How to Strengthen Patient Communications and Relationships

Maintaining positive relationships and communication with patients is important, but increasingly difficult in this changing healthcare environment. Physicians and providers today face growing barriers to connecting with their patients, including: cultural and language differences with an increasingly diverse patient population, the need to spend time facing a computer during appointments, shortened clinical visits, and time spent on coaching those with an unhealthy lifestyle.

When doctors’ ability to listen to patients is limited, they can miss important health cues and misdiagnose illnesses. Meanwhile, patients who don’t understand their doctors fail to follow their regimens. This can lead to preventable hospitalizations, complications and poor outcomes.¹ Additionally, a breakdown in physician-patient communication is cited in 40% or more of malpractice suits.²

Most physicians and providers report their relationships with patients as being exceedingly important to their job satisfaction, and are disappointed and frustrated when this aspect of their practice is hindered. Beyond that, poor communication and relationships with patients can lower satisfaction scores and negatively impact income and employment prospects.

It’s more important than ever to be intentional in engaging with your patients, exchanging information and building positive rapport.

Suggestions for strengthening patient communication and relationships.

Treat your patients as partners.

In her article “Improving Physicians' Communication Skills” Karen Cook emphasizes the importance of treating patients as partners by allowing them to participate in decision making - keeping in mind the importance of two-way communication. She adds, “You should be willing to modify the treatment plan based on patient input.”³

It’s important to remember patients are the ones who will be implementing and carrying out the plan when they are discharged and may have a clearer sense of realistic expectations based on their lifestyle.

Address patient lifestyle concerns directly.

Influencing unhealthy lifestyles is a challenge for most physicians. The American Academy of Family Physicians suggests⁴ having a direct, focused conversation with your patients on the topic, and offers the following advice:

• Expect resistance to any suggestions you make related to a change in patient behavior
• Avoid focusing on negative impact of current behavior, and assist the patient to see the benefits of change
• Allow your patient to express concerns about changing their behaviors, including the most difficult aspect of changing for

With your limited time, it’s unlikely you can provide in depth lifestyle coaching, so be prepared to encourage your patient to tap into the many resources that do exist for supporting lifestyle change. Additionally, it may be useful to pass on educational resources, articles and pamphlets.

Be aware of patients' cultural beliefs.

Health care providers must know and understand culturally influenced health behaviors. The Washington Traumatic Brain Injury Strategic Partnership Advisory Council suggests that a person's cultural background can influence views on:

• Family structure and authority
• The role of an elder
• Respectful communication
• Proper behavior
• Dress and personal hygiene preferences
• Food preferences

They recommend becoming aware of the patient and family's cultural beliefs when providing instruction on medical care can improve effectiveness.⁵

Be mindful of not letting your computer get in the way.

The article “Physician-Patient Communication Tips when Using EHRs” offers the following suggestions for things doctors can do lessen the strain EHRs place on communication:6

1. Be prepared. Go over patient records ahead of time to minimize time looking at the screen.
2. Be open. Strategically setting up the computer in the exam room can positively influence communication.
3. Eliminate barriers. If you're not ready to be completely transparent with the patient’s record, position the computer appropriately so it doesn't create a barrier between you and the patient.
4. Be upfront. If the computer is positioned poorly and you cannot move it, explain why your back is turned and what you are doing.
5. Explain thoroughly. Summarize what you are typing to confirm and verify the information and reassure the patient.
6. Finally, make it clear to the patient that you are using the EHR to document some of the things that you’ve discussed so you have a consistent record.

We Can Help

For assistance in strengthening communication with your patients, care teams or leadership, call VITAL WorkLife at 877.731.3949 or through the VITAL WorkLife App to schedule an appointment with a Peer Coach who specialize in this area. Most confidential sessions occur telephonically or through a video platform such as Zoom.

Sources:

1. Kelley J, Kraft-Todd G, Schapira L, Kossowsky J, Riess The Influence of the Patient-Clinician Relationship on Healthcare Outcomes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. PLoS ONE. 2014;9(4):e94207. doi:10.1371/journal.pone.0094207.
2. Landro The Talking Cure for Health Care. WSJ. 2016. www.wsj.com/articles/SB10001424127887323628804578346223960774296.
3. Improving Physicians' Communication Hhnmag.com. 2015. 
4. 4 Tips On Building Doctor Patient Relations. American Academy of Family Physicians Division of Medical Education; 2016. www.aafp.org/dam/AAFP/documents/medical_education_residency/fmig/tips_relationships.pdf.
5. Cultural Diversity and Communicating with Patients - Washington State Traumatic Brain Injury Council. www.tbiwashington.org/professionals/providers_diversity.shtml.
6. Westgate Physician-Patient Communication Tips when Using EHRs. Physicians Practice. 2016. www.physicianspractice.com/blog/physician-patient-communication-tips-when-using-ehrs.