Patient and physician communication forms the backbone of medical care. The patient's ability to describe symptoms and the doctor's and/or nurse's "ability to explain, listen and empathize has a profound impact on a patient’s care". In fact, when doctors and nurses don't take the time to stop and listen to their patients, many may have traumatic stress reactions go undiagnosed. When not treated, these reactions can have serious implications for medical treatment and health outcomes, such as adverse health outcomes, poorer treatment/medication adherence, and worse functional outcomes, and can represent a "hidden cost" to the health care system.

However, when doctors and nurses improve communication through principles of trauma informed care, patient-physician interactions are viewed with an understanding of not only the traumatic aspects of injury, illness, or medical care, but also with an understanding that additional outside stressors, such as family issues or lack of social support, can affect the patient and family's ability to cope, and thus ultimately affect health outcomes.

Asking questions, or conducting a more formal assessment, helps facilitate this type of communication. The DEF protocol is designed as a practical tool to guide health care providers in implementing trauma-informed pediatric care and helps providers identify what they can do to address and prevent traumatic stress responses and improve health outcomes.