Today in the chart

5 Key Practices that Improve Provider-Patient Relationships

Simple steps such as chart review, open body language and reading emotional cues can help foster a better connection.

New research out of Stanford aims to solve the challenge many providers face when building relationships with patients. Donna Zulman, MD, and Abraham Verghese, MD, MACP, have been focused on researching ways to improve patient-provider relationships for more than two years. They aimed to solve some 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 frustration, compassion fatigue, and burnout. Thanks to months of surveys with both patients and providers, Drs. Zulman and Verghese may have cracked the code behind a perfect patient visit. Their report published in the Journal of the American Medical Association outlines five critical practices for providers to prompt more meaningful patient interactions. 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 follow-up questions on the patient’s history, especially social ones. Without a chart, the researchers found that getting a quick verbal update from the team member who roomed them could 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 essential here. For instance, sit at an equal level with the patient, lean in, and convey an open stance. Also, 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. To avoid it, set a clear agenda at the start of the visit. For example, you might say something like, “What is your #1 concern today?” to help you 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 open-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 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 your conversation and care. 

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

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?). Still, there’s evidence that when providers “actively attend” to patients’ emotional concerns and respond, illnesses are less severe and have shorter recovery times.

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 healthcare 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.”

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