Trust, Honesty and Effective Communication
I consider myself to be a pretty decent mom, but there is that one time of year I have my doubts. It’s almost every September when I take my children to their well checkups and the pediatrician asks me a list of questions regarding their daily habits.
“How many daily servings of vegetables does she eat?”, asks the pediatrician. Followed by, “How many hours of the day does she spend in front of a screen?” Despite my desire to exaggerate, plead the fifth, or even stoop so low as to point the finger at my children, I offer up the truth.
Ok, I don’t actually leave doubting my skills as a mom, but I do feel pretty exposed. Despite my embarrassment, I know the pediatrician needs truthful answers to be able to properly treat my children and assess their overall health. Furthermore, after several years of treating my children, I trust she knows I’m not a negligent mother (just an imperfect one), and she has my children’s best interest at heart. I choose to subject myself to the annual interrogation (only slightly exaggerating) because we have a successful patient-provider relationship. We have developed a relationship over the years based on trust, honesty, and effective communication.
According to a blog published by Privia Health on September 11th, 2020, seventy-eight percent of patients have not been truthful with their provider at some point during their annual visit. Furthermore, “twenty-three percent of patients report habitually lying about, minimizing, or avoiding certain details of their health history.” (1)
In an article published by the New York Times titled, “Do You Trust The Medical Profession?”, author Dhruv Khullar writes, “Compared with people in other developed countries, Americans are considerably less likely to trust doctors, and only a quarter express confidence in the health system.” (2) The article explains how trust in the professional healthcare system has rapidly declined since 1966. Not to mention the article was published before the outbreak of COVID-19. The polarization of those who do versus those who do not trust the medical profession is greater than ever. Evidently there is a great disconnect between professional healthcare providers and their patients; and I would argue neither party actually desires it to be this way. Doctors and patients, both, truly desire a successful relationship based on trust.
Trust is Essential
Brian Tracy once said, “The glue that holds all relationships together – including the relationship between the leader and the led – is trust…” (3) It’s not new news to anyone that at the foundation of every healthy and successful relationship in life, is trust.
The patient-provider relationship is no exception to this. J. Flowers Health Institutes published an article titled, “Doctor Patient Communication With One-on-One Analysis” and in it states, “It is essential that patients trust their doctors. Without trust, patients may not disclose certain information that may be crucial to diagnosing and treating conditions.” (4) When patients trust their physicians, they feel safe and are more willing to share intimate (and sometimes potentially embarrassing) information necessary to formulate a healthcare plan. In addition, when patients trust their providers, they are more likely to follow through with suggested medical protocols. Going back to the New York Times article I previously mentioned, “Two thirds of patients with high levels of trust always take their medications, but only fourteen percent of those with low levels of trust do.” (2)
It Takes Two
Furthermore, trust is a two-way street between the provider and the patient and it has to be mutual to work. Patients are trusting their doctors with their healthcare (and in some cases their lives), and providers are trusting patients to be forthcoming with any relevant information and to follow suggested medical protocols. When providers trust their patients, patients consequently feel heard, valued, and respected. Earlier this month, Sociology Compass published an article on the matter of healthcare professionals’ trust in patients and writes, “Distrust in patients can lead to the neglecting of symptoms and different treatment plans, while the negotiation of trust can facilitate patients’ disclosure of stigmatizing issues and, in the long term, the development of good patient-professional relationships.” (5)
Fully trusting a patient means checking all preconceived notions at the door before walking into the very first appointment. There’s nothing more frustrating from a patient’s perspective than to feel demeaned, disrespected, stereotyped, or judged by a physician based on appearance, background, religious beliefs, gender, ethnicity, or socioeconomic status. Looking again at the J. Flowers Health Institute article, the authors write, “Matters relating to cultural backgrounds or spiritual beliefs that may be important to the patient should be allowed in a free and open discussion. The patient should feel that both doctor and patient are on a joint exploration through the patient’s history, life experiences and current symptoms.” (4) When patients feel respected, valued, and heard they are more likely to trust their providers and consequently, more willing to follow a collaborative healthcare plan.
If a mutually trusting provider-patient relationship is the destination, effective communication is the vehicle you use to get there. Stephen R. Covey once said, “When the trust account is high, communication is easy, instant, and effective.” (6) Patients want their doctor to be able to communicate in a way that they can easily understand and this goes beyond just words. Effective communication encapsulates availability, honesty, respect, and body-language.
Availability – Patients want to be able to schedule an appointment with their doctor within a reasonable amount of time, such as within a few days. Furthermore, patients appreciate a variety of ways to communicate with their doctor such as email, Telehealth, online portals, voicemail, etc. More importantly, patients expect a prompt answer from their provider.
Honesty – Honesty goes hand in hand with trust and it’s hard to say which came first, the chicken or the egg. The two are completely interwoven and are both key components in a successful patient-provider relationship. In an article published on August 27th of 2020, author Scott Rupp writes, “Patients appreciate a doctor they can count on who communicates with complete transparency.” (7)
Respect – From the patient’s perspective, a respectful doctor is one who listens well. In an article titled, “Patient Care and the Importance of Doctor/Patient Relationship,” MEDIjobs Redaction writes, “Being treated impersonally or being rushed through exams may feel disrespectful.” Furthermore, taking the appropriate amount of time with each patient not only makes the patient feel respected, valued, and heard; but it also enables the physician to infer information patients may not be verbally offering, which can benefit the patient care plan. (8)
Body-Language – Oftentimes a trip to the doctor’s office can be a potentially intimidating experience for some patients. Body-language such as a warm smile, a relaxed posture, intentional eye contact, and a moderate tone of voice can all help put the patient at ease and foster a relationship of trust.
At the center of every successful patient-provider relationship is trust and effective communication. Annals of Family Medicine published a recent article that sums it up nicely: “A strong physician-patient relationship involves good interpersonal communication, the development of a shared understanding that allows for reliance and trust, and ease of obtaining care, facilitated by the physician serving as a patient advocate.” (9)
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Jerry L. Stone