A new paper published by researchers from Stanford highlights five practices that could play a critical role in implementing and achieving more meaningful interactions with patients. The paper, published in JAMA, addresses the need to repair doctor-patient relationships as they exist today. It is based on research conducted with Presence, an interdisciplinary centre at Stanford that focuses on the art and science of human connection in medicine. The goal of their research and work is to shift the current emphasis from institutional procedure to meaningful human interaction. 

The current climate of healthcare and medicine has limited the amount of time doctors spend with their patients. Increased number of patients, increased demands of care, the explosion of biomedical knowledge and the constant demands to update and review electronic health records (EHRs) leave very little time for doctors to actually interact with their patients. 

In this new paper, the authors highlight five key practices (The Presence 5 practices) that could potentially repair this increasing gap in doctor-patient relationships. These practices were identified through a systematic review of 73 studies of interpersonal interventions, as well as through observations of clinician-patient encounters and interviews with clinicians and physicians. These five practices are as follows:

  1. Prepare with intention: This would include familiarising yourself with your patients and creating a ritual so as to focus your attention before the patient visit.  
  2. Listen intently and completely: This would involve sitting down, leaning forward, and positioning yourself to listen. Don't interrupt your patients as they are your most valuable source of information. 
  3. Agree on what matters most: By listening to your patient carefully, find out what they need and what they care about. This should be a key priority in your patient visit agenda. 
  4. Connect with the patient’s story: Try to connect with your patient. Understand their circumstances and what influences their health. Acknowledge their efforts and celebrate their successes. 
  5. Explore emotional cues: Keep your eyes and ears open. Tune in and notice your patient's emotions. Understand their cues and try to become their trusted partner. 
“The Presence 5 practices resonate because they speak to something that is timeless and central to medicine,” said Verghese, the Linda R. Meier and John F. Lane Provostial Professor and director of the Presence Center. “Patients want us to be more present. And we as physicians want to be more present with our patients, because without that contact, our professional life loses much of its meaning.”

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Patient, EHR, patient engagement, physician, doctor-patient relationship, Presence 5 practices In a new paper, Stanford researchers recommend 5 practices to improve doctor-patient relationships.