Meaningful Connection with Patients: Five Simple Practices

Human connection between a physician and a patient, though central to clinical care, is being increasingly neglected due to time constraints, technology and administrative demands of healthcare environment (Butler et al. 2018; Young et al. 2018). Researchers from Stanford identified five practices that can help clinicians with multiple demands and distractions to understand patients better – by being present, aware and focused during interaction.

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This mixed-methods study (Zulman et al. 2020) was conducted in conjunction with Presence, an interdisciplinary centre at Stanford dealing with matters of human connection in medicine, and its results published in JAMA. The ultimate goal of the research was to identify evidence-based measures that would help clinicians to be fully engaged with patients and understand their perspectives, life circumstances and priorities, shifting the emphasis from institutional procedure to meaningful human interaction.

The authors obtained data from several sources (a systematic literature review; observations of primary care encounters; qualitative interviews with physicians, patients and nonmedical professionals). This yielded 31 preliminary practices, of which a final set of 5 recommended ones was defined. The recommendations are the following:

1. Prepare with intention: take a moment to prepare and focus before greeting a patient.
2. Listen intently and completely: sit down, lean forward, avoid interruptions.
3. Agree on what matters most: find out what the patient cares about and incorporate these priorities into the visit agenda.
4. Connect with the patient’s story: consider life circumstances that influence the patient’s health; acknowledge positive efforts; celebrate successes.
5. Explore emotional cues: notice, name, and validate the patient’s emotions.

According to Donna Zulman, lead author of the research, an assistant professor of medicine and the director of Stanford Presence 5, one of several Presence initiatives, the recommended practices could help clinicians “to rediscover the joy of medicine."

References

Butler R et al. (2018) Estimating Time Physicians and Other Health Care Workers Spend with Patients in an Intensive Care Unit Using a Sensor Network. The American Journal of Medicine, Volume 131, Issue 8, 972.e9–972.e15. Available from https://www.amjmed.com/article/S0002-9343(18)30296-1/fulltext

Young RA et al. (2018) A Time-Motion Study of Primary Care Physicians’ Work in the Electronic Health Record Era. Fam Med, 50(2):91–99. Available fromhttps://journals.stfm.org/familymedicine/2018/february/young-2017-0121/

Zulman DM et al. (2020) Practices to Foster Physician Presence and Connection With Patients in the Clinical Encounter. JAMA, 323(1):70–81. Available from https://jamanetwork.com/journals/jama/article-abstract/2758456

Source: EurekAlert

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