Fahad Aziz, MD, FASN, WMJ Editor-in-Chief
As clinicians, we know that “connecting” with our patients is a powerful tool. However, not all clinicians are able to establish this level of rapport. I faced the same problem early in my career as a resident in internal medicine, then as a nephrology and transplant trainee. My medical knowledge was excellent, and I could formulate strategic management plans for my patients; I used to discuss these plans with my attendings and colleagues, who frequently agreed with them. For these efforts, I was awarded the “Best Educational Resident” of the year for two consecutive years. However, despite these efforts, I never had good patient satisfaction scores, and it was an extremely frustrating feeling. But then, an incident changed my life.
I was reading John Maxwell’s book Everyone Communicates, Few Connect, in which he quotes Zig Ziglar: “If you help people in getting what they want, they will help you in getting what you want.” With this powerful statement in my mind, I reexamined what patients want and need in their relationship with their clinician. I looked around and found several excellent physicians who have an outstanding ability to connect with their patients: my cardiology attending at Jersey City Medical Center, Dr. Ameen Abdul Aleem; my nephrology fellowship chair Dr. Ramesh Khanna; and my mentor in transplant medicine, Dr. Arjang Djamali. It was astonishing to see how they established a “connection” with their patients, which was much more than just “communication.” I witnessed how several patients were sad and tearful at the news of Dr. Djamali’s move from the University of Wisconsin to Maine Medical Center. By carefully reviewing the qualities of these extraordinary physicians, I found that they all shared some unique attributes that set them apart from their colleagues. The first two qualities are essential to establishing a connection with patients, and the others are imperative for maintaining it.
Establishing a connection
Get to Know Them
To truly establish a connection, it is essential to learn more about a patient than what is included in their medical history. A few examples include learning the patient’s profession, hobbies, interests, and their spouse’s name. Knowing such simple things helps establish a good rapport, and starting a patient encounter by asking about their general well-being and interests offers a bridge for clinicians and patients to connect. It helps builds the patient’s confidence in their clinician, as they consider them someone who is genuinely interested in them and, in turn, their health-related issues. The clinicians who begin their conversations with direct medical questions are less likely to be able to forge this connection.
Listen to Patient Concerns
One of the most critical components of connection is listening. There is an old saying: “Fifty percent of medical problems would be cured if your physician just listened to your problems.” I have found this statement very accurate. With their busy schedules, many clinicians don’t have much time to listen to all of their patient’s concerns, and patients often feel rushed through their visits. Patient encounters are part of a clinician’s daily routine; however, one crucial thing we forget is that a brief patient encounter may be the single most important aspect of that patient’s whole day. They will think about each word their clinician says, and they will likely discuss it with their friends and family. To be “connecting” clinicians, we need to understand the importance of listening to our patients and the concerns they have.
Maintaining the connection
Communicate Clearly and Share Honest Opinions
Sharing your expert, honest opinion with patients helps to strengthen your connection with them but communicating complicated information in a way that’s understandable can be difficult. To help, I have seen outstanding physicians using a paper and pen or whiteboard while discussing complex issues and possible solutions with their patients. Difficult medical decisions are easier to make when the patient understands the problem and can share in decision-making. It’s human nature for them to accept the decisions where they have ownership.
Make Time to Answer Concerns
Another critical component of maintaining a connection with patients is giving them time to think through the issue and then making yourself available to answer any questions. It’s important to remember that all questions are valid. Patients should be encouraged to ask anything, no matter how minor or straightforward it may seem. Making them feel comfortable and answering their questions helps patients develop confidence in their clinician—and it’s a crucial component of maintaining an already established connection.
I firmly believe that hope is life. While clinicians must be honest with their patients, they should also try to convey to them any “silver linings” in difficult situations. Doing so can help patients find hope and strengthen an already established connection. I have seen firsthand that clinicians maintaining a positive attitude toward their patients is contagious, and miracles can happen with hope.
If we wish to be “connecting” physicians, it’s essential that we put extra effort into this vital relationship and that we also demonstrate the power and importance of connecting with patients with future health care professionals.