The Conversation Is Part of the Care

A discussion between a clinician and patient is personal. One person is trying to help; the other is asking for help with something that may feel vulnerable or uncertain. In these situations, “what” is said matters as much as “how” it is said. The importance of these conversations extends to the national effort to improve healthcare in rural areas. 

Over the next five years, the US government will award $50 billion to states under the Rural Health Transformation Program; part of the effort includes making healthcare available closer to home in rural communities. But what will it take for that care to work well?  

Information Is Only Part of the Conversation 

“Clinical communication” is the exchange of information between healthcare professionals and patients to help them understand health concerns, discuss treatment options and make informed decisions about care. From a clinician’s viewpoint, a common approach is to provide optimal information with the intent that it will lead patients to make different choices. But recent research has challenged that assumption. 

For example: a clinician is speaking to a person with pre-diabetes. While discussing nutrition and exercise, the clinician suggests a lifestyle choice: consider going for a short walk after dinner to reduce blood sugar spikes. But the patient does not feel comfortable walking in their neighborhood in the evenings. So, “going for a walk” is actually not a choice for them. 

Information isn’t always enough. Clinicians need to consider communicating in ways that connect with a patient’s values, experiences and circumstances.  

“Compassionate listening, showing curiosity, acknowledging fears and gently offering resources and stories that help people gain new perspectives may be some of the most important things that clinicians can do,” authors Dr. Joanna Katzman, MSPH, professor emerita at The University of New Mexico, and Ann Searight Cristiano, director of the Center for Public Interest Communications at The University of Florida, recommended in their JAMA Network Open article.

Why This Matters in Rural Communities 

Policymakers may envision rural healthcare transformation at a systems level. But delivering care closer to home often puts trusted local clinicians at the center of that effort. Provider communication can support the practitioner-patient relationship—or undermine it. That makes communication particularly consequential in rural healthcare. 

An aerial image of farmland in the Midwest (US). Photo Credit: Adobe Stock, licensed October 2026.

Putting Trust into the Heart of the Practice 

The idea of “trust” prompted Searight Cristiano to focus on communication as a critical element for patient care in rural communities. In the final session of the Clinical Communications ECHO Program, she presented three strategies:

• • Avoid bringing up broad political topics when building support for local health policy.
    • An effective approach is to spot language that is obviously political, such as the terms “left wing” and “right wing.”
    • Instead, focus on listening to understand another person’s point of view and find common ground.
  • Frame in moral values, identities and analogies that conservatives already agree with.
    • Indeed, common ground is often found by speaking to the values people already hold. A clinician can better share health facts without making a patient feel like they are betraying their group.
    • Analogies are useful because they make complicated ideas easier to understand by comparing them to something familiar. An example is: “Washing your hands is like locking your front door. It reduces risk.”
  • Build a solution–together
    • If a clinician wants a community to trust their health message, they need to listen as much as they talk and build a solution together. Clinicians may ask: “What issues are you worried about?” “How would you solve this?”
    • People respond better when they feel they have the power to decide on a course of action.

Learn More:

• • • • New Mexico Infectious Disease Office Hours ECHO Program
      • New Mexico Syphilis Syndemic ECHO Program
      • Explore our other New Mexico ECHO Programs
    • Watch a presentation from a New Mexico Clinical Communications ECHO Program session (September 2026) 
    • Funding Note: From 2022 to 2026, the New Mexico Clinical Communications ECHO Program was funded by the U.S. Department of Health and Human Services, Health Resources and Services Administration, through the Telehealth Technology-Enabled Learning Program.
    • With questions about the New Mexico Clinical Communications Program, email the program team.

Featured Image Credit: The University of New Mexico Health Sciences Center, stock photography.