“But they just aren’t listening.”
This is a phrase I hear constantly—both from my patients and from my colleagues. It echoes across exam rooms, hospital hallways, and in whispered frustrations among healthcare professionals. The irony is that both sides—patients and physicians—often feel unheard. This breakdown in communication creates frustration, mistrust, and ultimately, a system where no one feels truly cared for.
As a family physician, a mother, and a daughter, I have experienced this firsthand in multiple roles. The frustration of advocating for a loved one, the exhaustion of justifying decisions to patients who don’t believe they are being heard, and the disillusionment that comes from realizing that even within my own profession, I sometimes feel ignored.
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A Mother’s Struggle to Be Heard
I first felt this deeply when my youngest child was a baby. She suffered from recurring ear infections, something I remembered all too well from my own childhood. Each time an infection arose, I diligently took her in to be evaluated. But time and again, I was reassured that she was “generally developing okay.”
That wasn’t enough for me. I knew my family’s history. I knew what untreated ear infections had led to in my own experience. So I advocated—relentlessly—to get her seen by a pediatric specialist, to have the conversation about tympanostomy tubes. The pediatricians weren’t initially convinced, but I pressed forward, recounting our family history and the subtle changes I saw in her behavior, and lack of development in her speech in comparison to her sister. Eventually, she met the criteria for tubes, and we proceeded with the surgery.
The moment she came out of recovery, she sang for the first time.
That moment validated everything. It also solidified a hard truth—sometimes, in medicine, we don’t listen until we are forced to.
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Advocating for My Mother
A few years later, I faced a similar struggle when my mother needed medical care. This time, I wasn’t just advocating for a child—I was advocating for a parent, and the stakes felt even higher. Her care teams weren’t listening—to her or to me. I was watching this previously strong woman fight for the best care possible. They dismissed her concerns, and they only seemed to take me seriously when I introduced myself as a physician. Even then, I had to bypass residents, insist on speaking with attendings, and repeatedly advocate for her care.
One of the hardest aspects of this experience was seeing the profession I had dedicated my life to failing a patient so deeply. It was disheartening to realize that my medical credentials—not my role as a concerned daughter—were what finally granted me access to meaningful conversations about her care.
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A Physician Who is Trying to Listen
Now, in my daily practice, I am the one being accused of not listening.
Patients come to me with concerns, and when I don’t immediately order a battery of tests or prescribe an intervention they expect, they feel dismissed. They don’t believe I hear them when I explain that certain tests won’t change management or may cause more harm than good. They don’t hear me when I explain that insurance may not cover unnecessary diagnostics. They want action, and when that action doesn’t align with their expectations, they feel unheard.
Meanwhile, I find myself thinking—I am listening. But are you?
The challenge is that listening does not always mean agreeing. As a physician, my role is not just to hear patients’ concerns but to integrate them with medical knowledge, guidelines, and the principles of good clinical practice. Listening means considering a patient’s worries and fears while also guiding them toward the best course of action—even if it is not the one they initially hoped for.
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This tension between listening and decision-making is particularly difficult in an era where information—both accurate and misleading—is widely available. Patients often arrive with a preformed conclusion about what they need, influenced by social media, anecdotal stories, and misinformation. When my medical recommendations contradict their expectations, they assume I am not listening rather than considering that I might be offering a perspective grounded in years of education and experience.
I try to bridge this gap by explaining my reasoning in detail, taking time to acknowledge their fears, and validating the emotions behind their requests. However, in the fast-paced reality of modern medicine, time is limited. I may only have fifteen minutes to navigate a patient’s concerns, provide education, perform an exam, and develop a plan. In that brief window, the depth of listening that both sides need and deserve is often impossible to achieve.
Additionally, physicians themselves often feel unheard—by hospital administrators, insurance companies, and the healthcare system as a whole. We are expected to provide exceptional care while facing increasing documentation requirements, productivity metrics, and bureaucratic barriers that make it harder to connect with patients in the way we truly want to. There are constant concerns about patient happiness and the sense that it trumps the medical recommendations. It is no surprise that burnout is so common among healthcare professionals who constantly give their emotional energy to patients yet often feel unacknowledged in their own struggles.
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Navigating This Divide
This disconnect has only been magnified in an era where public figures routinely question the validity of evidence-based medicine. The erosion of trust in the medical profession has made it harder for physicians to confidently guide patients while also making them feel heard.
So how do we bridge this gap? How do we maintain our professional integrity, our confidence in evidence-based decision-making, while also ensuring that our patients feel genuinely heard and valued?
While this is a daunting challenge, there are strategies we can employ:
- Control Our Own Responses – We cannot change how others interpret our words, but we can control how we deliver them. Approaching each conversation with empathy and clarity is key.
- Hold Boundaries and Communicate Expectations – As physicians, we cannot always give patients what they want, but we can make it clear why we are making the choices we do. This means setting boundaries while explaining our thought processes transparently and asking out teams to do the same.
- Share Our Thought Processes Openly – Patients may feel unheard because they don’t understand the rationale behind our decisions. By verbalizing our clinical reasoning, we can help patients feel more engaged in their care.
- Accept That Not Every Doctor-Patient Relationship Will Be Ideal – No matter how hard we try, there will be times when patients still feel unheard. We have to recognize that we are not always the right fit for every patient—and that’s okay.
As physicians, we cannot always give patients what they want, but we can make it clear why we are making the choices we do. This means setting boundaries while explaining our thought processes transparently and asking out teams to do the same.
The Path Forward
The reality is, medicine is not just about making diagnoses and prescribing treatments. It is about relationships—between physicians and patients, between families and healthcare teams, and even within our own profession.
If we are all feeling unheard, the solution cannot simply be speaking louder. We must find ways to communicate differently, to engage with empathy, and to recognize that feeling unheard is a shared experience, not a singular burden.
This isn’t an easy task, but it is a necessary one. Because in the end, the health of our patients—and the health of our profession—depends on it.
