- The first clinical encounter is crucial in shaping the patient relationship, emphasizing the importance of empathy, effective communication, and following through on promises.
- And it starts with setting appropriate boundaries to maintain professionalism, especially with challenging patients.
- Consistent practices in patient interactions foster equitable care and strengthen relationships over time.
Early career cardiothoracic surgeons have many important relationships that need to be managed and developed. The patient relationship can be excellent, a source of pride and healing, or damaging, a source of stress and contempt. In training, there are many explicit lessons about technical parts of procedures and guidelines to follow, and publications to remember, but there are few explicit lessons about achieving the best of and managing the worst of patient relationships.
Never Get a Second Chance
The essence of the patient relationship is established in the first clinical encounter. Whether it’s an inpatient or outpatient setting, your approach will lead to a similar outcome. Patients have historically shared a relatively strong preference for physicians wearing business casual clothes or scrubs with a white coat. Though this is a formality born of tradition, appearance sends a strong message to patients especially when they are at their most vulnerable looking for guidance and support.
The most important aspects of how patients will interact with you are how you communicate and understand their problem. Knowledge alone is not sufficient. Taking the time to be empathetic, making good eye contact, and active listening will help you build a relationship with a strong foundation. It is mission-critical to do what you say you will do. If you promise to speak to a consultant or practitioner or review a result, you must do so and communicate that you have done it.
Setting Boundaries
Even with your most beloved patients, it is important to set boundaries. Many physicians feel comfortable sharing their personal cell phone numbers with patients. This is a practice many feel builds a strong relationship and prevents miscommunication. Others see this as a bridge too far and may only do this with select patients. Some physicians choose a middle ground by signing up for a ghost number using services like Google. This can give patients heightened access and still allow enough of a barrier that it doesn’t become overly intrusive.
Similarly, you need to set clear boundaries of appropriate behavior with challenging patients who are difficult with you or with your staff. This is far more valuable when it’s done early in the relationship rather than later. You have a moral and ethical obligation to ensure patients have continued appropriate care, but there is no obligation to suffer hostility, verbal abuse, or violence. Medical practices have protocols and policies for discharging patients from their care if necessary.
Consistency
The consistency of a physician is one of the best ways to build a strong relationship. Establishing minimums for patient interactions allows you to provide equitable care to all your patients despite the variability in how you may or may not mesh with patients. Whether that means always personally calling patients with their CT scans and pathology reports or always using your pronouns on introductions, keep these practices in place and consistent to set a tone for relationships that is straightforward to maintain.
Like all relationships, surgeon-physician relationships require thought and energy to maintain. Given the power of imbalance, there is an onus on the physician to thoughtfully curate this relationship to everyone’s benefit.