How to Build Relationships to Establish Lifelong Patients in Your Practice
By Kate Gettinger, OD September 21, 2022
Bedside manner means a lot more to patients than you may think. As a low vision specialist, I often find myself in a secondary or tertiary position with patients being referred by their ophthalmologist or primary OD. I cannot count how many times I have had a patient furtively glance at me after I mention their primary provider, and then ask if I have suggestions for a “better doctor.”
Most of the referring doctors I work with are all excellent clinicians, which I explain to the patients, and ask why they specifically would like to see a different doctor. Almost every time the answer is in the same general vein: “They don’t seem too friendly. Would it hurt them to talk a little more?” “They seem like they know their stuff, but their personality is cold as ice.” “They just don’t have a good bedside manner.”
At the end of the day, we all know that clinical skill and expertise is the most important aspect of our job. If we aren’t able to accurately diagnose and treat, then we have no right to call ourselves clinicians. So, assuming we are all performing to the top of our ability, why isn’t this enough to satisfy our patients? Shouldn’t patients be satisfied as long as they are walking out of our office healthy or with the treatment they need? Why do patients seem to correlate a friendly demeanor with a better clinical outcome?
The difference between a good and an excellent clinician, then, usually comes down to how the provider establishes relationships with his or her patients. A doctor-patient interaction should rarely be one-sided, and in the examination lane we need to remember that both parties must be committed to the treatment plan to assure overall success.
Strengthening your relationship with patients involves establishing a sense of trust and taking the extra time to make sure they are a contributing component of the overall care experience. This can be harder than it sounds, especially as we seem to find ourselves having to squeeze more and more patients onto our daily schedule in order to offset shrinking insurance reimbursement rates.
So how can we improve our professional relationships with patients without completely derailing our schedule? Continue reading to find out some of the top tips for strengthening doctor-patient relationships. Sometimes, even a small tweak to how you already conduct your examination process can make a huge impact on how a patient will view your overall clinical acumen.
1. Be prepared for your appointments.
This one might sound like a no-brainer, but it really can make a big difference and doesn’t take a lot of extra time out of your schedule. Review patients’ charts before seeing them in person. This can help you avoid asking them repetitive questions already documented, which can make patients feel like you aren’t listening or mindful. You can also follow-up on any noted findings from their last encounter, which can help a patient feel you are attentive to their individual needs.
If a patient offhandedly mentions something about themselves or their family, such as they are currently in school studying business or they have two toddlers at home, I will make a note of it in their chart. When they come in for a subsequent appointment, these notes help me remember a bit more about the patient. Occasionally, usually when transitioning between tests, I will offer a quick question pertaining to this information. When I ask “oh, how many years of school do you have left now? Still working towards that MBA?” Many patients light up and seem tickled that I was interested and bothered to inquire. It only takes a few extra moments of an exam but can show genuine compassion for the patient as a unique individual.
2. Get to know the individual, not the condition.
I still remember the day in my fourth-year clinical rotations when my fellow classmate got chewed out by our preceptor because he referred to his patient as “the diabetic retinopathy patient” rather than by the patient’s name. Sometimes, as clinicians, we try to distance ourselves from the human aspect of a patient because it can be easier to do our jobs efficiently if we aren’t distracted by emotional elements. However, this robotic approach is not a particularly good coping method, and it can make a patient feel like they aren’t being respected as a human being.
A simple way to try to avoid this is just taking time to get to know the patient. Ask them their preferred name and pronouns and make note of it so you don’t err at a later point. If you stumble over the pronunciation of their name, politely ask them to pronounce it for you and make your best effort to get it right.
Don’t forget to also introduce yourself to the patient. Remember that this is a two-sided relationship, after all.
3. Listen to the patient’s needs and concerns.
A critical part to a healthy relationship is having all parties feel that they are being heard and respected. As doctors, we often steer most of the dialogue during the examination, but it’s also important to make sure our patients feel heard and understood in the process.
Listening to a patient also usually means providing time for a patient to speak to you. Our schedules frequently don’t permit a lengthy conversation, but simply making time for a few extra minutes to talk to a patient can make a big difference. I usually try to take a brief moment between the major portions of an examination to stop and explain what I have done so far and give the patient the option to ask clarification questions as needed.
I have found that when I wait until the very end of an examination to explain all my findings at once and ask a patient if they have questions, it can often feel a little overwhelming to the patient and, in the moment, they may deny any concerns. However, when I instead break up this information throughout the course of the examination and stop to listen to any patient concerns along the way, I find this usually is received much better by patients.
4. Explain as you go and provide appropriate education.
While you don’t necessarily need to go into the technical detail of every test you are performing, it can be helpful to give short explanations of what you are doing or what the patient can expect during the procedure. For example, before I pull a slit lamp up to a patient, I state that I am going to be looking at the health of their eyes and the light will be a bit bright. When I go to look at the fundus, I explain that I am now looking inside the eye to make sure all the internal structures are healthy. I reassure them that they can blink as much as necessary but try to keep focused on the target provided. Simple explanations like this help the patient feel like an active participant in the process and lowers anxiety by letting them know what to expect.
It can also be helpful to take the time to explain your findings, even if they may seem simple to you. Taking the time to explain a concept as common as astigmatism can make a patient feel more informed and involved. In addition, be prepared with resources and materials to direct a patient to if you either don’t have the time or the expertise to explain in the moment. For example, a patient with diabetes may ask for advice on how to improve their blood sugar levels. It can be useful to know of a reputable website or information pamphlet to provide to the patient in these sorts of situations.
5. Follow up appropriately and be consistent.
While we obviously should follow-up on conditions that might require medical interventions, sometimes it can be useful to follow-up on patient concerns that otherwise do not warrant a subsequent examination.
For example, a patient with mild dry eye that started artificial tears and some lifestyle changes might greatly appreciate a phone call from the doctor a couple weeks later to see if any improvements have been made. The simple gesture of following up can comfort a patient, and also provide an opportunity for the patient to ask questions or address any new concerns. While this does take extra time out of your schedule, the effort can make a huge improvement in a patient’s perception of you.
In addition, be consistent about addressing a patient’s needs within a reasonable time frame. If a patient calls or emails the practice, most want a response by the end of the day. This turnaround time can be difficult, especially if you work at multiple practice locations. Even if you are not able to answer the patient’s concerns at that time, sending an email or message to confirm that you noted the patient’s question and will follow up with a response soon is often better than leaving the patient unaddressed for several days.
We all know that at the end of the day, most patients would prefer a competent doctor with no charm than a friendly but clinically inept physician. However, you and your practice’s reputation can grow substantially if you supplement your clinical expertise with good patient rapport. By implementing some of the suggestions outlined above, you can be well on your way to establishing patients with a devotion to you and your practice for years to come.