The 3 R’s in 20 Minutes:
Dr. Fanestil’s Approach to Helping Patients Rethink Chronic Pain

When you have just 20 minutes (or less) with a patient, especially one navigating chronic pain or complex health issues, the way you show up in the room as the care provider can make all the difference. Over the course of more than 30 years of practicing medicine, I’ve developed a simple yet powerful model to support doctors in introducing a new treatment pathway in a compassionate, relationship-centered way.

It’s called the 3 R’s: Repeat, Respect, Reframe. These steps allow you to move from a “fix-it” mindset to a relationship-driven one that empowers your patients. Here’s how to do it:

Step 1: Repeat Back

Listen first. Reflect back.

Start by giving your patient the space to briefly share their story. It doesn’t take long, just a minute or two. You might hear them talk about:

• A flare-up of chronic pain that medication didn’t quite resolve
• Ongoing stomach pain
• A recent traumatic event, like a family accident or divorce

Then, repeat back what you’ve heard. This is about more than nodding – it’s about demonstrating you’re fully present. Say something like:

“It sounds like you've been dealing with this pain for half a year, and the medications haven't provided the relief you hoped for. That must be incredibly challenging.”

This kind of listening breaks through the clinical rush. Your patient will feel heard, accepted, and respected. Many times, all I have done is repeat – almost verbatim – what the patient has just told me, and the patient will respond, "Yes! That's what happened!" To me, it is obvious that I just repeated back verbatim what they said. But, to the patient, it is (surprisingly) obvious that I completely heard what they said.

Why it matters:

When patients feel listened to – not just for their symptoms, but for their story – they’re far more open to the care plan you’re about to propose.

Step 2: Respect How Difficult It's Been

Acknowledge the struggle. Pause.

Next, step out of “diagnose-and-treat” mode and reflect on the emotional toll their journey has taken.

You can say:

“I want to pause for a second. Just listening to everything you’ve been through, I can feel how heavy this has been. That’s a lot for anyone to carry.”

This moment doesn’t need to be long. Even a 10-second pause of just sitting together in shared awareness can be incredibly healing. This approach may come naturally to some clinicians, but for me, it felt formulaic and a bit patronizing when I first tried it. However, for all patients universally, when I verbally recognize how difficult this must have been for them, the response is an emphatic "thank you for acknowledging!"

Why it matters:

This is often the first time anyone has validated their experience in a clinical setting. You’ll see the shift. Their body language changes. They breathe more deeply. You’ve earned their trust.

Step 3: Reframe

Turn the narrative from suffering to strength.

Now you help the patient see themselves in a new light: not as broken, but as resilient.

"Despite everything we just talked about, you’re still getting out of bed, taking care of your child, visiting your mom, walking the dog — you’ve kept going. That takes serious strength. You’re already doing what many people would find impossible.”

This is your bridge to introduce Lin Health’s pain signaling treatment:

“That’s exactly why I think Lin Health could really work for you. It’s not about sending you somewhere to ‘cope better’; you’re already doing a great job at that.  It’s about building on the strength you already have. And Lin Health has figured out how to make this treatment accessible virtually from home and covered by insurance.”

Why it matters:

Patients light up when they realize their efforts are recognized. This reframe makes them receptive. They go from skeptical to “I’m in.”

Conclusion: The Power of Your Presence

As physicians, we often underestimate how strong the provider-patient bond really is. Patients respect their doctors deeply. If you shift from a “do” mode to a “listen and relate” mode, your patients will follow your guidance because they trust you.

The 3 R’s model isn’t hard. In fact, the more you do it, the easier it becomes. And in just 20 minutes, you can lay the foundation for lasting healing.

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What if your patient asks more questions about Lin Health’s treatment? Check out Dr. Echterling’s 5 steps to introducing patients to pain signaling treatment.

Interested in more insights from Dr. Fanestil? Don’t miss his TEDx Talk on the new neuroscience of brains in pain: “Chronic Pain and Anxiety: Why Doctors Get It Wrong & How to Hack Your Brain.”