. Respect for patient autonomy and shared decisions
5. Willingness to use silence as a therapeutic tool
6. A clear path forward aligned with the patient’s values
Practical tips to elevate care in any specialty
1. Start with feelings: “What are you most worried about?” Then reflect back what you hear.
2. Then use plain language and avoid jargon—summarize key facts in one sentence at a time.
3. Name choices and trade-offs—anchor decisions in what matters most to the patient.
4. Allow silence—it gives people room to process and prevents rushing past grief.
Small, intentional steps—taken consistently—help us arrive fully, listen deeply, and deliver care that’s exceptional for every patient.
This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.