• Health literacy. Use simple, concrete words rather than medical jargon. Know that a patient’s language level and reading skills may not match his or her intelligence.

• Income. Try not to assume a patient can afford the treatment, diet, or medication you’re recommending. If you have any doubts, ask.

• Motivation. Know that you may have to motivate, as well as educate, a patient on some health behaviors.

• English proficiency. Provide language assistance services such as bilingual staff and interpreter services at all points of contact for patients with limited English proficiency. Try to avoid using family members as translators to preserve patient confidentiality.

Position yourself, whenever possible, at eye level with your patients. Healthcare providers who sit are perceived to spend more time with their patients than healthcare providers who stand for the same amount of time. Try to maintain eye contact with patients while they’re talking, rather than writing or looking in a chart. Listen to the patient’s tone of voice and watch the body language: either or both may not be consistent with what the patient is saying.

Nod. Ask questions, or comment on a patient’s efforts to change a health behavior. You can also paraphrase what patients say to check your understanding.

Some patients have cultural beliefs that can affect compliance with treatment. They may be trying alternative therapies, such as herbal medicine. In fact, current estimates suggest that as many as one-third of Americans use at least one herbal remedy. Or they may view the role of a healthcare provider less as final authority and more as an influence when it comes to adhering to their care.

Become familiar with the cultures in your community. Try to keep an open mind with your patients so they’ll feel comfortable telling you about other treatments they’re trying or problems they’re having in adhering to your recommended care. Try to take advantage of elements of the patient's cultural background to achieve outcomes the patient and you both desire. For example, activities around food preparation can help whole families or groups of friends to be more physically active.

Ask for patients’ ideas about the cause of their conditions. This can uncover critical clues to their attitudes and beliefs about health, such as other treatments they’re trying. It also gives you a chance to show you respect their opinions and awareness.

Try to make one empathetic statement during each visit, such as acknowledging a difficult emotion with, “That has to be painful.” Hold emotional, difficult, or personal conversations in private.