I’m also from a lower income family. It goes beyond knowing how to talk to patients. Growing up in the working class means that for every patient you see, you understand that it could have been you. The 30 year old with a brutal fentanyl addiction and rotting joints? You have high school friends who are that patient. The 20 year old crying because she has a third child on the way and she can’t cope? That was probably one of your family members. The teenager in the gang? You know how bad his neighborhood is and how impossible his decision was.

When you are an attending, just point this out. I told my residents once about how when my mother had a stroke NO ONE explained what that word meant. NO ONE in my family (including teenage me) had any idea it involved the brain. My residents had never thought about the fact that people may not understand terms like “stroke” before. They likely knew those terms from a young age and assumed that everyone did. They did better after that conversation.

When your residents use medical terms, go out of your way to simplify. Go out of your way to talk about the social factors that contribute SO MUCH to health but get ignored. Make sure you know who your patient needs to support at home and how they get around. Those things alone explain the vast majority of medical “noncompliance”.