625 Optimism = Compassion = Trust
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Dynamic Chiropractic – April 15, 2015, Vol. 33, Issue 08

Optimism = Compassion = Trust

By Donald M. Petersen Jr., BS, HCD(hc), FICC(h), Publisher

A randomized clinical trial recently published online in JAMA Oncology1 examined how patients viewed their doctor based upon how the practitioner presented bad news to the patient.

One hundred patients with advanced cancer viewed two video vignettes in which a doctor discussed treatment options. In one video, a doctor spoke in a way most would consider optimistic, while in the second video, the doctor spoke in a less-optimistic fashion. Both doctors displayed similar postures and demonstrated an equal amount of empathy to the patient's condition. Here's what the results showed:

  • "In this randomized clinical trial, we found that physicians delivering a more optimistic message were perceived as more compassionate as compared with equally empathetic physicians delivering a less optimistic message."
  • "[W]e found that patients preferred the second physician that they observed. A possible explanation of this sequence effect is that dialogue on difficult topics may need to be repeated and processed to become acceptable. Hence, patients may perceive that the physician is more thoughtful during the second visit and that they themselves are also more ready to make difficult informed decisions regarding their cancer care."
  • "Perception of a higher degree of compassion was associated with a higher degree of trust in the medical profession independent of the type of message."

These findings should serve as food for thought about how you discuss your patients' conditions with them. Clearly, your optimism impacts how your patients hear what you say – and what they think about you as their doctor. Here are some suggestions to help you speak to your patients in a way that will reflect optimism, demonstrate compassion and build trust:

  1. Consider talking to your patients twice about important, difficult or sensitive issues. You may want to present the information on two separate visits, allowing them the time to process the information from the first conversation. The second conversation can build on the first and allow them the opportunity to ask questions they have formulated between visits.
  2. Be optimistic in your presentation. Knowing you care means a great deal to patients. Being optimistic is a way to increase their perception and understanding that you do care.
  3. Build trust through compassion. Consistent optimism about their health will demonstrate reliable compassion, which will develop their trust in you and in chiropractic. This will not only benefit you and your clinic, but also the chiropractic profession.

While the vast majority of your patients aren't in advanced stages of cancer, they may still be frightened or wary of the potential for their present health challenges to impact them negatively. How you communicate with your patients can lead to a stronger doctor-patient relationship built on compassion and trust.

Our profession has not yet reached the point at which every consumer has a clear understanding of the benefits of chiropractic care and a desire to enjoy those benefits. We suffer from decades of slander that still persists in the minds of the medically oriented.

But the winds of change are blowing harder than ever as medical providers break ranks in their search for better ways to care for their patients. Integrated medicine is no longer heresy. It is now the cutting edge many primary care physicians are embracing – and many more are considering doing so.

Speaking to your patients optimistically will demonstrate compassion which, over time, will lead to high levels of trust. That trust in chiropractic will express itself with family, friends and even other health care providers.

Patient trust is an important part of the chiropractic story. After all, without it, we have no one to tell our story.


  1. Tanco K, Rhondali W, Perez-Cruz P, et al. Patient perception of physician compassion after a more optimistic vs a less optimistic message. JAMA Oncol; published online Feb. 26, 2015.

Click here for more information about Donald M. Petersen Jr., BS, HCD(hc), FICC(h), Publisher.

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