Maybe it should be easy, but there are a lot of factors that can get in the way of the doctor-patient relationship.
From quick visits to all that typing into the electronic health record, there are obstacles when it comes to physicians connecting with patients in a clinical encounter.
“Time constraints, technology and administrative demands of modern medicine often impede the human connection that is central to clinical care, contributing to physician and patient dissatisfaction,” said authors of a new study from Stanford University's School of Medicine on physician-patient relationships in JAMA.
There are some keys, however, that can help busy clinicians with multiple demands and distractions make those interactions meaningful, the study found.
A panel of researchers, clinicians, caregivers, patients and health system leaders reviewed 73 published studies, observed primary care encounters in three diverse clinics and interviewed doctors, patients and nonmedical professionals whose occupations involve intense interpersonal interactions. They generated 31 ideas and narrowed those down to five practices:
- Prepare with intention. Take a moment to prepare and focus your attention before greeting a patient.
- Listen intently and completely. Sit down, lean forward and don’t interrupt the patient.
- Agree on what matters most. Find out what the patient cares about and make those health priorities part of the visit agenda.
- Connect with the patient’s story. For instance, consider life circumstances that influence the patient’s health. Acknowledge positive efforts and celebrate successes.
- Explore emotional cues. Tune in, notice, name and validate a patient’s emotions.
Those steps can work to create a better experience for both doctors and patients, said the study’s lead author, Donna Zulman, M.D., an assistant professor of medicine at Stanford University School of Medicine
“We were looking for practices that would improve the experience of patients and lead to better care for them, but would also improve the experience of clinicians and help them to rediscover the joy of medicine,” said Zulman, who is also the director of Stanford Presence 5, one of the several initiatives of the school’s interdisciplinary center that promotes the art and science of human connection in medicine.
“As physicians, we are privileged to work with people in their most vulnerable moments,” she said. “And in today’s climate, particularly in primary care, it’s easy to lose sight of that with all of the administrative demands, time pressures and technology distractions.”
Zulman said the next step is to evaluate how using the five practices affects the experiences of patients and clinicians. The study authors said also needed are system-level interventions to create a supportive environment for doctors and other clinicians to implement the practices.