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Establishing Doctor-Patient Trust in a Tense Healthcare Climate

Posted on: June 08, 2016

Huckins

written by

Jess Huckins

It isn't always easy for patients to trust their doctors. We’ve heard that helping patients feel comfortable enough to open up about their lifestyle choices is a real challenge, especially now that tensions at the doctor’s office seem to have reached an all-time high.  

A 2015 study from Zocdoc confirms the growing distrust between patients and medical professionals. It found that close to half (46 percent) of Americans declined to tell the whole truth about a health issue out of embarrassment or a fear of being judged.

"As doctors, we expect some patients will withhold information in the exam room. There is a lot of emotion around personal health. But I think many doctors would be surprised to hear they're getting half-stories often because they haven't left enough time to ask," said Dr. Oliver Kharraz, founder and president of Zocdoc.

These white lies or sins of omission — reportedly told by 30 percent of women and 23 percent of men — were usually in response to physician questions about diet or fitness. That so many patients would choose to lie and risk serious complications is indicative of the poor state of consumer confidence in the medical field.

But this isn't exactly a recent development. The Harvard School of Public Health published a report in 2012 showing that just 34 percent of American adults felt a high degree of confidence in the medical profession’s leaders. That was down from 76 percent in 1966 — certainly a dramatic decline over nearly half a century.

So, while the current relationship status between physicians and patients might be most accurately described as "It's complicated," there's no reason to believe the flame can't be rekindled.

How Medical Professionals Can Gain Trust

A 2012 study published in the Journal of Family and Community Medicine found that a solid doctor-patient relationship encouraged the patient to share information they would otherwise have kept secret. This is hardly surprising, but how is it accomplished? 

Building the proper dynamic begins in medical school. Educators are increasingly vocal proponents of the idea that schools should offer courses on empathizing with patients, as well as good communication and forming relationships. In recent years, a growing number of medical schools — including those of Duke University and Emory University — have included doctor-patient relationship instruction in the curriculum.

"We teach students how to respond empathically to patients; ask questions not just about their history of disease, but how they are coping with their diagnosis and what they're most fearful of," Stephen G. Post, director of the Center for Medical Humanities, Compassionate Care, and Bioethics at Stony Brook University, told the Huffington Post.

This is a promising start. The next step is to encourage patient sharing by having physicians reciprocate. Dignity Health suggests that medical professionals describe clearly and accurately all important information related to a treatment plan, taking special care to emphasize how it will work and why it's beneficial. Communication of this sort can work wonders.

Improving Outcomes: It Takes Two

Establishing honest communication between providers and patients goes beyond a sense of empathy and common humanity (though that's an admirable end in its own right). Report after report shows that compassionate care actually has a direct effect on healthcare outcomes.

A study published in PLOS One, for instance, reveals a statistically significant relationship between a close patient-clinician bond and improved outcomes for health problems such as asthma, obesity, and certain infections. The Huffington Post described other studies showing that patients treated with kindness had lower blood pressure and anxiety.

"When clinicians make these kinds of empathic connections with their patients, when they don't interrupt them, when they are comfortable with moments of silence, when they can pause a little bit when they see their patient is getting emotional, you see much better diagnostic accuracy," said Post. "When patients feel that kind of security in a relationship, they are able to say things about themselves that are diagnostically relevant that you never would have come up with in a more formal-type questionnaire."

Not all the work of building trust falls on clinicians' shoulders, however. Patients also need to be willing, and those who have had poor past experiences with providers or who suffer from white-coat syndrome may pose a challenge.

The Zocdoc study also shows that, like a fine wine, the doctor-patient bond improves with age. The amount of patients who go to a doctor first when feeling ill jumps from 39 percent in the 35–44 demographic to 58 percent for those 65 years or older. Occasional white lies remain, though the reasons for telling them shift from mistrust and embarrassment to a judgment call about the issue's seriousness.

As experts analyze the decline in patient-physician trust over the last 50 years, medical professionals’ incredible daily workload cannot be ignored. Physicians, nurse practitioners, and physician assistants are often pushed to the very limits of their time and energy, leaving little space to truly connect with patients.

We all know the system needs to change, but talking about it isn't enough. Consistently giving providers work environments that are conducive to helping them connect with each and every patient on a human level will require major reform.

In the meantime, hospitals and care facilities can rely on expert locum staffing to supplement full-timers who need a break. Everyone deserves a vacation, after all, and happy, well-rested care providers are more likely to have the energy and emotional capacity to build strong relationships with their patients.

Have you ever struggled to build a rapport with patients? What strategies helped you establish a better bond? Let us know in the comments, or tweet us @bartonlocums.

Jess Huckins
About Jess Huckins

Jess Huckins was formerly the managing editor at Barton Associates’ Peabody, MA, headquarters. She joined Barton after nearly a decade of professional editing in the publishing, marketing, and healthcare fields, and she holds a master's degree in publishing and writing. 

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