Editor's note: This story was updated on January 18, 2018.
It can be difficult to form a positive physician-patient relationship, but doctors can forge more meaningful bonds by working on a few key skills, Timothy Poulton, a family medicine physician at Mission Medical Associates, writes for Hospitals & Health Networks.
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Having a positive physician-patient relationship is vital, Poulton writes, but "collectively and individually, physicians are losing some of their capacity to form connections that are not only essential for an excellent patient experience but also for quality of care and safety." Workplace demands and "the lack of effective skills to address them strain physicians' ability to consistently deliver care in an efficient, caring, high-quality fashion," he says.
Poulton recommends five key skills physicians should work on to become better at engaging with patients and forming relationships with other care team members.
According to the Institute for Healthcare Excellence, about half of preventable errors—from wrong-site procedures to a patient withholding information from a doctor—are due to communication breakdowns.
Poulton writes that, as patients witness breakdown after breakdown in communication among their physicians, they slowly lose trust in the health care system at large. "Taking a deep breath and time for calm before knocking on the exam room door can take physicians to a place of presence," Poulton says.
To help prevent communication errors, physicians need to be present in the moment and engage in "reflective listening," Poulton says.
There's a right and a wrong way to listen to the patient, Poulton argues. To practice reflective listening, physicians need to listen to the person without interrupting. Interruptions aren't just verbal: They can include checking the person's chart or typing something into the computer.
"After you've listened, reflect what you heard back to the person," Poulton writes.
According to Poulton, information gathering and agenda setting "are inextricably combined."
Sometimes, Poulton writes, physicians can begin to address a patient's first concern without stopping to listen to the rest. Instead of beginning to address the first problem, he says physicians should ask the patient "What else?" to ensure they hear every concern. From there, physicians can work with the patient to determine what to prioritize.
Patients can get overwhelmed when receiving care, but physicians often don't know how to handle their patients' emotions. The reality, Poulton says, is that different patients prefer different responses from their doctors. Some respond well to respect, such as doctors telling them, "That was tough. You handled it well." Others feel validated when a physician legitimizes their emotions, such as saying, "Anyone would be (confused, sad, irritated) by this situation."
Finally, Poulton writes, it's important to acknowledge others on the care team. Showing appreciation and gratitude for their work strengthens bonds, Poulton writes, "and solidifies long-lasting, productive relationships."
"It is easy to lose [these skills] in the midst of hectic days and increasing demands," Poulton concludes, but "with consistent practice and use in clinical, professional, and personal lives, these skills are a path to stronger physician-patient relationships and a shift in organizational culture" (Poulton, Hospitals & Health Networks, 8/18).
Excellent patient experience is a critical piece of modern medicine, reflected clearly in outcomes. And more than amenities, clean rooms, or quiet during night, the factors that most inflect patient experience all relate to communication and coordination among the care team—factors that physicians are in a unique position to influence.
Clinician-patient communication, leadership of the care team, and support and empathy for the patient across the unit are the most important factors for success, and they're all driven by the physician as the "Influencer in Chief."
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