10 communication tips for physician phone visits during COVID-19

Virtual visits have quickly become standard during the COVID-19 pandemic. Telephone visits may pose fewer technology challenges than telehealth (video) visits, but they present unique communication challenges due to the lack of face-to-face contact. Here are some tips for making telephone visits more productive and meaningful for you and your patients:

1. Take a breath before you call the patient. For patients you know, reflect upon something you admire about them before initiating the call.

2. Smile when you greet the patient. Research has shown that people can tell if you’re smiling by the tone of your voice. Warmly express that you’re happy to have the chance to talk with the patient today.

3. Acknowledge the elephant in the living room: ask how the patient is coping with the COVID-19 pandemic. This part of the conversation could include several elements:

• Acknowledge uncertainty (e.g., “This is a really tough time. How are you doing?”). It may be appropriate, depending on the patient, to use a small amount of self-disclosure, and acknowledge that this is a stressful time for everyone,
• Offer education and appropriate reassurance based on reputable (e.g., Centers for Disease Control and Prevention) guidance on topics such as social distancing and hand washing,
• Elicit questions about COVID-19,
• Reassure the patient that the clinic is here for patient care, and encourage the patient to call any time with questions or concerns.

4. Note visit duration. Tell the patient how much time is allotted for the visit (e.g., “We have about 15 minutes for our visit today”), and offer a reminder when the visit is almost over (e.g., “We only have a few minutes left”).

5. Remember to engage the patient in agenda setting. Prioritize and negotiate what you’ll address in the visit.

6. Elicit reactions to recommendations overtly. Because you cannot see the patient’s nonverbal reactions, regularly ask, “What do you think about that?”

7. Increase the frequency of empathic statements and use a warm tone of voice. For example, you could say, “Gosh, this sounds really tough.” Patients are missing out on your nonverbal and facial expressions of care, so you need to convey these sentiments with your voice.

8. Shorten your educational spiels. Break up your explanations into short chunks. Repeat them if necessary. Elicit reactions and questions regularly.

9. Remember that the summary and teach-back are vital. You may consider typing the recommendations into the after-visit summary as you speak. Be sure to assess the patient’s understanding of your co-created plan, elicit questions, and define next steps, including a follow-up appointment as needed.

10. Encourage the patient to sign up for the patient portal to facilitate ongoing communication.

— Eli Martinez, PhD; Adam Sattler, PhD; Michelle Sherman, PhD; Michael Wootten, MD; University of Minnesota, Department of Family Medicine and Community Health.

Editor’s note: For more tips on telephone encounters, see “Managing a telephone encounter: five tips for effective communication,” by FPM Medical Editor Sarina Schrager, MD, MS. And please share your tips by commenting below.