Building trust with patients (7 principles)

Building trust with patients (7 principles)

Why does trust matter between a doctor and a patient?

You can make a diagnosis without trust, just based on clinical information and data.

However, without trust, your management plan is unlikely to work – and without that, you are unlikely to get them better. Then the whole doctor-patient interaction is pointless.

In fact, without trust, you cannot be a doctor. It is not enough ‘to be nice’, or friendly, or clever, or ‘know your stuff’.

You need to actively build trust with your patients, every day

So. How do you start building trust with patients (7 principles)

1.  Introduction, showing genuine interest
2. Good communication skills (verbal)
3. Good communication skills (non-verbal)
4. Touch
5. Express empathy
6. Be trustworthy yourself
7. Project calmness.

Note. You can use gentle humour but only when the trust relationship is built.

The trick

Is to ..

Sit, listen, ask questions with genuine and respectful curiosity; then decide the next step together, based on trust and what you have learnt

We will now go through the 7 points in more detail.

1. Introduction, showing genuine interest

The best way to start is to introduce yourself clearly by name, and check the patient’s name. That already shows you want to know them.

Make sure your name is in an easy format – e.g. “My name is Andy and I’m a XX”. This is especially important if you have a complex surname. Your interest and questions need to be genuine, not just an academic exercise to get to the diagnosis.

After that, a good start is ..

Thankyou for coming to see me today. How can I help you?” This is AS’s (co-founder of myHSN) favoured opener

Repeat their name thereafter, e.g. with a ‘thankyou Mrs Smith” in the middle and end of the assessment etc. Remember they are not a number, and never ‘the breast lump in Bed 5’. People who know you by name will feel more comfortable around you, and trust you.

Some other good phrases at the start

Or ..

“How can I help you?”
“What is the problem?”
(listen and respond to what they say)

2. Good communication skills (verbal) 

Communicate often and well

Effective communication is the foundation on which you can establish trust with your patients. If you go through a ‘getting-to-know-you phase’ with the patient, it is better to quickly establish a snapshot of their life – such as learning about their hobbies, friends, family, and their work.

Active listening

Doctors like to talk (often about themselves!), and are not always good at listening.

But building trust requires active listening to the patient. Let them know what they are saying is being taken seriously, and is understood. Take a break from things like looking at blood tests on the computer – and look and listen to them.

Being an active listener is vital. You should hear all their concerns, not just what you think they think is important. Do not try to push or accelerate the frail elderly; and try not get frustrated with them when they are slow of thought, or speech. That will be you one day.

Knowing that they are being listened to, will make the patient confident their concerns are being addressed – and that makes them trust you.

Don’t interrupt the patient

Patients speak for an average of 60 seconds after an open question from a doctor. But doctors often interrupt a patient’s story after an average of 18 seconds, the most common reasons for interrupting being clarifications and closed questions. If you have time, let them speak.

Confidentiality

Respect also comes from the patient knowing whatever they tell you will be 100% confidential; and only shared with other health professional colleagues if necessary. Never break that confidentiality. If you do, you will lose their trust forever.

You can emphasise this in how you communicate with them – e.g. making sure curtains are drawn on the wards (and keeping your voice down), or door closed in clinic.

3. Good communication skills (non-verbal) and behaviour

Body posture and environ

Body posture shows our level of interest in the situation, encouraging or discouraging a sense of safety.

If we’re standing half-in and half-out of a doorway, behaving in a distracted way, or trying to multi-task when not strictly necessary, it will be immediately obvious that we’re not actively listening. Similarly, stance and proximity to the patient, will lead to trust.

Also. What does the room, or space on the ward, look like? Does that exude trust? What will they think of a dirty coffee cup in view? Why is your mobile visible? What can be done to improve the look of the room?

Eye contact

Maintain eye contact. Maintaining eye contact communicates care and compassion.

Facial expression

Facial expressions are immediately recognisable, and therefore can quickly affect perception. So it is important to think about what your face is ‘saying’ at any moment.

Mimicking gestures and feelings

Simply nodding in agreement along with the patient or copying hand gestures can be useful in demonstrating that you are on the same page. This is sometimes called ‘mirroring’. Notice a patient’s gestures and copy them, just as we do with spoken word. This can help to build trust as well.

4. Touch

This is a sign of caring, both during examination and procedures (like blood taking). Any hands-on connection, therefore, is more than likely going to indicate our level of care, leading to trust. So touch the patients, it reassures them.

Touching is important and reassures the patient

5. Express empathy

You need to empathise with your patient at all times. This can be hard. You may have a lot on your mind – with jobs to do, rows at home – and the patient may not be the most pleasant person to be around (perhaps due to illness). But it is important to show genuine (and non-fake) empathy, whilst also not allowing their problems to overwhelm you.

Your goal should be to relate to them, but keep some barriers between you and them. They are not your friend remember. This also helps you make objective decisions, whilst being an advocate for the patient.

6. Be trustworthy yourself

People trust people who act in a trustworthy fashion. Full stop. Being open and honest is the best way you can show you are trustworthy. Even in situations which may not be very pleasant, honesty must be maintained. Both the patient and their family will trust your word if you show honesty.

It is also important to keep your word. Do not promise something you know you will not, or cannot, do.

Building a relationship with patients can improve their recovery time; making it easier to carry out the next treatment. This may be more invasive, for which more trust will be required. In other words, in long-term care, trust is required to achieve the best final result such as a cure, or near cure.

7. Project calmness

As a health professional, you need to come across as calm, competent, and in control of the situation. Your confidence helps to reassure the patient that all is as it should be. If a situation is frightening for the patient, they can remain calm, if you remain calm.

Summary

We have described building trust with patients (7 principles). Trust is vital in the doctor-patient relationship. There are many advantages to that trust, especially increasing the likelihood that the patient follows your management plan, and returns to you for follow-up. We hope this information helps you build trusting relationships with your patients.