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. 2026 Feb 23;15(1):188–199. doi: 10.5334/pme.2372

Table 2.

The Linguistic Lens on Agency: Recommendations for Providers.

TYPE OF AGENCY RECOMMENDATION TARGET LANGUAGE
Patient individual agency Ask open-ended questions and give patient time to express questions, needs, concerns, thoughts Patient:

  • - “I know/don’t know…”

  • - “What/how/why/do…?”

  • - “I need/want…”

  • - “I think…”
External resource agency (e.g., apps, websites) Identify and make available decision aids (including apps or other resources) that facilitate shared decision making Provider:

  • - “What did you learn from the [resource] about your preferences? What questions do you have for me?”


Patient:

  • - “It [resource] stated/suggested…” (followed by question for provider)
Physician agency (supportive) Ask questions to determine patient knowledge and needs; validate patient decisions; listen actively. Provider:

  • - “What/how/why/do you…?”

  • - “What is most important to you in this decision?”

  • - “I agree with your decision to…”

  • - “Tell me more…”
Physician agency (hindering) Do not use directives or make decisions for the patient Provider—to AVOID:

  • - “You’re/We’re going to do…”

  • - “I’ve decided that…”
Joint patient-provider agency Listen for patient use of “we” but do not initiate it unless used by patient. Patient:

  • - “I/we should do…” (provider follows patient lead)
Distributed agency (across patient, provider and/or other resources) Consider “three-talk” model to enhance autonomy. Cue and listen for patient values, preferences, and sociocultural context. Avoid directives. Patient-Provider:

  • - “Frequent turn-switching between patient and provider

  • - “This resource suggested…”

  • - “My friend/partner and I talked about…”