10 Tips for Improving the Patient-Physician Relationship

This transcript has been edited for clarity.

Hi. I'm Benjamin Levy, a gastroenterologist at the University of Chicago. Here are 10 tips to build trust and improve the patient-physician relationship.

1: Be Prepared

I highly recommend reviewing the patient's chart and past medical history before going into a clinic room to see them. If possible, try to have your nurse obtain any needed previous medical records, like previous colonoscopy or esophagogastroduodenoscopy procedure reports, in advance.

Being well prepared will place patients at ease, improve trust, and expedite care.

2. Make Eye Contact

When talking with a patient, sit down and look them in the eyes, instead of focusing on the computer screen. Physicians should never tower over patients. Be mindful that you are sitting at an equal level or sit lower than the patient. Try to arrange the furniture in your clinic room so that you can easily see the patient from the computer.

3. Engage the Patient With Your Notes

If you like to write your note with a patient in the room, I recommend that you read out loud sections of it as you type. Patients love experiencing the great attention to detail that we include in patient notes. Flower your note with specific details like what the patient does for a living, their past medical history, and medications. Read out loud a simplified version of your medical workup and management plans while you type them.

This recapitulation emphasizes the important parts of your recommendations. The more times you state your plan, the better patients will understand and remember.

4. Ask for a Recap

The best way to end a clinic visit is to ask the patient to recall and explain the plan to you. This ensures patient understanding. Use this opportunity to correct anything not fully understood. This extra step also shows that you care and are invested in a positive outcome.

5. Have Easy-to-Read Handouts

Make sure that your patient education handouts are understandable on a fifth-grade level. Have copies available in the most common languages spoken by your patients. This is especially important for immigrants and refugees.

Take advantage of the specialized handouts that gastrointestinal societies, like the American College of Gastroenterology, provide to members for use in their clinic. These handouts illustrate that your care is standardized and congruent with physician thought leaders, and that you are active with your national physician organization.

6. Build End-of-Visit Rapport

Whenever you can, walk patients to the front desk for a check out. In front of the patient, emphasize to your relevant staff any urgent tests that need to be scheduled.

Patients will love your advocacy work and attention to detail. This simple step builds rapport with patients, and they will remember you as the doctor who went the extra mile.

7. Take Steps to Stay on Schedule

Set up your clinic schedule in a manageable way so you stay on time or even ahead of schedule. Patients appreciate it when you value their time too. Keep in mind that many patients must take breaks from work or even taking care of loved ones to attend your clinic visit. Patients will remember, admire, and recommend punctual physicians.

It's sometimes difficult to fit everything you need to do into one clinic visit, so provide a review of systems checklist for patients to complete before their clinic visit. The waiting room is a great opportunity for patients to do this, right after check in. This will speed up your history-taking.

I also recommend that you educate your nurses and support staff to teach patients how to prepare for colonoscopies and schedule their procedures.

These small steps will help physicians stay on schedule.

8. In the Hospital, Don't Rush It

In the hospital setting, try to avoid obtaining history and physical exams while someone else is working on the patient (eg, getting blood pressure, starting a line). Patients will feel rushed and might not be able to concentrate on the medical conversation if two different healthcare professionals are interacting at the same time.

It's courteous to do one thing at a time with the patient.

9. Create an Effective Discharge Summary

Write excellent clinic discharge summaries, which should read like empowering recommendations. I personally number each recommendation and place in order of importance.

I recommend writing clinic and inpatient discharge recommendations in easy-to-understand language. In the discharge summary, I reference each medication that I have either started or discontinued, and, if needed, describe possible side effects for the patients to look out for. This technique dramatically improves patient adherence to our recommendations.

10. Don't Forget Aftercare

Patients love it when you call them at home to check on them and to follow up on abdominal pain, nausea, constipation, etc. It shows that you really go the extra mile for them. Instead of answering a patient's question in an electronic health record, call them for a quick conversation.

Patients will recommend you to their friends as a compassionate doctor who truly cares for patient happiness and excellent clinical outcomes.

Benjamin H. Levy III, MD, is a gastroenterologist at the University of Chicago. In 2017, Levy, a previous Fulbright Fellow in France, also started a gastroenterology clinic for refugees resettling in Chicago. His clinical projects focus on the development of colorectal cancer screening campaigns. Levy, who recently gave a TEDx Talk about building health education campaigns using music and concerts, organizes Tune It Up: A Concert To Raise Colorectal Cancer Awareness with the American College of Gastroenterology (ACG). He frequently publishes on a variety of gastroenterology topics and serves on ACG's Public Relations Committee and FDA-Related Matters Committee.

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