Establishing a relationship with the patient – advice for physicians

Mastering the Medical Consultation by Bruno Kissling and Peter Ryser, outlines a systemic, solution-oriented approach to the way that modern medicine has become automated and impersonal. In this extract from the book they explain the basic, but necessary changes that a doctor might make to their own behaviour when meeting a patient. 

Physicians should introduce themselves politely and warmly and say their name. They should speak their name loud and clear, knowing that, especially after the first encounter, patients may not actually remember their name. If the physician has an unusual name, it may be advisable to wear a badge with the name on it or present a card with the name. The physician can also prepare a few words outlining their profession, how long they have been at the present practice, how long they have been a doctor, and who else belongs to the practice.

Introducing oneself is a mutual process. The physician actively invites the patient to do the same, particularly during the initial consultation. The physician listens carefully and attentively to what the patient says, repeats it briefly, and then poses any necessary questions concerning further details. 

With a new patient, the physician may assume that the patient has come to the practice for specific reasons, perhaps because of its proximity to their home or because of a recommendation by an acquaintance – or having discovered the practice on the internet. An inquiry about this circumstance reveals interest on the part of the physician and may provide other, valuable information, such as whether the patient’s previous general practitioner had long wait times or didn’t take the patient seriously etc. This all serves to establish a good working relationship. 

Such an inviting beginning to the consultation is more than just a formality; the physician is so to speak spreading out the welcome mat. Such a greeting introduces the patient to the physician’s basic approach and value system, namely, that a consultation consists of two persons who, despite their very different roles, nevertheless meet on equal grounds. The patient can then feel assured of receiving complete medical and human attention from the physician – and the physician will be there for the patient not just as a medical doctor but also as a human being. 

The physician utters friendly, fraink, and encouraging words in a clear and understandable manner. But equally as important are the physician’s nonverbal behaviours: a calm, quiet voice; an honest and reassuring facial expression; direct eye contact; a firm handshake; gentle movements; a clear touch; authentic, empathetic, and understanding behaviours; a clear and positive posture as well as appropriate clothing, with or without the lab coat. The examination room should be outfitted with functional furnishings and comfortable chairs properly positioned to enable a communicative atmosphere and with an appropriate distance between the two parties. All of these things contribute to creating a positive encounter.

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