“We have to be very careful not to blame the patients.”
Victor Montori’s sentence invites a change in the question asked when care does not proceed as expected. He made the statement during a 2013 conference talk about patient engagement, as reported by the event’s organizer, MedCity News. The Mayo Clinic physician drew attention to the burden that health care can place on a person already managing the demands of life. His warning asks that blame not become an explanation before those demands have been understood. It is a useful distinction: noticing that a plan has not been carried out is different from knowing why. A conversation that stops at the observation may leave the important obstacle untouched. One that asks what happened can discover where an intended plan and an actual day failed to fit together.
Consider a patient trying to coordinate appointments with a work schedule that changes each week. A proposed time can appear straightforward on a booking screen and still require several arrangements outside the clinic. The person may need to ask for leave, find transport and decide who can take over a responsibility at home. If one part falls through, the appointment may become impossible to keep. None of this tells us what happened in every missed visit. It illustrates why asking is more informative than assuming. A conversation might begin with the practical difficulty and then explore what arrangements are available. The patient’s knowledge of their own schedule becomes relevant information, rather than a detail outside the discussion. That shift makes room for participation in working out the next step instead of assigning a motive from a distance.
Montori’s words do not mean that every difficulty has an easy solution or that professional advice should be disregarded. They encourage a clearer account of what a person is being asked to do and what makes it possible. Understanding that account can include discussing concerns, asking for an explanation of available choices and recognizing the time and effort that a plan requires. The conversation is most useful when it allows relevant problems to become visible before someone is judged for them. Readers supporting another person can use the same approach. Instead of offering a verdict about what they should have done, ask which part was difficult and whether there is something specific they would welcome help with. They may need assistance arranging a journey, preparing a question or explaining a conflict in their schedule. The choice should remain theirs. The quotation leaves us with an everyday standard for care: be curious about the work someone is doing, and be cautious about turning an unmet expectation into a conclusion about their character.
It encourages a question about why a plan was difficult to carry out. An unmet expectation is an observation, not a complete explanation.
The person’s account can identify an obstacle that assumptions would overlook.
A visit may require transport, leave from work and arrangements at home. These tasks exist beyond the booking screen.
The example does not explain every missed appointment. It shows why relevant circumstances deserve to be discussed.
Ask which part was difficult and whether practical help would be welcome. Let the person choose what is useful.
Clarifying a concern or preparing a question can support participation. A thoughtful offer begins with what the person says they need.
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