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

Helping Patients Navigate Risk in The New Normal


Using empathic listening to give COVID-related advice will help your patients balance the risks of the pandemic with enjoying the activities in their lives that matter most. 

The pager for our outpatient geriatrics clinic was uncommonly busy one summer weekend morning: 


A gentleman in his 70s: “I’m supposed to have lunch with college friends whom I haven’t seen in 20 years, but I’m still testing positive 10 days after diagnosis even though I have no symptoms. Do you think it is ok to go?” 


A homebound couple in their 80s: “With all the COVID cases going around, should we cancel our grandchildren’s visit this weekend?” 


These questions, interspersed with new COVID diagnoses (I’d already prescribed three antiviral courses by 10 a.m.), reinforced my sense that, with each twist and turn of the pandemic, there are infinite new variations on the theme of “getting back to normal.” As the virus, treatments, and CDC guidelines all mutate, so do our perceptions of risk and reward. 


After countless phone calls, I’ve learned to structure these discussions into three parts, giving me an opportunity to appreciate the patient’s perspective before offering my own: 


1. Why is this activity important to you?


2. What is the risk that you will contract COVID and have severe illness?


3. What is the risk that you will give to COVID to others?


“Seek first to understand, then to be understood,” states one of Stephen Covey’s “7 Habits of Highly Effective People.” The advice lives up to its hype when it comes to shared decision-making about enjoying life in the era of COVID. 


Certainly, my patients expect me to interpret the CDC guidelines for them, and they appreciate a firm recommendation using objective evidence. But by adding empathic listening into the risk calculation, my assessment and plan is always more effective. 






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