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ME & OU | Sept/Oct '20

Doctor-Patient Relationships

The ABCs of successful patient interactions.

Each visit with a patient offers a new chance to forge a relationship, build trust, and provide exceptional care. According to author, speaker, and customer service and experience expert Shep Hyken, “Every interaction you have is an opportunity to make a positive impact on others.”1 As physicians, we should strive to use every encounter with a patient to improve their health and quality of life.

Our knowledge, skills, character, habits, and manners can all influence our relationships with patients. Thus, it’s important to have the proper tools at our disposal to ensure the success of each patient interaction. Based on my experience, here are the ABCs of cultivating and maintaining successful doctor-patient relationships.

Ability and Knowledge

Every medical practitioner is expected to have adequate diagnosis and treatment skills. If a diagnosis falls outside the physician’s area of expertise, they should first reassure the patient with honesty and then explain that a consultation with or referral to a colleague may be warranted. In this scenario, I have found that patients always appreciate a truthful explanation.

Patients today are more informed about their conditions than ever, so it is important that every member of their health care team is updated and able to offer the best individualized care possible. In a recent survey of health care consumers performed by a private US health care provider, patients reported that the competence of their nurses and other staff members was almost as important as the competence of their doctors.2 Surround yourself with knowledgeable staff members who share your interests and values.

Balance and Patience

Remember that time is precious to patients as well, and when they are in our office, they should know that they come first. Although patients are aware of our busy schedules, they don’t want to feel rushed out, so take the time to be an active listener and respond in a helpful manner. Sometimes just a few minutes of listening to a patient explain their ailment can guide you to a diagnosis. From there, a patient and careful explanation of the treatment strategies and instructions is key for a successful outcome.

Most patients accept that complications may arise. However, no patient will forgive you for not taking the time to explain a complication when it occurs, or worse, for not disclosing it. This behavior only leads to mistrust.

An observational study by Gross et al3 showed that, by prolonging the duration of a visit, a physician had the power to affect a patient’s satisfaction with their care. Patient satisfaction can be improved by small efforts, such as having a brief personal chat with the patient that demonstrates consideration for them as a human being3 and increasing the ease with which patients can schedule an appointment at your practice.2

Care and Compassion

It has been said that “The patient will never care how much you know until they know how much you care.”4 Medical practice should involve the expression of empathy toward others—after all, the patient’s well-being is our ultimate objective. In every interaction with a patient, the physician should try to establish bonds of trust. In difficult moments, a comforting, warm tone of voice may provide the patient with the compassion they need to get through whatever they are facing.

In addition, patients should be encouraged to engage in their own care. They should fully understand all of their options and the possible outcomes and know that have a say in every decision. As medical practitioners, we should always provide patients with as much information as they need to make a well-informed decision about their care. Finally, respecting whatever decision they make will help you to earn the patient’s trust.

Communication Skills

Physicians should be able to communicate effectively with their staff and with patients and their families. Assertive conversations approached with confidence and compassion are important when explaining the details of medical conditions and treatment options. Avoid clinical jargon and look for simple examples to explain complex situations.

In a review on doctor-patient communication, Fong Ha and Longnecker concluded that doctors with better communication and interpersonal skills may detect problems sooner, thereby minimizing medical crises and the need for more expensive interventions. This, in turn, may lead to improved outcomes and patient satisfaction as well as to reduced costs of care, greater patient understanding of health issues, and better adherence to treatment.5

Emotional Intelligence

Taking care of others carries significant responsibility and can be stressful at times. In order to cope with this stress in a healthy way, medical practitioners need to be emotionally intelligent and stable. Emotional intelligence not only improves the doctor-patient relationship but also enhances patient safety.5 In relation to patient care, Mayer et al6 maintain that emotional intelligence is based on four abilities:

1. The ability to correctly identify emotions in one’s self and in others;

2. The ability to use emotions in the reasoning process;

3. The ability to understand emotions; and

4. The ability to deal effectively with one’s own emotions in emotional situations.

CONCLUSION

A successful doctor-patient interaction requires the use of multiple the tools in the physician’s toolbox. When engaging with a patient, utilize your knowledge and abilities, exercise compassion and emotional intelligence, remain patient, and communicate honestly and effectively. In addition, always keep in mind these two principles, which should prevail in every doctor-patient interaction:

  • “Do unto others as you would have them do unto you”; and
  • Primum non nocere,” or “First, do no harm.”

1. Hyken S. On being ‘real.’ Accessed October 27, 2020. https://hyken.com/customer-relationships/on-being-real/

2. Survey of Healthcare Providers. Weatherby Healthcare. 2017. Accessed October 26, 2020. https://weatherbyhealthcare.com/blog/weatherby-healthcare-modern-patient-survey

3. Gross DA, Zyzanski SJ, Borawski EA, Cebul RD, Stange KC. Patient satisfaction with time spent with their physician. J Fam Pract. 1998;46:133-137.

4. Tongue JR, Epps HR, Forese LL. Communications skills for patient-centered care: research based, easily learned techniques for medical interviews that benefit orthopeadic surgeons and their patients. J Bone Joint Surg Am. 2005;87:652-658.

5. Fong Ha J, Longnecker N. Doctor-patient communication: a review. Ochsner J. 2010;10(1):38-43.

6. Mayer JD, Salovey P, Caruso DR. Emotional intelligence: a new ability or eclectic traits? Am Psychol. 2008;63:503-517.

author
Jorge R. Hernández-Cospín, MD, BSc
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