You must be able to quickly determine the patient's level of education and speak with them on this level. Questioning or counseling patients above their level will create confusion. Communicating below their level of understanding will be frustrating. There are some natural obstacles to communication and rapport that you should recognize and attempt to overcome. Primarily, these are related to the stress and anxiety created by the situation.
Patients feel even greater stress being sick, and frightened by the possibilities of the illness.
They feel helpless, sometimes confused, and can't understand the need for all the questions you ask. Anger is a frequent emotion that develops when people are under stress. If you realize this it is easier to deal with a patient's anger without becoming angry yourself. Another obstacle in the fact that Americans have a habit of thinking of what to say next rather than listening to what is being said, and you must work hard to avoid this. Your attempt to put the patient at ease will probably be interpreted as either unconcern, unbelief of the patient's story, or a reprimand for coming to the clinic with such a minor problem.