What if the most preventable risk in a malpractice claim isn’t a medical error but unclear speech?
Today’s healthcare environment often involves high pressure, high stakes encounters. Even highly skilled physicians can become vulnerable to lawsuits, especially if patients misunderstand their words. Whether this language disconnect results from a doctor’s non-standard accent, sped-up delivery, or ambiguous phrasing, unclear communication can hurt. It can erode trust, and cause confusion with the patient. Either of which can ultimately lead to costly litigation.
As a veteran speech coach, I’ve worked alongside physicians and legal teams. And I’ve seen how sharpening medical professional’s communication skills can reduce liability, strengthen legal defense, and, all-in-all, improve patient satisfaction. I’ll highlight the impact of speech clarity on medical malpractice defense outcomes and guides doctors on how to safeguard both their patients and their practice with the following stats and anecdotes:
Unclear Communication: A Hidden Malpractice Trigger
At its most basic, miscommunication is inconvenient. At its most extreme, it’s dangerous.
Roughly 1 in 3 healthcare professionals will face malpractice lawsuits during their career, and in many cases, communication failure is at the core (as cited in a Forbes article). CRICO shares that Harvard Medical System’s malpractice insurance arm noted “communication failures were a contributing factor in 30% of malpractice claims” and that this number rises even higher in severe cases.
Some common breakdowns in doctor-patient communication include:
- Unclear Pronunciation or Non-Standard Accents (in English for US Patients)
Patients can struggle to understand doctors if they speak with strong, unfamiliar accents or unclear articulation. Patients may fail to grasp even basic instructions, especially in high-stress or time-sensitive situations.
In my own experience, I walked into the ER with extreme abdominal pain. The PA or perhaps nurse on duty asked me: “Is the pain ‘ruh-JAY-Ting’ ?” I paused for a moment and thought about it…puzzled. Then it hit me! Smiling and wincing in pain, I inquired: “Do you mean ‘RAY-dee-ay-ding?’ If so, then YES, the pain is ‘ruh-JA-Ting’ all over my body!” We both had a laugh and an interesting dialect conversation as they wheeled me in to see a specialist. (And in case you’re wondering, the word-of-the-day was radiating, and, fortunately/unfortunately, I had a kidney stone!)
- Overuse of Medical Jargon
Clinical terms or medical jargon that doctors employee internally may overwhelm patients. Words like “benign” or “contraindicated” may be second nature to providers but can be meaningless or misleading to patients without proper explanation.
From personal experience, while recovering from a life-threatening illness and attending Occupational Therapy (OT), the therapist used jargon I hadn’t heard prior. She said my results were “within normal limits” which seemed promising but was still fuzzy and somehow offputting.
- Ambiguous Language
Patients can become confused, bewildered, or even feel threatened if word choice (diction) is unclear or if physicians don’t provide supporting context clues. Doctors using multiple-meaning expressions risk being misunderstood, particularly across cultural or gender lines.
In my neurological emergency, doctors were very clear – they would gesture with their arms and ask for actions like “Don’t let me push! Don’t tell me pull!” So kudos to the NYU Langone Neurology medical team. However, I overheard content from a “Standardized Patient” course that an actor in my life attended. During that session, the instructor suggested that the neurologists might say, “Resist me” during physical exams. For example, I can visualize the dismay that a young female patient might feel if an older, larger male doctor pushed his torso towards her and barked “Resist me!” This could feel like a very confusing, alarming, or even inappropriate sexual advance. Without context and knowledge of the purpose and mechanics of the exam, those words could prove catastrophic for doctor-patient relations.
- Rushed Explanations
When doctors speed through instructions or explanations, patients often miss key details. This leaves little room for clarification and increases the chance of serious misunderstandings.
I recall that after my gynecologist left her medical practice, I was assigned to another doctor. The doctor came in for what must have been routine for her. As the exam was likely routine for her, she muttered something under her breath and turned to leave. I yelled “Hi, I’m Melanie – – I didn’t catch your name!” as a sarcastic joke during her flight out of the door. She sheepishly giggled and apologized for her abrupt and gruff demeanor and for failing to explain the results of her exam and any next steps. Thankfully in my case, they told me “Just come back next year for your annual.” And I made sure to make that appointment at another practice.
I’ve also received voicemail messages from doctors’ offices sounding rather urgent. Upon frantically calling back, I was happy (and confused) to find out that my tests came back normal (and there was no follow-up needed).
- Interpreter Confusion
Multilingual settings may require interpreters to bridge communication gaps. However, when a physician’s speech is unclear, interpreters may unintentionally mistranslate the message, delivering inaccurate information, even when using clear articulation in the patient’s native language (as shown in an Advanced Journal of Emergency Medicine study). And in this case, the patient may have total confidence in the received translation, as they are hearing the medical information in clear language from a confident interpreter—compounding the effect!
As a native speaker of English living in the US, I did not encounter this issue myself. However, a trusted veteran of the medical industry, and retired Director of Nursing from Los Angeles County Department of Health, shed light on this issue and inspired this section of my blog!
- Written Communication Pitfalls
Accents aside, written test results can be just as confusing as the spoken word. The more we rely on app alerts and results notifications, the more we are likely to see our results before we speak to a medical professional. Unclear written results can cause unnecessary confusion, anxiety, and cause the patient to take unintended actions or accidentally neglect a time-sensitive issue (if they take no action despite an urgent need for care).
I recall a moment of sheer panic when I saw a result I didn’t understand. Apparently one of my tests had a quick/rapid version which was irregular but the more comprehensive test came back negative.
When I took a recent COVID test, I saw the result: “Reference range: not detected null” which, to me, was an unclear and unnecessarily complicated way to say “Negative” or “No COVID detected.” As for my husband’s COVID test results (earlier in the pandemic), he received an even more garbled gobbledygook result, so confusing he had to call the clinic to find out that he indeed tested positive.
These misunderstandings, if left unaddressed, can escalate quickly, and the consequences can be far-reaching and even cascade, creating a domino effect of problems.
Speech Coaching & Accent Reduction Builds Trust and Better Outcomes
The purpose of Accent modification is not to erase cultural identity. Speech coaching and accent reduction aim to remove barriers to effective communication and to promote understanding. Accent clarity as part of the big picture—namely communication training—can help physicians speak with precision, calmness, and confidence. And patients will receive the incoming information with more understanding and less anxiety.
When physicians communicate clearly, patient outcomes improve, including:
- Stronger rapport: Patients feel safer asking questions and sharing concerns
- Improved adherence: Medical practitioners give clear instructions, which lead to better follow-through
- Greater trust: Patients perceive physicians as more competent and more compassionate
- Reduced liability: Doctors have fewer misunderstandings with patients—which means fewer complaints, reduced number of mishaps, and fewer claims
And, when non-native English-speaking physicians feel confident that they sound clear, they can focus entirely on the patient experience. They can pour their energy into human connection—rooted in clarity and mutual understanding. They can foster stronger relationships and more effective outcomes. And their medical institution will benefit from consistently higher patient satisfaction scores, more testimonials (and fewer public-facing complaints).
Accent Reduction Isn’t Just Preventive. And it’s Proven!
Improved communication benefits patients but also protects physicians from legal risk. When patients trust their doctors, understand instructions, and feel heard, they are far less likely to file complaints or claims.
A large-scale study published in BMJ Open found that improved communication training resulted in a 23% reduction in malpractice claims over a five-year period. This is a proven risk-reduction strategy.
–Max Schloemann, Medical Malpractice Insurance Broker & CEO of MEDPLI
What Does Speech Coaching / Accent Reduction Involve?
At Speech Fox, our engagement typically begins with a 90-minute assessment of the physician’s current communication style, including speech clarity, tone, pacing, intonation, and body language. From there, I develop a customized plan based on each client’s needs.
Strategic speech coaching/accent reduction options include (but are not limited to):
- 10 to 15 sessions for native English speakers, focused on pacing, tone, and articulation
- 20 to 30 sessions for non-native English speakers, covering pronunciation, stress patterns, rhythm, and idiomatic usage
Physicians facing courtroom testimony, sometimes with just a day’s notice, can also access rapid, trial-focused coaching. Whether your goal is to strengthen a doctor’s, nurse’s, PA’s or other professional’s bedside manner, reduce patient complaints, or prepare for a legal appearance, I tailored my speech training and services to meet physicians where they are. I quickly help them to build clarity and confidence under pressure.
Informed Consent Starts with Clear Speech
Informed consent is more than just a signature; it’s a conversation.
In order to give valid consent, patients must fully understand the risks, benefits, and alternatives of a proposed treatment.
When doctors resort to unclear language, use complex terms, or choose unclear wording, this compromises the validity that that supposed consent. If a patient retroactively claims that they did not fully comprehend the situation or understand the documents, the provider may face serious legal consequences.
Melissa McCall, J.D. of Find Law noted that courts place greater emphasis on evidence that patients have received and comprehended the information, which underscores the concept that plain-language communication is a legal and ethical obligation.
Healthcare Systems Are Catching On
Forward-thinking hospitals and medical groups are beginning to treat communication as a core clinical competency. They increasingly recognize that the way in which providers speak with patients directly impacts patient outcomes, safety, and even their institution’s credibility as a whole.
Key drivers of medical institutions’ increasing awareness include:
- Reimbursement tied to patient satisfaction metrics
- Online reviews that influence reputation
- Accreditation bodies that reward excellence in provider-patient communication
To put it bluntly, Healthcare organizations, cannot afford unclear messaging. If they are striving for top-tier status, strong communication is no longer just good medicine or even a strategic advantage. It is a requirement.
Preventing Malpractice Starts with Clear Communication
According to the MedPli website, a single malpractice lawsuit can cost hundreds of thousands, or even millions of dollars in legal fees, settlements, and lost time. Beyond money, the resulting emotional toll and reputational damage can be just as severe…or perhaps even more devastating to a practice or a physician’s career.
Investing time and money into strategic speech coaching is, by comparison, just a fraction of the cost. Moreover, it fosters trust, mitigates risk, and enhances patient outcomes.
The goal for the medical practitioner is not to speak perfect academic English. It is to communicate with patients in a way that is clear and instills confidence – to reflect the competence of a skilled, compassionate professional. That is what patients respond to during tense moments in an exam room, just as jurors do during high-stakes moments in a courtroom.
Where to Go Next
If you’re a physician or part of a healthcare system, now is the time to act. Clear communication is a safeguard, a defense, and a competitive edge.
For each day unclear speech goes unaddressed, the risk of misdiagnosis, patient dissatisfaction, and potential litigation mounts. Speech coaching and accent reduction training are among the most cost-effective, high-return investments you or your organization can make to protect your practice, empower your team, and ensure that your patients feel heard and understood.
Your words matter! Make sure those words work for you, not against you.
About the Author: Melanie Fox
Melanie Fox is a Georgetown-trained linguist with over 20 years of experience helping people speak clearly and confidently. Her passion began early, as she assisted immigrant families with pronunciation and learned languages such as Spanish, Italian, German, and a bit of Cantonese along the way. After teaching Adult ESL, she founded SpeechFox to offer personalized training in Standard American English and dialect coaching. Melanie’s approach emerged from her academic background and practical experience—her work is methodical, strategic, and rooted in a deep love of language and human connection.
