Five Practices to Strengthen the Physician-Patient Relationship

A new study authored by Stanford Medicine 25’s Donna Zulman and Abraham Verghese shares five practices they say can “enhance physician presence and meaningful connection with patients in the clinical encounter.” Their research, published in JAMA, outlines application for the following evidence-based exercises. They write that:

• Preparing with intention requires “personalized preparation for the patient” and “taking a moment to pause and focus” before the clinical encounter. These two components are critical to physician presence and will facilitate “a more immediate connection with the patient.”

• Listening intently and completely, specifically avoiding interruptions and using open and receptive body language and positioning, will support “relationship building, trust, and patient satisfaction with treatment.”

• Agreeing on what matters most “is at the core of patient-centered, humanistic care, and when achieved early in the visit, helps set the stage for meaningful encounters.”

• Connecting with the patient’s story requires consideration of the “personal circumstances that influence a patient’s health” which “creates an atmosphere of shared presence.” Furthermore, acknowledging a patient's efforts and successes in a genuine and positive manner is “associated with positive patient health outcomes."

• Exploring emotional cues is achieved by reading a patient’s verbal and nonverbal cues, “eliciting patient emotions through questions and reflecting and validating perceptions of a patient’s emotions.” These exercises are “associated with positive patient outcomes, including patient satisfaction, appointment adherence, and learning of conveyed information.”

Zulman and Verghese note that these “simple and tangible practices” can likely “be adopted with minimal training and effort” and, used collectively, can preserve the elements of medicine “that are central to effective patient-centered care and partnership.” In an interview discussing the research, Verghese further articulates this notion, emphasizing that at the core of medicine is a very intimate human encounter between physician and patient. In a technology-driven era, he says this meaningful interaction must serve to foster a connection between both parties.

A Stanford Medicine news article reports that these exercises will soon be incorporated into curriculum for training medical students and residents and further developed to be adapted for different clinical settings. Like Zulman, we are eager to see how the application of these “five practices affects the experiences of patients and clinicians.”