139. Five Ways to Connect With Patients

Being a patient can feel like a lonely experience, especially when you sense your doctor is disconnected. A rushed or disengaged interaction can leave patients feeling unheard and uncared for, no matter how clinically skilled the physician is. At the same time, doctors struggle with overwhelming workloads, which can lead to unintentional detachment from those they treat. 

In this episode, we explore five ways to build connection in the exam room quickly, why small gestures matter, and how intentional preparation can change the entire dynamic. Finally, we dive into the emotional complexities of patient care and the essential role of listening and presence in preventing burnout. Our conversation centers around the ‘Presence 5 Practices’ from this article. 

Guest Bio: Clay Smith, MD, is an Associate Professor of Emergency Medicine at Vanderbilt University. He is triple board-certified in Internal Medicine, Emergency Medicine, and Pediatrics and the founder of JournalFeed, which provides concise, daily summaries of top medical journal articles.

 

We Discuss:

Why Doctors are Disappointed with Their Doctors

• Even highly qualified physicians can feel let down by their own doctors when the human connection is missing.
• Patients often feel ignored or undervalued when their doctors fail to engage emotionally, even if the care is clinically sound.
• A rushed medical interaction can feel impersonal, making patients perceive the care as lacking.
• Many patients notice when their doctor seems distracted or disengaged, which can undermine trust in the relationship.
• Most physicians acknowledge that they sometimes provide care while feeling detached or pressed for time, reflecting the same disconnection they may criticize.

Why Genuine Doctor-Patient Connections Matter More Than You Think

• Patients are more likely to trust their care when they feel their doctor is fully present and engaged.
• Rushed interactions can leave patients feeling unimportant or as if they’re just another item on the doctor’s to-do list.
• Physicians face the challenge of balancing clinical demands with the need to give patients their undivided attention.
• The emotional reassurance of feeling cared for often plays a larger role in patient satisfaction than clinical precision alone.
• Building a genuine connection with patients requires slowing down and being mentally focused in each encounter.

Easing Patient Anxiety and Shame

• A simple reassurance that seeking care was the right choice can significantly reduce patient anxiety.
• Patients often carry feelings of shame, especially when they fear their concerns are not serious enough to warrant attention. The right words from a clinician can quickly ease stress and foster a trusting patient-doctor relationship.
• Validating even minor concerns is essential for building a strong, compassionate connection with patients.
• Dismissing patient worries, particularly with frequent visitors, risks clinician burnout and erodes empathy over time.

The Impact of Preparation and Focus on Patient Care

• Preparation with intention, like reviewing a patient’s chart before walking in, shows respect and attentiveness and sets the stage for a more focused encounter.
• Familiarizing oneself with the patient’s full story, including any underlying conditions, avoids missteps and fosters trust.
• Developing a ritual to mentally reset before each patient encounter can help physicians remain present.
• Small gestures like remembering a patient’s name or connecting on something personal can strengthen the doctor-patient relationship.
• Being rushed can lead to oversights, such as prescribing harmful treatments due to lack of preparation.
• These simple, time-efficient actions have a powerful effect on how patients perceive the quality of their care.

Listening Intently and Completely

• Active listening without interrupting for at least one or two minutes can give a patient the feeling of being heard.
• Sitting down during conversations gives patients the perception that the doctor spent more time with them, enhancing trust.
• Effective use of silence encourages patients to open up more, while interruptions can disrupt the flow and erode trust.
• Taking notes during patient conversations can help ensure all concerns are captured without forgetting details.
• Fully listening allows doctors to understand the true concerns behind a patient’s initial complaints, leading to more effective care.

Aligning Care with Patient Priorities

• Establishing a plan that aligns with the patient’s concerns and priorities, rather than focusing solely on clinical findings, is essential for a productive and satisfying encounter.
• Asking explicitly, “What concerns you most about this issue?” helps clarify the patient’s main fears and guides the conversation.
• Setting clear, realistic expectations about treatment and outcomes reduces the risk of disappointment and miscommunication.
• Addressing the patient’s most significant worry upfront avoids surprises and ensures a more aligned care plan.Creating an agenda based on the patient’s top priorities ensures a more productive and satisfying encounter.

Building Trust by Connecting with the Patient’s Story

• Recognizing the patient’s life circumstances, values, and background fosters a deeper, more empathetic connection.
• Finding shared personal ground can strengthen trust between doctor and patient. Small gestures, like discussing hobbies or personal interests, can make the doctor-patient relationship feel more human.
• Understanding cultural or familial factors, such as the role of extended family, helps doctors offer more personalized care.
• Validating the patient’s story and acknowledging their efforts makes them feel seen as a whole person, beyond their diagnosis.

Understanding Emotional Cues

• Fear often presents as anger in patients, and addressing the fear can help de-escalate tense situations.
• Picking up on both verbal and non-verbal cues is essential to truly understanding a patient’s emotional state.
• Offering validation, even when you can’t solve the immediate problem, reassures the patient and strengthens trust.
• Simply acknowledging that the patient’s feelings are valid can make them feel heard, even in challenging discussions.
• Emotional intelligence is key to navigating difficult conversations and resolving underlying concerns effectively.

The Delicate Balance of Antibiotic Stewardship

• Many patients expect antibiotics for viral infections, which leads to difficult conversations about appropriate care.
• Doctors must explain the risks of overprescribing, such as antibiotic resistance and side effects like C. diff infections. Providing alternatives and validating the patient’s symptoms can soften the refusal of antibiotics.
• Post-dating prescriptions for use only if symptoms worsen helps manage patient expectations without unnecessary prescribing.
• Balancing patient satisfaction with responsible antibiotic use requires both empathy and clear communication.

Understanding Fear Behind Patient Anger

• Patients often present with anger when they are actually afraid, and recognizing this is key to de-escalation.
• Addressing the underlying fear can provide emotional relief and help build a stronger connection.
• Empathy and understanding, rather than a focus solely on clinical outcomes, enhance the patient’s experience.
• Emotional support, such as validating a patient’s fears or concerns, can help diffuse intense situations.
• Physicians who look beyond the anger to the fear driving it can foster more productive and compassionate interactions.

References

Zulman, Donna M., et al. “Practices to foster physician presence and connection with patients in the clinical encounter.” Jama 323.1 (2020): 70-81. Full text