The Art of Persuasion

Understanding Ethos, Pathos, Logos, and Kairos, and How to Apply Them to Medicine

David Hendry, PA-C

Interacting with patients requires mastery of many types of persuasion. In one way or another we have all encountered these processes in discussions with our patients. Whether it be the manipulative drug seeker or the Angry family member. The pushover husband or the enabling wife. This article will help you master the art of persuasion with your patients.

A good friend of mine once said “ what we sell is advice”. Really isn’t that the reality of it? The rest is certainly up to the patient. Whether they take our advice, follow it, share it, its all relative.

Understanding how the modes of persuasion work can better help you identify and pick them out when having a conversation with a patient or family. Not only is a better understanding useful for your arguments but it is beneficial in seeing other peoples arguments as well. Look at it as a rulebook or a directors script. Because simply when you understand how the rules of persuasion work you are less susceptible to them.

Ethos

Is the ethical appeal. Better said, it means to convince or the audience based upon the authors credibility, character, or appeal. This is emotional persuasion working.

Advertising is one of the ways we most often see the modes of persuasion. This is the commercial with the gorgeous actor that is selling cologne. Come buy “Smell”, and the consumer thinks “ if I buy SMELL, I’ll be just like actor so and so. Any celebrity endorsement prompting a product. We even use this in our daily conversations with patients. Because we are Doctors or Nurse Practitioners, Physician Assistants, Nureses. Our title holds some weight, some standing in the community and have required some sacrifice to attain them. When we see Mathew McConaughey driving a Buick and we admire him, We want to buy a Buick. Likewise, if Sylvester Stallone says we should vote, it inspires people to go vote, and that is why ethos works so well.

Pathos

Comes from the Greek word for suffering or experience. As a mode of persuasion, it appeals to the audience on an emotional level. A common use would be to draw pity from someone or make them feel sorry for you.

How many of you have sat through an SPCA commercial and almost broken down in tears? What about the starving kids? Similarly, all the inspirational videos on YouTube. The music in the background, the buff athlete, You CAN do it, everyone’s getting pumped, I mean who doesn’t feel that. That my friends is Pathos hard at work. From a clinical standpoint who hasn’t had the drug seeker say, “I left my medication on the sink and my cat bumped it into the toilet, and I’m only here for a week from NY and I just need 1 refill, please, please, please.” By appealing to our emotions and making us feel sad sometimes our patients also try to get a desired outcome or action.

Logos

Is founded on Logic and reasoning rather than emotion or community standing. It’s the argument if A=B and B=C then A=C. This mode of persuasion works really well if someone is thinking logically. This when seen in advertisement is the cell phone commercial touting “Super retina XDR display.” When no one really knows what that is, but it seems special because of the scientific sounding language.

It doesn’t really matter if the audience understands the scientific jargon, just that they feel confident the ad is selling something they need. This is the case in medicine when you’re looking at a patient’s BMI and trying to tell them to louse weight. Or trying to explain the COVID vaccine and how it works. The success rate of a medication, the risk factors. Many times, patients do not understand the scientific jargon. They just know you feel confident and they trust your opinion, so they feel confident too.

It should be noted that sometimes all reasoning does not come to the correct conclusion. For example, say our friend Karen has a cough. And all people who have COVID have a cough. Can we conclude that Karen has COVID because she has a cough? No. She could have a cold, or allergies or dust.

This is an article in itself, however when looking at a trial or study all parameters should be looked at without making incorrect assumptions. This needs to be closely looked at with name brand medications, and drug brands that are asking you to promote them. 75% of people experience weight loss. 30% reduction in triglycerides, 10% improvement in overall life.

Kairos

Kairos is all about timing. The ancient GREEKS had two words for time. Chronos and Kairos. Chronos being the more quantitative. Minuets, hours, Seven o’clock. Kairos was more about WHEN to act. The speaker uses time and place to their advantage to persuade the audience. Like the time you asked your dad to borrow the car right after you finished washing it when you were a teenager. Or maybe the homeless guy that stands outside your church on Sunday morning with a sign. It’s the Holiday M&M commercials that would have no merit if advertised in June or July. It’s the poignant Political cartoon or silly meme of the President. A friend of mine once said, “ it’s not what you say but when”, this is Kairos.

In medicine we have somewhat of a captive audience. They are there for our opinion, advice. Sometimes they are desperate, destitute, alone, lost or angry. We as clinicians need to evaluate timing as much as what’s being said.

Concept in motion

This reminds me of the hilarious AT&T commercial from 2019. It opens with on a Patient in a bed, his wife holding his hand. His two kids in the background. The nurse is standing over him with a clip board.

The wife asks “ have you ever worked with Dr Francis?”

NURSE: “oh yea, he’s OK”

PATIENT: “ Just OK?”

and then rounding the corner in scrubs, a surgical hat and a lab coat is Dr Francis who yells down the hall, “Guess who just got reinstated” and as he enters the room he says “well not officially”.

The look of OH NO on the patient and his wife’s face

Dr Francis”: “Nervous?”

PATIENT “ yea”

Dr Francis: “Me too”, “Don’t worry about it, well figure it out,” “See ya in there!”

Then the ad ends in “Just OK is NOT OK“.

Now that you understand the differences in the modes of persuasion you will have a much easier time identifying them in your everyday patient interactions. In fact, this concept can also be applied to nearly every human interaction. If you run into trouble you can always ask questions about what you’re seeing, hearing or reading.

Is there a timeline or specific time?

Are a celebrities or Authority figures involved?

Does it include a percentage, or does it involve statistics?

Are your emotions being influenced?

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