Why healthcare must reclaim communication from “comms” and return it to human care
A patient leaves the hospital with discharge papers in hand, a medication list that changed twice, a follow-up appointment that was explained too quickly, and a portal message waiting at home. The daughter is worried. The home health team is missing part of the picture. The primary care office has not yet seen the update. Everyone involved can say communication happened.
Yet what the patient experiences is something very different.
Confusion is not a side issue in healthcare. Mistrust is not a side issue. Feeling unheard is not a side issue. When communication breaks down, the harm is emotional, clinical, relational, and financial all at once. That is why communication should no longer be treated as a soft skill parked on the margins of care. Communication is a condition of wellbeing.
Somewhere along the way, communication was reduced. It became a department. It became a corporate function. It became “comms.” In universities, it was often narrowed into rhetoric, media studies, digital influence, public address, organizational messaging, and strategic persuasion. Those areas matter, but the field was too often organized around influence inside institutions rather than wellbeing among human beings.
That narrowing has come at a high cost.
Communication is not owned by marketing teams, media scholars, or institutional strategists. Communication is a human construct. It is how people make sense of illness, express fear, ask for help, build trust, repair harm, carry memory, navigate difference, name what matters, and remain connected to one another. It lives inside every subject because it lives inside every relationship.
Healthcare should have recognized this earlier than most fields. Instead, it has often treated communication as secondary to the “real” work. The result has been costly. AHRQ’s patient-safety literature describes communication failures as significant contributors to medical errors and patient harm, especially during transitions of care. In one study cited by PSNet, 70% of observed hospital-to-home health transitions included at least one safety issue, often involving incomplete information, medication problems, unsafe home environments, or poor understanding of the care plan.
That should stop us.
When care moves from the hospital to the home, from the specialist to the primary care office, from the exam room to the patient portal, from in-person visits to telemedicine, communication is no longer a courtesy layered onto care. It becomes continuity itself. A 2026 systematic review in the Journal of Medical Internet Research found that effective communication for patient engagement in telemedicine spans interpersonal skills, teamwork and care coordination, cultural and linguistic sensitivity, and system-level design such as usability and privacy. In other words, communication is not one thing. It is the connective tissue that allows modern care to hold together.
This is why the phrase Communication Is Wellbeing is more than a slogan.
It is a structural claim. Human beings do not experience communication as a narrow technical exchange. They experience it as reassurance, dismissal, dignity, abandonment, clarity, belonging, confusion, partnership, or shame. A well-explained diagnosis can lower fear. A rushed answer can increase it. A respectful cross-cultural conversation can open the door to adherence. A demeaning interaction can close it. The health consequences may not all show up in the chart, but they are real.
There is already plenty of evidence that social connection shapes health in powerful ways. The U.S. Surgeon General’s advisory on social connection reports that about one in two adults in America has experienced loneliness, and that social disconnection is associated with higher risks of cardiovascular disease, dementia, stroke, depression, anxiety, and premature death. HHS also notes that poor social relationships, social isolation, and loneliness are linked to a 29% higher risk of heart disease and a 32% higher risk of stroke, while chronic loneliness and isolation among older adults are associated with about a 50% increased risk of developing dementia.
If social connection affects health this deeply, then communication deserves to be recognized as one of the daily mechanisms through which health is either strengthened or weakened. Communication is how social connection is built, tested, repaired, or lost. It is how care becomes collaborative instead of coercive. It is how a patient comes to believe, “These people understand me,” or, “I am on my own.”
That truth matters even more in 2026 and 2027 because healthcare is entering a sharper period of strain. Administrative overload remains intense. Drug spending pressures are rising. Care is continuing to move across home, community, and lower-cost settings. In that kind of system, human communication does not become less important. It becomes more decisive.
Take ambient AI scribes. Their best use is not to make healthcare feel more automated. Their best use is to give clinicians back the attention that documentation has been taking from patients. In a 2025 multicenter study published in JAMA Network Open, burnout among ambulatory clinicians dropped from 51.9% to 38.8% after 30 days of using an ambient AI scribe, with reported improvements in cognitive load, after-hours documentation time, and the ability to give undivided attention to patients. That is the right frame for AI in care: remove clerical drag so human presence can return to the center.
At the same time, financial pressure is intensifying. U.S. spending on GLP-1 receptor agonists rose from $13.7 billion in 2018 to $71.7 billion in 2023, an increase of more than 500%. State Medicaid programs have also been wrestling with whether and how broadly to cover GLP-1s for obesity treatment. When cost pressure rises at that scale, patients are pushed into harder conversations about access, affordability, tradeoffs, adherence, and trust. Those are communication challenges as much as policy challenges.
Payment policy is shifting too. KFF reports that Medicare’s 2026 site-neutral reform reduces rates for drug administration services at all off-campus hospital outpatient departments by 60%, and CMS’s 2026 home health final rule estimates aggregate Medicare payments to home health agencies will decline by 1.3% compared with 2025. The policy details matter less than the direction of travel: more care will be expected to work across settings, at lower cost, with cleaner coordination. That means communication is now infrastructure.
This is where healthcare needs a conceptual correction.
Communication should not be framed mainly as persuasion, messaging discipline, or institutional polish. In healthcare, communication is a human wellbeing practice. It should begin with relationship, dignity, care, and connection. It should include cross-cultural communication, cross-professional communication, cross-generational communication, and the everyday language people use to make sense of pain, hope, confusion, and change.
One of the strongest existing models for this shift is the Age-Friendly Health Systems movement. Its 4Ms framework begins with What Matters, then Medication, Mentation, and Mobility. That sequencing is deeply important. It means care begins by understanding the person’s priorities rather than forcing the person to fit the system’s priorities.
That logic should move far beyond older adult care.
Every serious healthcare system should be asking what matters to the person being served, then exploring how those priorities interact with the social conditions of life: housing, transportation, food access, financial strain, family support, neighborhood safety, digital access, language, time, grief, isolation, and the quality of day-to-day relationships. A 2025 JAMA Network Open study of Medicare and Medicaid beneficiaries in the Accountable Health Communities model found that specific unmet health-related social needs were associated with higher inpatient and emergency department use. A related commentary warned against expecting downstream social-needs interventions to carry the whole burden while leaving upstream conditions untouched. That is exactly the point. Communication cannot stay trapped at the level of scripts. It has to reach the level of lived reality.
This is why “What Matters” should not be treated as a scripted line delivered near the end of a visit. It should become a way of practicing care. Patients and residents should be invited to name what matters in their own words. Teams should learn to hear how those answers connect to clinical choices, family roles, community life, and the social barriers that shape outcomes. Care plans should reflect those realities. The person’s voice should guide the work as much as possible.
Communication, then, is not for commerce. It is for human wellbeing.
That sentence may sound obvious, but it is far more radical than it appears. It suggests that communication belongs back with the people. It suggests that staff need better lines of communication to express their own needs as well as the needs of patients. It suggests that healthcare training should no longer isolate communication inside an occasional professionalism lecture while the rest of the curriculum races toward procedures, platforms, and productivity.
It also suggests that the communication field itself has unfinished work to do.
If communication scholars, healthcare leaders, and educators want to meet the moment, they should build around a different center of gravity. The next era of communication must be grounded in human connection, wellbeing, care, repair, meaning, and shared understanding. The technical and strategic dimensions still matter. Even so, they should sit downstream from a more humane foundation.
Here is one practical framework for getting there.
- Reclassify communication as a core health outcome.
Treat communication as part of safety, quality, access, workforce wellbeing, care coordination, and patient experience. TeamSTEPPS, AHRQ’s long-standing teamwork model, was built on this insight: better communication and teamwork improve patient outcomes across hospitals, primary care, and long-term care. - Put “What Matters” at the front of care, not the edges.
Ask early. Revisit often. Use the answers to guide care planning, discharge planning, home-based care, and community referral pathways. The 4Ms framework already offers a credible structure for this work. - Train communication across difference.
Healthcare needs stronger human-centered communication, along with cross-cultural, cross-professional, and cross-generational skill. The 2026 telemedicine review makes clear that patient engagement depends on relationship-building, teamwork, and cultural and linguistic sensitivity at the same time. - Use AI to reduce burden, not replace relationship.
Ambient tools should create more room for eye contact, listening, explanation, and trust. Their value is highest when they return time and attention to the human encounter. - Measure what humane communication actually changes.
Track handoff reliability, patient understanding, staff speak-up culture, trust, adherence, after-hours documentation, avoidable confusion, transition safety, and whether social barriers are being surfaced early enough to matter. Communication improves when systems decide it is worth measuring.
The deeper point is simple.
Healthcare will not solve its most persistent human problems with better branding language. It will solve them by restoring communication to its rightful place. Communication is how people carry meaning across difference. It is how they decide whether they belong. It is how they understand what is happening to them. It is how they remain visible to one another inside systems that are often rushed, fragmented, and impersonal.
That is why communication belongs in the center of social health. It belongs in the center of medical education. It belongs in the center of patient safety. It belongs in the center of workforce wellbeing. It belongs in the center of health equity. And it belongs in the hands of the people who live with the consequences of whether communication is handled with care or without it.
Communication was never meant to be a narrow professional silo.
It was always meant to be part of how human beings help one another live.
If this piece is heading onto JeremyHolloway.com, the strongest companion move after posting would be to build the next blog in the series around “What Matters as a Clinical Method” so this becomes the opening chapter of a real book arc.
