Launchpad: The 2 Words That Changed How I Talk to Clients

Most high school students end up enrolled in an activity they aren't thrilled about. For me, it was Mrs. Napp's improvisation class. I resented being there, and I couldn't see how it would help me down the road. My classmates and I would grumble that instead of learning useful skills, we were doing trust falls and pretending to be trees or whatever. The irony is that I was learning two words that I now (20ish years later) use every day as a doctor: “yes, and.”

In improvisation, “yes, and” means you accept whatever your scene partner gives you and build on it. You never shut down the premise; you keep the scene moving forward. “Yes, and” works in medicine for the same reason: you have to work with what the other person brings, not override it.

Clients come into the examination room with their own ideas, fears, and limitations. Early in my career, my instinct was to play the expert over my clients, but every time I shut a conversation down with a flat, "no," or a correction wrapped in medical authority, the client disengaged. 

“Yes, and” helps me remember to stay in the scene. It helps me validate the client's concerns and move forward together. “Yes, I hear you, and here's what I'm thinking.” 

That might look like:

• For the client who can only afford a partial workup: “Yes, I understand your budget, and here's what we can do right now that still helps your pet.”

• For the client who swears their cat isn't in pain, even though you can see the swollen foot: “Yes, you know your cat better than anyone, and even if we disagree on whether it's painful, let's figure out together what might be causing that limp.”

• For the client who wants to try a supplement before medications: “Yes, I understand wanting to start conservatively, and here's what I'd want to monitor so we don't lose ground.”

You don't have to agree with everything a client says, but you should make them feel heard before starting to educate. I learned this using two words from a class I didn't want to take.