In my practice as a registered nurse, I’ve met many patients who openly shared with me the following self-talk before a doctor’s appointment:
- “What’s the point, nothing will change.”
- “Why am I even seeing the doctor? They’re just going to do the same thing, ask the same questions.”
- “I already know what’s wrong with me. I don’t need them to tell me what it is.”
- “I really don’t want to be poked today. I’m just afraid of needles.”
- “They just don’t get me. I feel like they don’t listen.”
These are just a few of the countless reasons why patients could be hesitant to see their providers. Not only do these thoughts discourage patients from seeing a provider, they can also discourage patients from engaging with their own health, which can lead to poor health outcomes.
But there is hope! Communication plays a major role in the healthcare experience. Feeling heard, respected, and included in decision-making can help patients feel more confident, supported, and engaged in their care. There is actually a simple communication technique that can be used to improve patient outcomes called Motivational Interviewing (MI).
While motivational interviewing is often discussed as a tool for healthcare professionals, many of its principles can also help patients and caregivers navigate conversations with providers more effectively. In this blog, we’ll explore the basics of motivational interviewing, how providers may use this approach in clinical care, and ways patients and caregivers can communicate in a similarly collaborative and self-advocacy-focused spirit.
Motivational Interviewing: What It Is
Motivation interviewing (MI) is an evidence-based communication technique to address an individual’s hesitance and/or ambivalence (mixed feelings) towards change (Bischof et al., 2021). It involves a collaborative approach where the patient feels teamed up with the healthcare providers to bring about a positive health change or carry through a health plan.
In the medical setting, the main goals of MI are for patients to:
- Explore their own reasons and/or barriers to make positive changes.
- Explore their own internal motivation to make positive changes. Motivational interviewing is patient-centered and goal-oriented.
Motivational Interviewing: What It’s Not
Although the provider implements motivational interviewing, the provider is not the expert of the patient’s health and motivation. In the spirit of MI, patients are the experts of their own health. The provider’s role is to create a safe space for patients to openly share about their honest, internal thoughts and dialogue regarding change without bias or judgement.
Providers do not solve the patient’s problems, but provide the patients autonomy and respect to help them reach an internal motivation to carry out a positive change (ex: Patient becomes determined to perform aerobic exercise three times a week and take medication as scheduled so he/she can play with grandchildren longer without feeling short of breath.)
Motivational Interviewing: How To Use it
One of the most effective and simple motivational interviewing tools (and my personal favorite) is the OARS tool.
OARS stand for (Cole et. al., 2023)
- O – open questioning
- Build trust and connection with patients by asking open-ended questions. (opposite of questions that require only “yes or no” answers)
- Examples: “Can you share some more about…”, “What’s been hard for you about…”, “Would it be ok for us to talk about…”
- A – affirmation
- Build rapport with patients by genuinely acknowledging and validating positive patient efforts or behaviors.
- Examples: “It is very impressive that you’ve been able to…”, “I know you’re discouraged because…”
- R – reflection
- Build trust and rapport with patients by reflecting back what the providers heard or re-state what the patient just said.
- Examples: “I hear you..you felt…”, “It sounds like that test made you feel worried about…”, “I heard that you realize…”
- S – summary
- In concluding the encounter, the provider pulls in information gathered through strategic and selective thought processes that invites patients to correct or add further insights that may have been missed or misunderstood.
- Examples: “Let me check to make sure I am understanding you correctly so far…”, “Did I miss anything?”, “Is there anything you would like to add or correct?”, “What else concerns you?”
The diagram and table below are examples of phrases to use in each part of the tool.
For Patients: What You Should and Should Not Experience
As a patient or caregiver, it can be helpful to reflect on whether your healthcare provider communicates in a way that feels supportive, collaborative, and aligned with your goals.
Motivational interviewing is one approach that many patients appreciate because it emphasizes listening, partnership, and helping individuals feel empowered in their care decisions, but it is not the only effective communication style. Every patient’s needs and preferences are different.
Use this chart as a tool to think about how your current provider relationship feels to you, whether your concerns are being heard, and whether you feel respected and supported during appointments. If your needs are not being met, it is always okay to seek out a provider who may be a better fit for your desired communication style.
Motivational Interviewing (MI) Approach (what you should experience in this approach) | Non-Motivational Interviewing Approach (what you should not experience) |
You feel that you are treated as the expert of your own health. | You do not feel like any of your thoughts and feelings about your health are considered. |
You feel genuinely heard with your thoughts and feelings validated. | You feel like your thoughts and experiences are being dismissed or diminished. |
You feel respected and safe to openly share about your experiences. | You do not feel respected or safe to openly share about your experiences. |
You feel like your motivation to change health behavior(s) is acknowledged and validated. | Your motivation and/or reason to change health behavior(s) is dismissed or not considered. |
You feel that your thoughts and experiences are asked about by the provider. | You do not feel like your thoughts and experiences were considered during the visit. |
You feel involved in your own care and teamed up with the healthcare providers to carry out your own health plan. | You do not feel involved or are given little involvement in your own health care decisions. |
For Patients: How to Express Your Needs to Your Care Provider
Write Down Your Top 3 Concerns Ahead of Time
Medical appointments can sometimes feel too short or overwhelming. So before your visit, write down on a piece of paper or in your phone your top 3 concerns or goals that you would like to discuss. When you see your provider, hand it to or read it to your provider at the start by saying “I have three things I want to make sure we talk about today”. This sets your expectations during the visit right at the start.
Use “I” Statements
It’s routine for providers to ask about your symptoms or how you are doing. Instead of simply sharing your physical symptoms, explain how they are impacting your life and/or daily routine.
For example, when asked about head pain, you could say, “My headache is worse, 8 out of 10, that I can’t cook anymore when it comes in”. Another example for when you don’t understand what the provider is explaining is to say, “I don’t fully understand what you just said, can you please repeat that again?”
Use “I Feel” Statements
Providers cannot read your mind or know how you feel. So whenever you feel discomfort or troubled during the visit, you are allowed and can simply say “I feel….”
- “I feel like you do not understand what I’m explaining.”
- “I feel like my thoughts are not being considered here.”
- “I feel a bit judged.”
- “I feel overwhelmed right now and can’t make a decision at this time.”
Call Out Your Need
If you already know that the plan that the provider is proposing will not work for you, you must speak up early on with phrases such as “I want to manage this too/I want to work on this too.. But this plan will not work because…. (say your reasons: because of my schedule/my routine/work/family/conflicting plans, etc.). Can we talk about other options? What else can I do or can be done? What are realistic small steps I can take? Can we slow down?”
Summarize The Plan In Your Own Words
Before the visit ends, make sure you agree with whatever next steps or plans that were decided upon. Summarize the plan to your provider through the lens of your reality and in a way that makes sense to you.
For example: “So you need to see me back in 2 weeks but because I will be out of town then, I will meet with you virtually instead. Is that right?” or “I need to be on this treatment for the next 6 months but it starts to affect my sports activities, I will need to let you know right away because you said I can switch to another type of treatment and I love playing sports.”
Final Thoughts
Whether you are a healthcare professional looking to strengthen patient relationships or a patient or caregiver learning to advocate for your needs, communication is a skill that can continue to grow over time. Asking questions, expressing concerns, discussing goals openly, and seeking providers who make you feel heard are all important parts of building supportive and effective care relationships.
References
Bischof, G., Bischof, A., & Rumpf, H. J. (2021). Motivational interviewing: An evidence-based approach for use in medical practice. Deutsches Arzteblatt international, 118(7), 109–115. https://doi.org/10.3238/arztebl.m2021.0014
Cole, S. A., Sannidhi, D., Jadotte, Y. T., & Rozanski, A. (2023). Using motivational interviewing and brief action planning for adopting and maintaining positive health behaviors. Progress in Cardiovascular Diseases, 77, 86–94. https://doi.org/10.1016/j.pcad.2023.02.003
Written By Esther Kang, TSF Volunteer Blog Writer and designed by Adrianna Verzolini
© Turner Syndrome Foundation, 2026
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