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Monday, January 20, 2020
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5 Key Practices that Improve Provider-Patient Relationships

New research out of Stanford aims to solve the challenge that many providers face when building relationships with patients.

Donna Zulman, MD, and Abraham Verghese, MD, MACP, of Stanford, have been focused on researching ways to improve patient-provider relationships for more than two years. They aimed to solve some of the factors that have contributed to both patient and provider dissatisfaction, such as mandated times on visits, increased administrative tasks and shifting technology.

Ultimately, they’ve found shorter visits and more digital demands diminish interaction and relationship building, which, in turn, can lead to linked to frustration, compassion fatigue and burnout.

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But now, thanks to months of surveys with both patients and providers, Drs. Zulman and Verghese may’ve cracked the code behind a perfect patient visit. In their report published in the Journal of the American Medical Association, they outline five key practices for providers to prompt more meaningful interactions with patients.

It all boils down to the following:

Prepare with intention.

Try it: 1-minute chart review and deep breathing before each patient visit

Make time before seeing a patient to “pause and focus” by reviewing the chart and practicing a grounding behavior, like taking a few deep breaths. You may also want to prepare some follow-up questions on the patient’s history, especially social. In the absence of a chart, the researchers found that getting a quick verbal update from the team member who roomed them can be helpful.

Listen intently and completely

Try it: Use open body language, ex. Don’t put your back to your patient while looking at the computer; don’t interrupt

Although you may argue that of course you are listening intently and completely with every patient visit, Drs. Zulman and Verghese found that body language is key here. For instance, sit down at an equal level with the patient, lean in and convey an open stance. Consider sharing the computer screen as you converse instead of putting your back to the patient while you look at the chart.

They also found that, on average, physicians interrupt their patients after an average of 11 seconds of speaking, so make an effort to let your patient speak freely.

Agree on what matters most

Try it: Set the agenda at the beginning of the visit and use “something” instead of “anything” language

It’s called “doorknob syndrome,” and most of us have encountered it — when a patient brings up a new concern as you grab the doorknob to leave. 

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To avoid it, set a clear agenda at the start of the visit. You might say something like, “What is your #1 concern today?” to help stay on task. And before turning to leave, ask “Is there something else you’d like to discuss today?” instead of throwing out something more opened-ended, like “Is there anything else I can do for you?”

Connect with the patient’s story

Try it: Recognize the personal factors of your patient’s condition and praise efforts

Evidence-based practice is crucial, but it doesn’t always create a super personal experience. Recognize that there could be a matrix of issues contributing to your patient’s conditions or other problems, and incorporate their comments into into your conversation and care. 

The study also found that patients and providers were more satisfied when the visit included positive language. Try commending patients for taking steps to better their health instead of chiding them for waiting so long for a check-up. This approach can also improve patient adherence, the researchers said.

RELATED: Psychosocial Care: The Too Often Overlooked Key to Successful Patient Outcomes

Explore emotional cues

Try it: Use language such as “I can see this is difficult for you,” or “How are you feeling about this?”

Even small steps to show your empathy can make a difference. Pay close attention to patients’ body language, tone of voice and facial expressions to know when to delve deeper into an issue. If you’re at a loss for words, try something simple, like, “I see how hard this has been for you,” or “How have you felt about this issue?”

Of course, employing emotional-response strategies could prolong your visit (the horror, right?), but there’s evidence that when providers “actively attend” to patients’ emotional concerns and respond, illnesses are less severe and have shorter recovery times.

By now, you might’ve noticed that all these recommendations come down to authentic human connection.

As the authors note: “Human connection remains central to medicine but is in jeopardy in the current health care environment. In an era of increasing reliance on technology for health records, diagnosis, and treatment, recognizing and prioritizing the value of human connection and care are crucial.”

References:

Practices to Foster Physician Presence and Connection With Patients in the Clinical Encounter, JAMA Network.

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