How to Connect with Patients
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Elizabeth E. Hogue, Esq.
|A Special Communication, entitled “Practices to Foster Physician Presence and Connection with Patients in the Clinical Encounter,” by Donna M. Zulman, MD, MS, et al.; recently appeared in the Journal of the American Medical Association (JAMA) [2020;323(1):70–81. doi:10.1001/jama.2019.19003]. Although this article is directed to physicians, the activities described in the article also clearly apply to all practitioners. The article asks an extremely important question: What are the most promising practices to foster presence and connection with patients?
The study upon which the article is based identified the following five practices that will likely enhance presence and meaningful connection with patients during visits:
Prepare with Intention
Intentional preparation includes two key activities: (1) personalized preparation for the patient and (2) taking a moment to pause and focus.
Personalized preparation involves becoming familiar with the person about to be seen to facilitate a more immediate connection with the patient. Reviewing patients' charts prior to visits with them is an example of personalized preparation.
The second component of preparation requires taking a moment before or at the beginning of visits during which practitioners clear their minds of distractions and set the intention for encounters with patients. Practitioners sometimes engage in this activity while washing or sanitizing their hands prior to meeting with patients.
Listen Intently and Completely
This practice also includes two components: (1) listening with one's whole body using open and receptive body language and (2) avoiding interruptions.
The first component includes sitting down, leaning in, maintaining an open body position and orienting one's body toward patients. The goal is to convey openness and respect, as opposed to dominance.
The second key component of this practice is to avoid interrupting patients, especially during patients' opening descriptions of active health issues. Research shows that practitioners routinely interrupt their patients within eleven seconds! Practitioners should use silence and infrequent, timely and considered questions when patients are telling their stories.
Agree on What Matters Most
This activity focuses on discovering what is most important to patients and developing shared priorities. A key initial question is: “What is your main question or concern for today?” Toward the end of the visit, it is important to ask: “Is there something else you want to address today?”
Connect with Patients' Stories
This activity includes consideration of personal circumstances that influence patients' health and acknowledgement of patients' efforts, including celebration of successes.
With regard to the first component, practitioners should ask patients about their sociocultural background and life circumstances. Practitioners should “look at the world through the patient's eyes and walk through the world in the patient's shoes.”
Examples of the second component include positive language; such as statements of approval, empathy, and reassurance; offering praise for patients' efforts and acknowledgment of small successes.
Explore Emotional Cues
Practitioners should take note of patients' verbal and nonverbal emotional cues, such as changes in patients' tone of voice, facial expressions and body language. Practitioners should also elicit expressions of emotion from patients through questions such as, “How are you feeling about this?” Reflecting and validating perceptions of patients' emotions is also important.
Although emphasis on compliance with a myriad of regulatory requirements is certainly justified, the focus must remain on patients and encounters with them. In addition, effective interactions with patients may be the best way to ensure quality of care and manage risks.
©2020 Elizabeth E. Hogue, Esq. All rights reserved.
No portion of this material may be reproduced in any form without the advance written permission of the author.