Will Your Patients Ever Trust You?
Patients who have a trusted provider are more likely to seek care when they need it and to follow through on treatment. But it’s not always easy for patients—especially those from the Black community, which has a complicated history with the healthcare system—to confide in their providers. Building trust takes time and intention—and that’s largely going to fall on you.
The medical profession has a long tradition of failing to provide adequate care to Black people and violating their bodies without consent. This history includes the infamous Tuskegee Syphilis Experiment and a range of current health inequalities. Given that context, it’s no surprise that your patient might view you with suspicion. You may be able to change that if you:
- Use plain language. Describe what you are doing and why in “normal” words.
- Encourage questions. Your patient may be reluctant to ask because he’s afraid of looking ignorant. You can prompt him by asking “What questions do you have?” But this won’t build trust unless you respond calmly and with patience when he asks.
- Emphasize the importance of partnership. Be clear that the patient-provider relationship is a mutual one. You have medical/scientific knowledge. He has intimate knowledge of his body and life. Both are necessary for the partnership you’re building.
- Stress your commitment to confidentiality. This is a top concern for many patients. Explain how you keep his information safe.
It’s not easy to feel like an equal partner in your care when you’re wearing a skimpy paper gown and being asked to divulge information you may find embarrassing. As the provider, you can change this dynamic by the way you interact with him:
- Use common courtesy. Start by asking him how he prefers to be addressed—formally (e.g., Mr. Smith) or by first name or a nickname?
- Ask permission. Explain what you need to do and wait for his verbal consent before you do it. For example, when you’re doing a rectal exam, ask, “Is it okay if I insert my finger now?” Then wait until he says it’s OK to proceed.
- Recognize his right to make choices for himself. It’s a fundamental mark of respect to accept his decisions about treatment and honor any boundaries he chooses to set.
In order to build trust with your patient, you have to communicate in ways that he can “hear” you—and that includes both verbal and nonverbal interactions. Here’s how:
- Look. Pay attention to his nonverbal ways of communicating. Does he show signs of anxiety, like refusing to make eye contact, or tightly crossing his arms and legs? Try to be conscious of your own body language and model a relaxed physical presence.
- Listen. It can be hard to give your full attention when you’re pressed for time or trying to multi-task—but being a good listener is key to building trust. If you can get him to do most of the talking, you’re succeeding!
- Talk. To demonstrate that you were really listening, sum up what you heard, then ask “Did I miss anything?”
No one wants to be defined by his health conditions. You’re more likely to build a mutually beneficial partnership with him if you try to look past the “patient” and find the individual.
- Find out who he is and what you have in common. Ask about his family/friends, daily activities, work, and hobbies. There’s almost always something that can help you connect, whether that’s a common love of sports, bad television, or good food.
- Keep notes. It makes people feel special when you remember personal things about them, and helps create the goodwill that leads to trust. Jot notes about his interests in his chart—and remember to check them before his next appointment.
We live in an on-demand culture—but relationships don’t work that way. You can build trust with your patient if you:
- Respect his signals. For example, don’t push if you sense he is reluctant to answer a question. Explain why you asked and offer to come back to the issue later.
- Accept that he may not be comfortable with the idea of partnering with you. He may prefer to keep his distance. Or he may want you to take more control in directing his care. As long as you are making an effort to honor his wishes, that’s fine.
Patients want to trust their healthcare provider—and that requires confidence that you are working in their best interests. To build that assurance:
- Tell the truth. Respect your patient enough to be honest about his health, the potential pros and cons of particular treatments, and the odds of achieving the health outcomes he wants.
- Lay everything on the table. Give him as much information as possible about his treatment choices. Offering to refer him for a second opinion is a great way to show that he can trust you to put his needs first.