How “Never Split The Difference” Helps Osteopaths Master Patient Relationships

"Never Split The Difference" isn't just about negotiation—it's a blueprint for elevating your osteopathic practice. Use these 5 methods so you can elevate patient care, forge trust and contribute to the long-term reputation of your practice.

How an FBI negotiator can help osteopaths

In the world of negotiation, Chris Voss’s “Never Split The Difference” has redefined success through strategic tactics rooted in empathy and understanding.

While negotiation and the fact that Chris spent 24 years working in the FBI Crisis Negotiation Unit and was the FBI’s chief international hostage and kidnapping negotiator may seem a bit of a stretch from osteopathy, but the book’s principles offer a transformative approach for all osteopaths.

Let’s dive into the 5 lessons of active listening, emotional intelligence, calibrated questions, anchoring and assertive boundaries can revolutionise the therapeutic alliance and take your practice to new heights.

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Lesson 1: Active listening as a gateway to trust

Active listening may seem like a simple practice, but its impact cannot be understated. Much like Chris Voss’s emphasis on attentive listening in negotiation, active listening forms the bedrock of successful patient interactions in osteopathy. By mastering this art, osteopaths can create a profound impact, fostering trust, empathy and a more holistic understanding of patients’ well-being.

The power of listening

Active listening goes beyond the mere act of hearing words; it’s about engaging with your patients on a deeper level. When you truly listen, you’re not just absorbing information; you’re demonstrating that their words matter and that you’re fully present in the moment. This creates an immediate sense of validation, making patients feel acknowledged and valued. Just as Voss suggests that your words should be a net catching the other person’s words, your attentive listening acts as a safety net for your patients’ thoughts, concerns and emotions.

In the context of osteopathy, active listening is the gateway to understanding the whole patient. It’s the means by which you unravel not just their physical symptoms, but also their emotional state, lifestyle and individual circumstances. By allowing patients to share their stories and concerns, you gather a wealth of information that can shape a more comprehensive treatment plan.

Validating emotions

A fundamental concept in “Never Split The Difference” is the importance of validating emotions during negotiations. Similarly, for osteopaths, patients’ emotions hold immense significance. When you validate patients’ feelings, you’re creating an atmosphere of empathy and compassion. Validating emotions doesn’t necessarily mean agreeing with them, but it does mean acknowledging and understanding them.

In practice, this might involve mirroring their emotions. If a patient expresses frustration about chronic pain, acknowledging their frustration empathetically can go a long way. It’s about making patients feel heard and recognised on an emotional level, which often forms a stronger bond than the diagnosis alone. By validating emotions, you’re co-creating a safe space where patients can openly share their concerns, leading to a more accurate diagnosis and a treatment plan that aligns with their emotional well-being.

The osteopath’s advantage

As an osteopath, your advantage lies in your ability to approach patient care holistically. Active listening amplifies this advantage, allowing you to unearth insights that go beyond the surface. Patients often arrive with physical complaints, but active listening uncovers the psychological, emotional and lifestyle factors that can contribute to their discomfort.

When you engage in active listening, you’re not just treating symptoms; you’re addressing the root causes of those symptoms. For instance, a patient presenting with lower back pain might reveal that the pain intensified after a recent job change—information that might not surface without attentive listening. Armed with this understanding, you can tailor your treatment plans to encompass both physical healing and emotional well-being.

In essence, active listening transforms the patient-practitioner relationship. It goes beyond medical expertise and fosters a partnership built on trust and understanding. Your role as an osteopath extends beyond diagnosis and hands-on treatment; it becomes a journey towards holistic healing where patients feel valued, heard and empowered.

Lesson 2: Harnessing emotional intelligence

Emotional intelligence, a cornerstone of effective negotiation according to Chris Voss, is equally vital in the practice of osteopathy. When thinking of the pained patient, emotions play a significant role in patient experiences and outcomes. By honing emotional intelligence, you can foster a deeper connection, adapt to patients’ emotional states and forge lasting bonds that goes beyond what I’m sure they’d normally expect when seeing a healthcare professional.

The emotion connection

Much like Voss’s emphasis on understanding emotions in negotiation, emotional intelligence in osteopathy revolves around acknowledging and empathising with patients’ feelings. It’s recognising that patients aren’t just what they’re symptoms are; they’re individuals navigating physical and emotional challenges. Your ability to connect on an emotional level elevates patient care from clinical to compassionate.

Embracing emotional intelligence means being attuned to nonverbal cues—facial expressions, body language and tone of voice. A furrowed brow might hint at anxiety beyond the words spoken. By perceiving these subtleties, you open doors to discussions about concerns that might otherwise remain unspoken.

Adapting to emotions

In negotiation, emotional intelligence allows you to steer conversations with a grasp of the persons’ emotional state. Similarly, adapting to patients’ emotions enhances their outcomes. A patient’s emotional state can influence their perception of pain, recovery and overall well-being. By acknowledging and addressing these emotions, you’re contributing to a more comprehensive approach to healthcare.

For instance, imagine a patient who’s anxious about an upcoming surgical procedure. Your acknowledgment of their anxiety paves the way for an open conversation about their fears and concerns. By involving them in the decision-making process and offering reassurance, you’re fostering emotional well-being alongside physical healing. Your emotional intelligence becomes a bridge between medical expertise and compassionate care.

Strengthening patient bonds

Emotionally intelligent practitioners create an environment where patients feel understood and valued. Patients are more likely to return to practitioners who not only help their physical symptoms improve but also nurture their emotional needs.

As Voss highlights, empathy is a powerful tool in negotiation. This rings true in osteopathy too. Patients who sense that you genuinely care about their emotional well-being form deep bonds of trust. They’re more likely to engage in their treatment plans, openly share their concerns and actively participate in their healing journey.

By harnessing emotional intelligence, you’re co-creating a space where patients feel safe, respected and heard. It’s not just about diagnoses and treatments; it’s about acknowledging their fears, joys and struggles. This holistic approach enhances patient experiences and inspires a sense of partnership that resonates long after the appointment ends.

Lesson 3: Calibrated questions to discover insights

Calibrated questions, a strategic tool in negotiation as emphasised by Chris Voss, hold immense potential for transforming patient interactions. These thoughtfully crafted questions go beyond surface-level discussions, delving into patients’ experiences, concerns and aspirations. By integrating calibrated questions into your practice, you can empower patients, unveil hidden insights and craft tailored treatment plans that address their unique needs.

The art of calibrated questions

Calibrated questions are open-ended inquiries designed to spark meaningful conversations. Similar to their role in negotiation, calibrated questions in osteopathy create a space for patients to open up and share their stories. By allowing patients to voice their thoughts, feelings and experiences, you gain a deeper understanding of their condition and perspective.

Mastering the art of calibrated questions requires finesse. These questions are intentionally crafted to invite more than a simple “yes” or “no” response. Instead, they encourage patients to share details, elaborate on their experiences and express their concerns. By becoming adept at asking calibrated questions, you’re setting the stage for more comprehensive discussions.

Empowering patients

Voss’s approach to calibrated questions hinges on fostering collaboration and understanding during negotiations. In the context of being an osteopath, these questions empower patients to actively participate in their treatment journey. When patients feel involved and engaged, they’re more likely to adhere to treatment plans and take ownership of their health.

For instance, instead of asking, “Do you experience any pain?” a calibrated question could be, “Can you describe the nature and intensity of your pain?” Although this may sound simple, this shift encourages patients to delve into specifics, painting a clearer picture for you. By giving patients the space to share their insights, you’re acknowledging their role as partners in their healing process.

Tailored treatment plans

Calibrated questions pave the way for personalised care plans. Just as Voss uses them to gather insights and tailor negotiations, osteopaths can utilise these questions to create bespoke treatment strategies. The information gleaned from calibrated questions enables you to understand not only patients’ physical symptoms but also their emotional state, lifestyle and expectations.

Imagine a patient presenting with chronic back pain. A calibrated question like, “How does your pain impact your daily activities and overall well-being?” unearths not just the physical discomfort but also the emotional toll it takes. Armed with this holistic perspective, you can craft a treatment plan that considers both physical relief and emotional well-being.

In essence, calibrated questions are a gateway to patient-centred care. They demonstrate your commitment to understanding the intricacies of each patient’s journey, allowing you to tailor your approach to their unique needs. By using these questions effectively, you’re not just treating ailments; you’re enhancing the patient experience through conversations that matter.

Lesson 4: Anchoring for patient-centred care

Anchoring, a concept highlighted by Chris Voss as pivotal in negotiations, finds resonance for osteopaths as well. Anchors set the tone and expectations for discussions, creating a framework for productive interactions. In the realm of patient-centred care, anchoring plays a crucial role in setting positive treatment trajectories, enhancing patient compliance to advice and fostering collaborative decision-making.

Setting positive anchors

In negotiation, anchors establish a reference point from which discussions evolve. Likewise, in patient interactions, setting positive anchors lays the foundation for a therapeutic relationship built on mutual understanding. By discussing treatment goals, outcomes and expectations upfront, you create a roadmap for the patient’s treatment journey.

Anchoring in osteopathy involves transparent conversations about what patients can anticipate from their treatment plans. It’s about discussing not just the medical aspects but also the emotional aspects of their healing process. When patients are aware of the journey ahead, they’re better prepared to actively engage in their treatment and recovery.

Enhancing patient compliance

Anchors also influence patient compliance—the extent to which patients adhere to treatment plans. Just as Voss uses anchors to shape negotiation outcomes, you can use them to shape patients’ commitment to their health. When patients are informed and aware of the process, they’re more likely to follow through on prescribed treatments.

For example, by anchoring the duration of a recovery period and the expected milestones, you’re managing patients’ expectations. Patients who know what to expect are less likely to become discouraged and more likely to persevere through challenging phases. Anchoring thus becomes a tool for enhancing patient motivation and resilience.

Collaborative decision-making

Anchoring in negotiations often influences the direction of discussions. In healthcare, it fosters collaborative decision-making. By involving patients in setting the anchor—discussing treatment goals, options and outcomes—you’re empowering them to actively participate in decisions about their health.

When patients have a say in their treatment trajectory, they’re more invested in their healing journey. Anchors become a starting point for discussions that respect patients’ preferences and values. By collaborating with patients, you’re acknowledging their role as partners in their care, fostering a sense of agency and control.

In essence, anchoring in osteopathy aligns expectations and empowers patients to take charge of their health. These anchors become guiding lights, offering patients a sense of direction and purpose in their healing process. By setting the stage for open communication, positive engagement and shared decision-making, you’re not just delivering medical care; you’re creating an environment of trust and collaboration.

Lesson 5: The power of “no” for boundaries

Chris Voss’s emphasis on the power of “no” in negotiations holds a valuable lesson for the practice of osteopathy. Just as “no” sets limits and shapes discussions, it serves as a tool for establishing professional boundaries, empowering patient discussions and ensuring ethical practice. By embracing the strategic use of “no,” osteopaths create an environment of clarity, trust and ethical care.

Establishing boundaries

In negotiation, “no” is a boundary-setting tool, signalling limits and shaping the negotiation process. Similarly, in the context of patient interactions, “no” becomes a means of clearly defining the scope of practice. It’s about acknowledging your expertise while respecting the boundaries of your training and specialisation.

For instance, if a patient requests a treatment outside of your area of expertise, asserting a well-considered “no” is vital. By explaining the reasons behind your decision and offering alternatives, you’re showcasing your commitment to their well-being. Clear boundaries foster respect and trust, ensuring that patients receive care aligned with your expertise.

Empowering patient discussions

Voss advocates using “no” to encourage concessions and prompt deeper discussions in negotiations. For osteopaths, “no” can be a catalyst for open conversations with patients. If a patient’s request isn’t in their best interest, saying “no” becomes an opportunity to explain your rationale and involve them in the decision-making process.

When patients understand why a particular treatment isn’t suitable, they become active participants in their care. Instead of a unilateral decision, the exchange becomes a collaborative exploration of what’s best for their health. By embracing “no” as a tool for empowerment, you’re cultivating a patient-practitioner relationship built on mutual respect and shared decision-making.

Ensuring ethical practice

Ethical considerations underscore the importance of “no” in both negotiations and healthcare. Just as “no” prevents undesirable concessions in negotiations, it safeguards ethical practice in osteopathy. Saying “no” when faced with requests that compromise patient safety or violate ethical guidelines is a duty to patient welfare.

For instance, if a patient requests a treatment that you know isn’t appropriate or safe for their condition, your ethical responsibility mandates a firm “no.” Upholding your professional integrity reinforces patient trust and reinforces the values of your practice. It’s about prioritising patient well-being over convenience.

In conclusion, “no” in osteopathy isn’t just a rejection; it’s a safeguard for patient care and ethical practice. By setting boundaries, encouraging patient engagement and upholding ethical standards, you’re cultivating an environment of professionalism, respect and responsible care.


“Never Split The Difference” by Chris Voss isn’t just about negotiation—it’s a blueprint for elevating your osteopathic practice.

Active listening, emotional intelligence, calibrated questions, anchoring and assertive boundaries—by making an effort to use these methods, you’re elevating patient care, forging trust and contributing to the long-term reputation of your practice.

Written by Alan Zaia M.Ost

Founder & CEO of Osteohustle. You’ll find Alan coaching osteopaths, travelling in a van or writing our weekly newsletter, The Hustle.

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