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It starts with being mindful — not only of what we say, but also of how it is being heard.

Fam Pract Manag. 2021;28(2):42

Author disclosure: no relevant financial affiliations disclosed.

In the current environment — with increased stress among our patients due to the pandemic and other societal factors, as well as increased pressure on our practices to improve value and patient satisfaction — it is becoming more and more vital that we establish a positive and strong rapport with every patient. This rapport fosters trust and openness, and it ultimately yields better adherence to the care plan and improved health outcomes.

But how do we establish rapport? How do we get patients to trust us and to listen so that we can help them and improve patient satisfaction?

There is a slew of research on this topic, along with reams of potential strategies. But I'd like to focus on just one thing: Building rapport starts with being mindful of how we are communicating and what messages we are sending beyond the surface of our words.

We communicate all day long. We greet, we ask, we explain, we plan, we disclose, we lecture, we theorize, and we talk about numerous issues with our patients. Patients, however, only hear a portion of what we say. To physicians, this can be disconcerting and frustrating. After all, we've invested our time, expertise, and energy to tell our patients something beneficial. They should readily hear and understand it, right? But research shows that patients only remember 20%–60% of the information delivered to them, depending on the type and complexity of the information.1

Therefore, it is imperative to become increasingly aware of what the patient “hears” beyond our words. Patients “hear” our tone, posture, facial expressions, and most importantly our care and concern. In essence, patients hear our heart. They might not grasp the physiology of their diabetes or the details of how their beta blocker works, but they feel our concern and inwardly assess our genuine desire to help them at every encounter. From the patient perspective, our concern and intent speak louder than our actual words.

The following pointers can help us focus on sending the intended message to our patients:

  1. Foster a mindset of gratitude for the opportunity to participate in patient care,

  2. Take inventory of your posture, tone, and facial expressions,

  3. Be mindful of your own emotions,

  4. Be on guard for empathy burnout,

  5. Smile when appropriate,

  6. Take a moment of silence when critical or crucial items are being discussed,

  7. Don't be afraid to respectfully verbalize your care and concern for your patient,

  8. Most importantly, listen to the patient. When patients feel like they are able to share their story and make their voice heard, they will instantly gravitate to your advice and trust you as their physician.

As physicians, we must be sharp, knowledgeable, adaptable, and confident in our ability to administer care. These are great qualities, imperative for good care, and certainly expected of us. We must know the science of medicine and yet balance it with the art of medicine. Patients feel our care and concern beyond what we are saying. Once they know we care, they will trust us, and that establishes strong rapport.

We live in a culture that often breeds distrust, disunion, and apathy. However, when it comes to being a qualified and well-rounded physician, we must not allow the noise of the culture to overwhelm our desire to uphold the totality of the Hippocratic Oath (modern version): “I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.”2


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