We’ve all been there. A procedure has a complication, a patient misses a critical follow-up, or you hear those dreaded words, “You never told me that would happen!” When things go wrong, our first instinct might be to look at the clinical details, but I’ve learned over decades of practice that the real failure often happens long before the patient is in the chair.

The breakdown is in communication.

It’s a hard truth to swallow, but as practitioners, we must own the fact that if our message isn’t heard, understood, and acknowledged, we haven’t truly communicated. The responsibility is ours.

Informed Consent vs. Making an Excuse

There's a massive difference between informed consent and making an excuse. Informing a patient of every potential risk before a procedure is our duty; explaining it away after a complication is a failure. One is proactive, ethical care. The other is reactive damage control.

In our fast-paced world, it’s tempting to rely on one-way communication. We leave a voicemail, send a text, or fire off an email and consider the box checked. But this is a broadcast, not a conversation. It creates an illusion of communication and leaves both the patient and the practitioner vulnerable.

Why I Refused to Treat a Patient Over the Phone

Recently, I refused to create a complex surgical treatment plan for a patient over the phone. It would have been easier for both of us, certainly more convenient. But it would have been a profound disservice.

How could I ensure she truly understood the intricacies of the procedure, the potential for bone loss, and the long-term maintenance required? How could I see the look in her eyes that tells me she’s not just hearing the words, but comprehending the consequences? I couldn’t. So I said no.

It's our job to guide patients and, sometimes, help them avoid making a decision based on incomplete information. We must create systems in our practices that demand clear, precise, two-way communication.

The Bottom Line: Clear is Kind

I’m a big believer in what Brené Brown says: “Clear is kind. Unclear is unkind.” In our profession, unclear communication isn’t just unkind—it’s costly, it’s dangerous, and it’s unethical.

Next time something goes wrong in your practice, before you place blame or look for a clinical scapegoat, I challenge you to ask yourself one question: Was our communication crystal clear?

Did you confirm understanding, or did you only deliver information? The answer could change everything.

What strategies do you us for ensuring clear patient communication? Share your thoughts in the comments below.

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