Time management tips to enhance physician-patient relationships

Time becomes an ever-more precious commodity with our all-day and all-night availability on mobile communication devices. In addition, many more required tasks have been added to our daily activities in the hospital and office that take time away from our direct face-to-face communication with patients. This can be damaging to the physician-patient relationship and contribute to physician stress.

Since a growing amount of physician time is consumed by information technology, this may offer solutions to improve the physician-patient relationship. In this article I will share my techniques to improve interactions with patients and enhance mutual satisfaction to achieve better health outcomes.

My interactions with new patients begin before our meeting face-to-face. My practice’s website contains background information about the physicians, facilities, location and contact information for providers including phone, facsimile numbers and email addresses. Registration forms are available to be completed and submitted online or printed out, completed on paper and mailed or brought to the initial office visit.

Important patient contact information includes the patient’s preferred methods of communication: home and work phone, cellular phone and facsimile numbers, and e-mail addresses. Medical and surgical history, allergy, primary care or referral physician, and pharmacy contact information also is collected.

Obtaining this information before the patient’s visit saves time and improves office flow efficiency at the initial visit. This contact information is used to send reminders for follow-up visits, communications about health questions and to refill prescription medication electronically for better patient compliance and convenience.

My policy is to respond to all phone calls or electronic correspondence within one working day. Inefficiencies in office operations, unnecessary inconveniences and delayed responses to inquiries can reduce a patient’s confidence in a physician.

After the patient has registered at the front desk, the patient can watch health educational videos until  called by my assistant for a preliminary examination that is recorded in an electronic health record (EHR) system. When I enter the room, I introduce myself looking directly at the patient, greet him or her with a smile and shake hands. Then I upload the EHR onto the desktop computer with a large screen facing the patient so that the patient can see what I am seeing and doing.

Then I clean my hands in front of the patient and inquire about the details of the chief complaint and history of present illness. I enter this data into the EHR and encourage the patient to verify the accuracy of the information and correct any details. I do not use a scribe to enter this data into the EHR while I am talking to the patient because I have found that it interferes with my connection and communication with the patient, can be confusing when I talk to the scribe and patient at the same time, and can create inaccuracies in the information entered into the EHR.

After the review of systems has been entered and verified, I perform my physical examination. Before I actually perform different parts of the examination I describe to the patient what I am about to do to avoid unnecessary surprises and reduce anxiety. After completing the physical examination, I enter the information into the EHR as I verbally describe my findings to the patient in language understandable to the layperson. 

I also pull up images from diagnostic tests onto the computer screen for the patient and his/her family to see and review as I explain the results and answer their questions. Then I enter my assessment into the EHR as I discuss them with the patient and verify the patient’s agreement.

I find that this transparency and explanation of EHR information on the computer screen with the patient and family members enhances our rapport, improves mutual understanding and communication, and ensures the accuracy of data in the EHR. At the conclusion of the visit I offer to print out a copy of the patient’s information for him/her to keep, as well as to send to their primary care or referring physician. Showing the patient that there is nothing to hide and that everything is up front and clear generates greater trust.

Showing  the EHR on a large computer screen for the patient to see and ask questions about saves time and enhances, but does not replace, direct verbal face-to-face communication. Here are ten tips I use to improve patient communication and relationships.

• Carefully listen to the content and the emotion of what the patient says.

• Apologize if the patient is upset with something like waiting too long.

• Ask about personal details or shared common interests to make a connection at the beginning of an office visit like family, hobbies, vacations, etc. learned from the personal social history or earlier visits.

• Avoid interrupting or cutting off a patient’s narrative.

• Never criticize, argue, or threaten a patient.

• Find behaviors to compliment, such as good or improved compliance with a treatment plan.

• Ask if there are any further questions at the conclusion of each visit.

• Sit calmly in front of the patient and speak in a gentle tone, but loud and slow enough for the patient to hear.

• If a patient asks the same question several times, ask them to repeat the answer to verify that they heard and understood what was said.

• Suggest a second opinion if I sense that the patient has doubts about my advice or opinion.

Demonstrating sincere care for the patient’s best interests is essential to establishing a trusting physician-patient relationship.

Growing and maintaining a medical practice requires forging a series of successful relationships with patients and referring  providers. Guiding principles for success can be condensed into the seven A’s: Availability, Affability, Ability, Attitude, Ambition, Adaptability and Anticipation.

If someone needs help, be available to help and you will win a grateful patient or colleague. Being friendly and affable to patients, staff, and colleagues will generate a loyal following. Excellent abilities and clinical skills that generate good patient outcomes enhance your reputation and help grow your practice.

An optimistic attitude to life’s challenges attracts patients and opportunities, as does demonstrating the ambition to constantly improve and get better at everything you do. Adapt to a changing environment for survival and prosperity. Anticipate the future to make better decisions and to take advantage of new opportunities. Predicting a patient’s needs and expectations creates confidence and a strong relationship.

Leveraging limited time with technology is a key to creating and maintaining successful physician-patient relationships. Technology can change or support this intimate relationship, but it cannot replace it. Humanistic caring is the relationship between the physician and the patient.