Healthy Living

Communication, Patients

Patient-centered communication: what are the basic skills?

Communication skills needed for patient-centered care include:

– eliciting the patient’s agenda with open-ended questions, especially early on
– not interrupting the patient
– engaging in focused active listening

Practice this at least in the first 60-seconds, the so-called “golden minute”.

Understand patient’s perspective

Understanding the patient’s perspective of the illness and expressing empathy are key features of patient-centered communication.

Understanding the patient’s perspective entails exploring the patient’s:

– feelings
– ideas
– concerns
– experience regarding the impact of the illness
– expectations from the physician

Patient-centered communication – basic skills (click here to enlarge the image).


Empathy can be expressed by:

– naming the feeling
– communicating understanding, respect, and support
– exploring the patient’s illness experience and emotions

Before and after a diagnosis

Before revealing a new diagnosis, the patient’s prior knowledge and preferences for the depth of information desired should be assessed.

After disclosing a diagnosis, physicians should explore the patient’s emotional response.

Treatment options

Shared decision making empowers patients by inviting them to consider:

– pros and cons of different treatment options
– no treatment

Instead of overwhelming the patient with medical information, small chunks of data should be provided using repeated cycles of the “ask-tell-ask” approach. Using “tell-tell-tell” does not engage patients.


1. Ask permission to start a conversation
3. Ask what the patient thinks about their health
4. Ask questions to find out what the patient already knows
5. Tell the patient information in a way that is easy to understand
6. Gauge the patient’s understanding by asking questions after you tell

What Is “Ask, Tell, Ask”? video:


Patient-Centered Communication: Basic Skills. Hashim MJ. Am Fam Physician. 2017 Jan 1;95(1):29-34.
The 10 Building Blocks of Primary Care – “Ask Tell Ask” Sample Curriculum – UCSF
Ask-Tell-Ask: Simple Technique Can Help Hospitalists Communicate Difficult Messages

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