The Power of Active Voice Increases Patient Engagement

At the heart of good communication between providers and their patients is the use of active voice to put the focus of the information exchange on the patient and/or primary caregiver. Active voice focuses on precise action. At the core of most confusing communication lies an unclear action or intention.

 

Emphasize the patient first and the action second

The patient who is responsible for understanding and following treatment plans is the subject of the sentence who performs the action.

Passive: This antibiotic pill is taken with food.
Active: You will take this antibiotic pill with food.

Passive: The symptoms are improved by taking the medication correctly.
Active: Take your medication correctly. Your symptoms will improve.

 

Questions Can Contribute to Passive Interactions

Questions that can be answered with a YES /NO or body language like head nods, shrugs, or smiles are passive questions. A passive question does not insist on the patient/caregiver demonstrating real understanding.

Passive: Do you understand how to take this medication? (head nod)
Active: Tell me why you need to take this medication. Please explain how you are going to take it.

Passive: Do you have any questions about the two treatment options I’ve explained?
Active: What are the two treatment options we’ve talked about? Please, tell me what you think about these two options.

 

Passive Voice Contributes to People Behaving Passively

Passive voice tends to depersonalize any verbal or written exchange between people. Sometimes this can be a useful strategy to avoid naming or blaming, but it almost always encourages passive behavior. One of the biggest challenges with low health literate patients and families is their tendency to disengage from involvement in the process of understanding and managing their health. A patient needs to be actively interested and involved in his care, especially if he is expected to manage a chronic disease like asthma or diabetes.

• Passive voice is often used to be tactful, indirect, and avoid naming/blaming.
  The medication instructions were somehow misinterpreted.
• Passive voice can be used to make a broad reference to generic “populations.”
  Every year, thousands of people are diagnosed as having cancer.
  A certain percentage of people will tend to experience side effects from this medication.
• Passive voice effectively creates an authoritative tone for policies.
  Visitors are not allowed after 9:00 p.m.

 

Other Useful Tips to Improve Patient Understanding.

Revise common wordy verb phrases:

Instead of: is aware of/has knowledge of
Use: knows
Instead of: is taking
Use: takes
Instead of : are indications of
Use: indicates or shows
Instead of: are suggestive of
Use: suggests or shows

Avoid Vague Nouns

Try to avoid using the following vague nouns which sometimes lead to wordiness:

Vague: Consumer demand is rising in the area of services.
Precise: Consumers are demanding more services.

Vague: Poor reading skills are an important factor in low health literacy.
Precise: Patients need good reading skills for better health literacy

 

 Summary

The principles of using active versus passive voice can be found in any writer’s handbook, but in this article we are applying this concept especially to verbal communication between providers and patients/families. The examples given here can be applied to conversations that happen at every level of patient engagement–front and back office staff can just as easily apply these techniques and improve understanding for patients from all cultures, language backgrounds, and health literacy levels.