Not Just Words, Words, Words

I was in a most undignified position: lying on a gurney in a curtained cubicle, wearing a johnny under a flimsy sheet, awaiting my 5-year colonoscopy and feeling, well, washed out. That's when I overheard a doctor's voice from the next cubicle.

"Everything looked fine, Mrs. Jenkins," said the voice. "Just some small external hemorrhoids. You might consider drinking a lot of water and eating a fiber-rich diet."

Although I'm no gastroenterologist, I know it when I hear it: verbal boilerplate. I even know it when I say it, though I try not to.

Boilerplate language is a Victorian-age metaphor. From steel sheets that could be used over and over in different machines without change came the idea of reusable units of writing – no thought needed.

We all use verbal boilerplates every day, in and out of the office. ("How's everything?" "Fine. "What's happening?" "Not much.") Verbal boilerplate has two qualities: it's delivered without much inflection, and it doesn't convey a lot of information. Of course, the second quality can be helpful. You don't really want to know how everything is, do you?

But in a professional context, boilerplate has drawbacks. The way it's delivered signals what's really going on. That's how, chilly and distracted though I was, I sensed I was hearing verbal boilerplate even before the words registered. The delivery was quieter, faster, flatter. Hemorrhoids? Press mental button: lots-of-water-fiber-rich-diet.

The second aspect, not unrelated, is that verbal boilerplate is technically correct but doesn't say much. How much water is "lots?" How much fiber is "fiber-rich?" What kind of fiber? How often?

Maybe it doesn't really matter, but that's exactly the point: when you communicate with verbal boilerplate, what you're really saying is, "I'm telling you something I'm supposed to, but whether you understand or follow my advice isn't all that important."

Such communication presents problems. The first, from a medical standpoint, is that signaling that a piece of advice isn't crucial doesn't exactly promote adherence. (Reading compliance studies is always depressing anyway.) The second, from an ordinary human perspective, is that it's deflating to ask a serious personal question – which is how patients tend to think of their concerns – and get what is in effect a canned response.

We don't like to think we dispense boilerplate, but it can be hard not to. When we see a new acne patient, how many novel and creative ways are there to present the basic spiel: no, it's not food; yes, you can use makeup; please don't pick your pimples; apply the creams and take your pills regularly; don't be discouraged if you don't clear up in 2 weeks; and, as Jerry Seinfeld might add, "Yadda yadda yadda."

The same is true for eczema, warts, or any of the routine things any dermatologist deals with daily. How tempting is it to succumb and dispense boilerplate? You've got disease X? Here is response Y. Gotta go now.

But avoiding this is indeed possible without a lot of effort or time. The first step is to recognize the problem and listen to ourselves as though we're the patient. The second is to vary the mode of presentation, even if just a bit, between one visit and the next (changing sentence order, modifying phrasing.) The third is to add emphasis to show we're making a point we really want to put across and that it does matter whether the patient understands the instructions and knows how to follow the directions. The fourth is to maintain eye contact and vary inflection to show that we are not, in fact, automated attendants giving recorded announcements with implied or explicit disclaimers, that the opinions herein expressed are not those of the management, the medical society, or the Department of Homeland Security.

Written boilerplate in a contract or lease agreement has lots of words in tiny print to show that you don't have to spend time reading it. Verbal boilerplate sends a similar message: careful listening isn't required. In that case, why bother saying it?

A week after my gurney epiphany, I got a letter from the gastroenterologist telling me I don't need another colonoscopy for 5 years. Now that's what I call meaningful communication.

I was in a most undignified position: lying on a gurney in a curtained cubicle, wearing a johnny under a flimsy sheet, awaiting my 5-year colonoscopy and feeling, well, washed out. That's when I overheard a doctor's voice from the next cubicle.

"Everything looked fine, Mrs. Jenkins," said the voice. "Just some small external hemorrhoids. You might consider drinking a lot of water and eating a fiber-rich diet."

Although I'm no gastroenterologist, I know it when I hear it: verbal boilerplate. I even know it when I say it, though I try not to.

Boilerplate language is a Victorian-age metaphor. From steel sheets that could be used over and over in different machines without change came the idea of reusable units of writing – no thought needed.

We all use verbal boilerplates every day, in and out of the office. ("How's everything?" "Fine. "What's happening?" "Not much.") Verbal boilerplate has two qualities: it's delivered without much inflection, and it doesn't convey a lot of information. Of course, the second quality can be helpful. You don't really want to know how everything is, do you?

But in a professional context, boilerplate has drawbacks. The way it's delivered signals what's really going on. That's how, chilly and distracted though I was, I sensed I was hearing verbal boilerplate even before the words registered. The delivery was quieter, faster, flatter. Hemorrhoids? Press mental button: lots-of-water-fiber-rich-diet.

The second aspect, not unrelated, is that verbal boilerplate is technically correct but doesn't say much. How much water is "lots?" How much fiber is "fiber-rich?" What kind of fiber? How often?

Maybe it doesn't really matter, but that's exactly the point: when you communicate with verbal boilerplate, what you're really saying is, "I'm telling you something I'm supposed to, but whether you understand or follow my advice isn't all that important."

Such communication presents problems. The first, from a medical standpoint, is that signaling that a piece of advice isn't crucial doesn't exactly promote adherence. (Reading compliance studies is always depressing anyway.) The second, from an ordinary human perspective, is that it's deflating to ask a serious personal question – which is how patients tend to think of their concerns – and get what is in effect a canned response.

We don't like to think we dispense boilerplate, but it can be hard not to. When we see a new acne patient, how many novel and creative ways are there to present the basic spiel: no, it's not food; yes, you can use makeup; please don't pick your pimples; apply the creams and take your pills regularly; don't be discouraged if you don't clear up in 2 weeks; and, as Jerry Seinfeld might add, "Yadda yadda yadda."

The same is true for eczema, warts, or any of the routine things any dermatologist deals with daily. How tempting is it to succumb and dispense boilerplate? You've got disease X? Here is response Y. Gotta go now.

But avoiding this is indeed possible without a lot of effort or time. The first step is to recognize the problem and listen to ourselves as though we're the patient. The second is to vary the mode of presentation, even if just a bit, between one visit and the next (changing sentence order, modifying phrasing.) The third is to add emphasis to show we're making a point we really want to put across and that it does matter whether the patient understands the instructions and knows how to follow the directions. The fourth is to maintain eye contact and vary inflection to show that we are not, in fact, automated attendants giving recorded announcements with implied or explicit disclaimers, that the opinions herein expressed are not those of the management, the medical society, or the Department of Homeland Security.

Written boilerplate in a contract or lease agreement has lots of words in tiny print to show that you don't have to spend time reading it. Verbal boilerplate sends a similar message: careful listening isn't required. In that case, why bother saying it?

A week after my gurney epiphany, I got a letter from the gastroenterologist telling me I don't need another colonoscopy for 5 years. Now that's what I call meaningful communication.

I was in a most undignified position: lying on a gurney in a curtained cubicle, wearing a johnny under a flimsy sheet, awaiting my 5-year colonoscopy and feeling, well, washed out. That's when I overheard a doctor's voice from the next cubicle.

"Everything looked fine, Mrs. Jenkins," said the voice. "Just some small external hemorrhoids. You might consider drinking a lot of water and eating a fiber-rich diet."

Although I'm no gastroenterologist, I know it when I hear it: verbal boilerplate. I even know it when I say it, though I try not to.

Boilerplate language is a Victorian-age metaphor. From steel sheets that could be used over and over in different machines without change came the idea of reusable units of writing – no thought needed.

We all use verbal boilerplates every day, in and out of the office. ("How's everything?" "Fine. "What's happening?" "Not much.") Verbal boilerplate has two qualities: it's delivered without much inflection, and it doesn't convey a lot of information. Of course, the second quality can be helpful. You don't really want to know how everything is, do you?

But in a professional context, boilerplate has drawbacks. The way it's delivered signals what's really going on. That's how, chilly and distracted though I was, I sensed I was hearing verbal boilerplate even before the words registered. The delivery was quieter, faster, flatter. Hemorrhoids? Press mental button: lots-of-water-fiber-rich-diet.

The second aspect, not unrelated, is that verbal boilerplate is technically correct but doesn't say much. How much water is "lots?" How much fiber is "fiber-rich?" What kind of fiber? How often?

Maybe it doesn't really matter, but that's exactly the point: when you communicate with verbal boilerplate, what you're really saying is, "I'm telling you something I'm supposed to, but whether you understand or follow my advice isn't all that important."

Such communication presents problems. The first, from a medical standpoint, is that signaling that a piece of advice isn't crucial doesn't exactly promote adherence. (Reading compliance studies is always depressing anyway.) The second, from an ordinary human perspective, is that it's deflating to ask a serious personal question – which is how patients tend to think of their concerns – and get what is in effect a canned response.

We don't like to think we dispense boilerplate, but it can be hard not to. When we see a new acne patient, how many novel and creative ways are there to present the basic spiel: no, it's not food; yes, you can use makeup; please don't pick your pimples; apply the creams and take your pills regularly; don't be discouraged if you don't clear up in 2 weeks; and, as Jerry Seinfeld might add, "Yadda yadda yadda."

The same is true for eczema, warts, or any of the routine things any dermatologist deals with daily. How tempting is it to succumb and dispense boilerplate? You've got disease X? Here is response Y. Gotta go now.

But avoiding this is indeed possible without a lot of effort or time. The first step is to recognize the problem and listen to ourselves as though we're the patient. The second is to vary the mode of presentation, even if just a bit, between one visit and the next (changing sentence order, modifying phrasing.) The third is to add emphasis to show we're making a point we really want to put across and that it does matter whether the patient understands the instructions and knows how to follow the directions. The fourth is to maintain eye contact and vary inflection to show that we are not, in fact, automated attendants giving recorded announcements with implied or explicit disclaimers, that the opinions herein expressed are not those of the management, the medical society, or the Department of Homeland Security.

Written boilerplate in a contract or lease agreement has lots of words in tiny print to show that you don't have to spend time reading it. Verbal boilerplate sends a similar message: careful listening isn't required. In that case, why bother saying it?

A week after my gurney epiphany, I got a letter from the gastroenterologist telling me I don't need another colonoscopy for 5 years. Now that's what I call meaningful communication.