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    Dr. Steven Merahn, MD, FAAP

    Today’s physicians have found themselves in a world of healthcare that is shifting dramatically. Outside influences have changed the way we deliver care, and they’re not always based on the needs of patients. Administrative tasks and the demands of technology often distract us from the person-to-person connection that’s so vital to effective patient care. The good news is there’s research to remind us of that connection’s power to revitalize the care experience for both patients and professionals.  

    Dacher Kelter, a psychology professor at the University of California, Berkeley, is an expert in the social functions of emotion, and his research has dramatic implications for the practice of medicine and delivery of care. It also served as the basis of Pixar’s 2015 blockbuster, Inside Out.

    Dr. Keltner and his colleagues clearly illustrate how emotions influence interactions in relationships; how they help individuals recognize the beliefs and intentions of others; how they evoke complementary and reciprocal emotions; and how they serve as incentives or deterrents for other individuals’ behavior. These act as the foundation for the levels of engagement and motivation, aspiration, acceptance, and commitment required to achieve ambitious goals regarding the health status of individuals and populations.

    With this in mind, what can physicians do in today’s practice environment to make this kind of connection?  

    At the most basic level, take a moment to “humanize” each encounter. While it may seem intuitive or obvious to treat your patients as people, we rush through these encounters far too often, with our minds on charting or a full roster of appointments ahead. Instead, it’s helpful to be intentional in each patient encounter, and this starts from the first interaction. 

    Think: First five minutes!

    When you’re in a practice setting and under pressure to see a certain volume of patients in a day, adding even one more task or taking a few extra moments may seem daunting. At the same time, it may feel like a few minutes can hardly make a difference, so why bother? However, by taking the time to ensure that the first few minutes with every patient are intentional, you can set the stage for the entire patient experience. By incorporating the following tips into your first five minutes with a patient, you are demonstrating that you see them as a person, laying the groundwork for a meaningful patient-provider relationship.

    Get on their level

    It’s likely that the patient feels vulnerable, uncertain, anxious or irritated as they sit, perhaps in a paper gown, waiting for you to enter the room. After greeting the patient and anyone accompanying them, take a seat and ensure you’re either at or below their eye level. This gives them a sense of your genuine presence in the room. By not looking down on the patient, you can help put them at ease and contribute to an atmosphere of trust.

    Communicate to connect

    Before asking the patient why they’re there and focusing on their specific health issues, ask how they’re doing in a more general manner. Simply ask, “Before we get started, is there anything I need to know about you that would help me take care of you today?” Give them a second to respond. When you intentionally ask this question before inquiring about their specific reasons for the visit, you’re letting the patient know that you care, that they matter and that you are not just there to be a technician — you are there to care for them and to listen. By allowing the patient to tell their story in an open-ended fashion, you’re letting them know you’ll be interested and empathetic throughout the appointment.

    Beyond the exam room

    Of course, listening and relationship-building don’t stop after five minutes — or even at the exam room door. Strong relationships are built on effective communication across multiple touchpoints, through all stages of the patient journey. It’s important to ensure that an environment of trust and responsiveness is fostered across the entire patient experience, including when it’s time for billing and collecting payments. 

    When you ask your patient in the first five minutes, “Is there anything I need to know about you?” it’s very possible their answer may include financial barriers standing in the way of their health goals. This underscores the importance of having this conversation up front and ensures we’re truly listening. 

    If your patient does share financial concerns, or even if they don’t, it’s likely that having options for how and when they pay for care can help them manage their health expenses with less distrust and disruption. For larger expenses, offering promotional financing can make it much easier for patients to fit medical payments into their monthly budgets, allowing them to move forward with the care you recommend. Third-party financing solutions, like CareCredit’s dedicated healthcare credit card, can make it easy to offer this benefit in your practice. Your patients can get the care they need, with less effort and risk for your practice than with in-house patient financing solutions. 

    Your role in shaping the future

    Ultimately, in the healthcare field, we all likely feel external pressures that influence how we practice medicine and attend to our patients. But that doesn’t have to mean that we as physicians can’t shape how evolution occurs in our own practices. We, along with our entire office team, can commit to ensuring that human relationships stay at the forefront. This doesn’t have to be a transformational change; rather, it’s something we can achieve with each interaction and each encounter, starting with those first five minutes. 

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    Written By

    Dr. Steven Merahn, MD, FAAP

    Dr. Steven Merahn, MD, FAAP, trained in pediatrics in New York City before beginning a career in public health policy and program development. He then worked in the private sector in strategic communications, information sciences, digital health and consulting. Later, he returned to medicine via an independent academic medical center in the population health field. Most recently, Dr. Merahn has held Chief Medical Officer roles in primary care and behavioral health. He is currently the Chief Medical Officer of Centria Healthcare and Managing Director of Thinkwell Health. 


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