When communicating with patients, think PEAK

News that some patients struggle to understand complex medical language is nothing new. There is a lot of jargon in medicine. It can be hard to depart from it. Jargon works. It’s a form of private language used to make the transmission of complex ideas and information easier amongst practitioners. 

What’s more, it can save lives ensuring that even under pressure doctors know what each other are talking about. 

All the same, it can become a habit and it can be easy to forget that not everyone speaks in medical terms. In patient communication it can and will creep in – and can create ambiguity, confusion, or worse. 

Clarity matters, particularly where the risk of miscommunication could produce unhelpful outcomes. 

But by thinking about Perceptions, Emotions, Actions and Knowledge (PEAK) prior to any form of important communication it is possible to select the right words to achieve the desired outcome. 

PEAK is all about outcomes. It’s about asking four questions: 

  • What do I want this person to perceive? 
  • How do I want them to feel (emotions)? 
  • What do I want them to do (actions)?
  • What do I want them to know? 

It’s a recognition that we don’t just communicate with people so that they know things, we want them to feel and do things too. Added to that we may want them to perceive us in particular ways. 

At the heart of the PEAK approach is the need to understand whom you are communicating with. We communicate differently with different people. Doctors know this better than most. Patients have different backgrounds, outlooks, values and a different propensity for, amongst other things, anxiety, something that can cause them to misinterpret what they read, see or hear. 

Anxiety does little to aid understanding. I learned this lesson early on in my career whilst teaching with the Open University. When writing comments on Tutor Marked Assignments (TMAs), I was always conscious that the student could be reading the feedback in a heightened state of anxiety and could seek to read between the lines. It meant writing feedback carefully lest it be over-read or misinterpreted. 

I tried to imagine the student standing at the front door reading the long-awaited comments as they hastily tore open the newly arrived post. I then thought about how they might try to extract further meanings by reading and re-reading particular turns of phrases. Passing, ill-thought-through comments can be highly-damaging to students’ confidence and sense of self-worth. Getting it horribly wrong can be a powerful teacher but with unfortunate consequences for the recipient. 

Patient communication 

So how do you apply PEAK thinking to patient communication? 


Overall, what perception do you want to foster in the patient’s mind? How do you want them to perceive you? How do you they think they currently perceive you and why? 


How do you want them to feel about the communication in the light of their condition? Reassured, supported, comforted? How would the consultation normally make them feel? 


What, if anything, do you want them to do? Take medicine, change their lifestyle, seek further help, read around the subject, avoid Dr. Google?


And what do you want or even need them to know? The key elements of their condition, the level of support you can offer them, where they might get further information, what changes they must make to their behaviour?

The answers to these questions, which will be based upon your understanding of the person you are communicating with (their values, point of view, experience of the surgery, outlook and so on) should determine your choice of words and even your choice of medium – some things simply can’t be put in writing and must be delivered face to face. 

PEAK thinking also allows us to unpack our own habits. We might want to be perceived as intelligent and knowledgeable. A complex vocabulary will certainly help with that. As will the use of taken for granted assumptions. Both will save you time. But at what price? 

I would argue that all of us are in the business of managing perceptions, one way or another. Doing so helps to change outcomes. We don’t always do it consciously – the layout of medical waiting rooms and demeanour of medical support staff can affect how the practice overall is perceived. Often little things can have a disproportionately negative impact on our overall perceptions. By thinking about how perceptions are formed in the minds of your patients you can alter how they see things – changing communication, behaviour and culture. 

To find out more about how to change perceptions – and for advice on how you can use communications more effectively, take a look at Perceptionomics. It can be downloaded for free here – http://commsmasterclasses.com

Mark Fletcher-Brown is a director of reputation counsel.  

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