Three Ways To Manage The Mask Conversation

How do caregivers have conversations with patients who don’t wear masks when your clinic has a mask wearing policy? What do you say to a defiant patient comes into clinic just not wearing one and you have a policy on wearing them


It’s evident that wearing masks is a critical part of working toward protecting everyone from COVID-19. But not everyone is wearing a mask and we need to know how to have these conversations so they play out effectively.


Let’s start by reviewing the the latest about the protective benefits of masks.  

  1. Masks appear to reduce significantly the risk of viral transmission. A recent meta analysis released in Lancet in June 2020, looking at over 200 observational and comparative studies published through May, demonstrated a significant and strong protective impact of both social distancing as well as face masks. 
  2. An experiment using high speed video found that hundreds of droplets were generated by simply saying a phrase and speaking, and nearly all of these droplets were blocked when the mouth was covered by a cloth.  
  3. In an observational study, a man flew from China to Canada and subsequently tested positive for COVID-19. He had a dry cough and wore a mask on the flight. All 25 people close to him on the flight tested negative for COVID-19. 
  4. In late May, two hairstylists from Missouri had close contact with 140 clients while sick with COVID-19. Everyone wore a mask and none of the clients tested positive

In one simulation, researchers predicted that 80% of the population wearing masks would reduce COVID-19 spread more effectively than a strict lockdown.


So here are a few ideas for when when patients don’t play along.  

  1. Make your policy clear to everyone that this is your policy. Consider everywhere your policy should be announced: at the front door, on your website, within your employee communications, during bookings, during check in, at the appointment reminder so that it is over the-top-clear that masks are required in your facility. Be diligent about this.
  2. Everyone owns this. From environmental services to security to administrators to nurses to physicians–they should all speak up if someone is not wearing a mask.  
  3. Explain the options to patients. If a patient isn’t wearing a mask, try something like this, “Mr. Swift. There is good evidence now that wearing masks protect you, me, and everyone you come into contact with. I realize it’s a hassle, but we are committed to keeping everyone safe and wearing masks one hundred percent of the time. We have a mask for you if you don’t have one.” Be very clear on this. If they refuse, let them know that you can book a virtual visit for them but are unable to see them without a mask.


What are some communication approaches you have found effective in navigating conversations about mask wearing? Share in the comments what tips you use for having this tough conversation.

Providing support for clinicians in challenging circumstances such as managing mask conversations is essential during this time. Would you like to learn more about resources for fostering team supporting and improving the patient experience? Let us know on the Getting Started page.

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