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

Cognitive Psychology And Patient-Clinician Connections

"Deliberate practice is needed."


To foster warmth toward patients, first be aware of how you’re feeling. If you're feeling burned out, you can intentionally practice cultivating a more caring attitude. 

Connecting with Patients | January 19, 2022 | 2 min read

By Christine Ko, MD, Yale University

Burnout is at an all-time for all healthcare professionals. The COVID-19 pandemic has strained the system to breaking at various points over the last two years, and for many in medicine, there hasn’t been time for reflection. I still (mostly) love my job, but with the brutality of Omicron causing many staff to call out sick with COVID, just getting through each day feels like success. 


Meanwhile, patients, including ones in my own family, continue to need excellent healthcare. And that starts with clinicians showing feelings of caring and warmth to their patients. As a mother who’s encountered the coldness of healthcare when devoid of such connection, I strive to create better relationships between me and my patients. Here are 3 cognitive psychology concepts that have helped me: 


1. A growth mindset (Dr. Carol Dweck).

The culture of medicine tends to be one of perfection. Often, we feel we need to get things right the first time and that otherwise we have failed. While no one wants to make mistakes in patient care, no clinician is perfect (I am definitely not!). Having a growth mindset allows me to accept and learn from failure, which helps me do better next time. 


2. Deliberate practice (Dr. Anders Ericsson).

“See one, do one, teach one,” the saying goes. To see one of anything and then be “expert” enough to do just one before teaching the same—that’s a high bar indeed and one that’s not supported by research. Instead, deliberate practice is needed; practice that’s focused on measurable goals, with immediate feedback, and further practice as related to feedback. Patient-clinician connection is something that I’ve been learning to practice deliberately, focusing on my successes as well as my failures. The latter have become especially useful to help direct what I need to improve on. 


3. Metacognition, System 1 and 2 thinking (Dr. Daniel Kahneman). There’s System 1 thinking, or “hardly” thinking, like gut reactions, instincts, and biases. And there’s System 2 thinking, or “slow” thinking, which is used in solving complex problems. Doctors are familiar with both, for example in the rapid recognition of patterns of disease (System 1), and when that fails, using problem-solving skills (System 2) to parse the data toward a working diagnosis. Metacognition applies to the patient-clinician connection as well—System 1 and 2 are at play in what is seen, heard, and felt in a doctor-patient interaction. Seeing, hearing, and feeling—both fast and slow—can promote stronger relationships, which have been shown to reduce physician burnout. 


I hope 2022 brings the end of the COVID pandemic, with renewed connection between patients and their clinicians. 






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