Building Trust Patient Rapport
As a new graduate I was so focused on getting the diagnosis right, figuring out billing, and simply adjusting to a new stressful world of medicine. Patient relationships were not paramount in my mind. Looking back, I’m guilty of acting more knowledgeable than I was to impress patients and have them trust me. Little did I know, if I had sought to develop a relationship first, the trust would more naturally follow. Trust is so vital in our work. Many would agree that having a patient’s trust is often more important than getting the correct diagnosis. Of course, nailing the diagnosis is important, but how many times in our clinical sojourn have we been wrong? No one is right 100% of the time (especially with complicated conditions). Relationship and trust afford patient collaboration and forbearance during the investigative and confirmatory phase of a diagnosis or treatment plan. Ultimately, patients understand that you may not have all the right answers or that you may not be able to cure them, but they will trust you are doing your best and you are working in their best interests.
Building trust can be easier than you think. Here are some ways I build trust with my patients.
Trust building starts from the first seconds of the first interaction. I introduce myself to every individual in the exam room, welcome them to the practice, and inquire about any prior dermatology office encounters. I sit down immediately and ask the patient a few personal questions unrelated to their charted skin complaints. By sitting, even for just a minute, it demonstrates an unhurried desire to talk to them about them. It rarely delays a visit, but lays the foundation for relationship and trust. At the conclusion of that initial visit, I review and summarize my clinical impressions, the treatment plan, and expectations for follow up…but just as importantly, they are welcomed into our practice family and are treated as such! They are encouraged to call if there are any problems with our plan, their condition, or with prescriptions. Ultimately, patients should leave with the comfort and confidence that we are working for them.
My nurses document personal patient details, such as why they moved to the area, how many kids they have, or what they do for a living. At subsequent visits, this information reminds me that the patient is more than a hair loss, acne, or psoriasis. Moreover, I love the look of surprise on a patient’s face when they realize I ‘remembered’ something personal from previous encounters.
Other ways to build trust is by treating patients with respect, no matter what their age. I engage with little kids with gifts like stickers or by blowing up a glove balloon and drawing a face on it. These small connection points allow them to engage in the visit so that when asked to show their rash or bump(s), they feel more in control of the situation. Similarly, teenagers feel more respected when addressed directly about their condition and treatments, even if it means ignoring the parent that is trying to talk over everyone. I tell the parent, I am asking your child these questions because they are old enough to help in planning their treatment, thus becoming more invested in the process. Plus, politely defending the teenager further builds trust.
Patient Support and Support from Patients
I have been able to enjoy the unusual and fortunate experience of practicing dermatology in the same office for 21 years. The relationships that have developed over two decades has been amazing. I have laughed and cried with my patients and watched many patients grow up, get married, and then bring me their children. When it comes to my favorite elderly couple (now married for 70 years), I can tell you “who first flirted with who;” and I will never forget hugging a recently-widowed patient for an entire visit while they sobbed through the emotions of having their first Christmas alone.
My patients also have lived through my experiences, including my two pregnancies. One patient often recalls the surgery I performed on him while I was very pregnant. In order to successfully complete the procedure, my belly had to be basically parked on him. Halfway through the surgery, the patient laughed and shouted, “I think your baby just kicked me.” Now I joke with that same patient about that baby driving a car!
The relationships we build have value and we can make an impact whether we see the patient just once or every three months for 20 years. I consider my patients family and I try to treat them as such.
Seeking to build relationship and trust will allow a provider to build a family of patients. For me, this “building family” perspective has increased work satisfaction and improved overall quality of life. Focusing on gaining relationships through my medical training and skills makes me look forward to work each day. I no longer dread my schedule or a particular patient complaint. Every appointment is an opportunity to engage, share, and experience life together!
Vicki Roberts PA-C is a dermatology PA at Palmetto Dermatology in West Columbia, SC where her clinical focus is general dermatology and surgery. She also keeps busy with her two always hungry teenage boys, two loving dogs, and one sassy cat.