Fostering a good provider/patient relationship both online and off

The rise in telehealth visits is changing how many providers build relationships with their patients. However, it’s more important than ever to connect with your patients. Here are some ways to foster a good provider/patient relationship on screen (and in person).

1. Practice mindfulness during patient interaction

Mindfulness techniques like active listening can be valuable tools when it comes to understanding your patients and helping them feel at ease. Concentrate not only on what your patient is saying, but also on how they’re saying it, and the body language they’re using. Looking at the full picture in this way gives you more information about your patient and their situation than only their words can give.

Conversely, make sure you’re mindful of your own body language as well. Maintain eye contact and lean forward to show that you’re paying attention, and nod when appropriate to show that you’re understanding them. Keep your posture open and unintimidating, which means not crossing your arms. These things combined help your patient feel more secure and like their concerns are being heard, and in turn help you gain a better understanding of their problems and goals.

2. Use technology effectively

While telehealth has changed how providers interact with their patients (see the results of our Provider Rountable COVID-19 survey for information about this change), this change doesn’t have to negatively impact your patient relationships. Telehealth has the potential to be more intimate, as your patients are speaking to you within their own homes. To help achieve this intimacy, make sure your home office setup is good. This is more than making sure your lighting, audio, and connection are suitable, though we describe how to do so in an earlier blog post.

For example, put your camera in a place that allows you to look into it the majority of the time, since you can’t meet your patient’s eyes in the conventional way. The height of your camera is important, too. Keep your camera at eye-level or slightly above it for the most pleasant view for your patient. If you have multiple monitors, be cautious about how often you look away from the camera to read them. Doing it too often will make your patients feel like they don’t have your full attention.

3. Strive for the mutual participation model

A study done on the provider/patient relationship cites three common models. The oldest one, the active-passive model, has the provider acting on the patient as though they’re an inanimate object. This model is generally considered inappropriate outside of medical emergencies. The guidance-cooperation model, meanwhile, has the provider serving as a knowledgeable guiding force who knows better than the patient and instructs them accordingly. The patient is expected to cooperate with the provider’s instructions. But the model that’s gained the most traction over the past few decades is the mutual participation model.

The mutual participation model is different from the other two models in that it’s based on an equal partnership between the provider and patient. Instead of placing the provider above the patient, this model acknowledges that the patient knows more about their own life experiences and goals for their health than their provider. The provider’s role is to help the patient achieve those goals. Under this model, input from both sides is necessary for a good outcome.

The study on provider/patient relationships also identified the four elements of the provider/patient relationship that are proven to increase patient satisfaction. These elements are trust, knowledge, regard, and loyalty. It’s not just that your patients need you to know how to make and keep them healthy, they also desire friendliness, emotional support, and continuity of care. The mutual participation model offers the best way for you to foster these elements in your relationships with your patients.

4. Look beyond the patient

Factors that neither of you can control can also exert influence over your relationship with your patient according to the study referenced earlier. These include: 

• The patient is new. A new patient doesn’t know you yet, and therefore doesn’t have any trust built up with you. At the same time, you aren’t yet familiar with the patient and their needs. Taking the time to get to know them and expressing warmth can go a long way to starting the provider/patient relationship off right.
• Poor prognosis. A patient with a poor prognosis may have less trust, knowing they may not be able to be cured. They may also fear being abandoned by their provider. Make sure your patient knows that you’re doing all you can for them, and find out what’s important to them and how to give them the best quality of life possible.
• Family pressure. Your patient’s family may not approve of you, with the reasoning that they know the patient better than you. To help mitigate this, demonstrate care for your patient and keep the family informed of your patient’s status to an appropriate extent.
• Language/cultural barriers. Your patient may have a different first language than you and/or come from a different culture. Language or cultural interpreters may be necessary to help you and your patient understand each other and build a rapport.

In addition to these and other outside factors, consider your own impact on the provider/patient relationship. Consider whether you might have unconscious biases that could potentially affect your patient interactions.