Building Rapport for Improved Patient Outcomes

Establishing and maintaining an open line of communication with your patients is integral to facilitating the rehabilitation process. Patients need to know that their problems and concerns are being heard. More importantly – they need to know that you as a clinician care. We call this the therapeutic alliance – a level of trust that is created between a patient and a therapist that allows the two to work together effectively towards the betterment of the patient. Notice how I said that it is created, not implied or assumed. It is a relationship that takes time and effort to build up- to reach a level where a patient not only believes in your competence as a clinician, but also opens their self up to true improvements in therapy. Now - in some settings, it is not possible to always have 1- on- 1 treatment sessions in order to build this relationship. Increasing pressures to reach daily or weekly productivity goals have likely caused some therapists to sacrifice quality of care and neglect to build or maintain the therapeutic alliance. So what can be done?

The following are a few tips that hopefully serve as a helpful reminder in your everyday patient interactions:

Pay Attention

This seems like a no brainer. The patient is talking to you or doing an exercise – of course you’re paying attention… right? A common trend I’ve noticed is the tendency to actively document during patient sessions. There is nothing necessarily wrong with this; you’re just trying to be time-efficient and you claim multitasking is easy for you. But the main problem here is the message you’re sending to your patient. Imagine trying to have a conversation with someone and 80% of the time they’re nose down in some paperwork or a computer screen. Barely giving you eye contact. You’re going to think very quickly that that person does not care about what you have to say. This is not the message you want to be sending to your patients. So – pay attention – or at the very least, let them know what you’re doing so that they don’t think you’re more interested in latest cat video compilation on YouTube.

Understand Their Perspective

Patients want you as the healthcare professional to understand what they are going through. During initial evaluations for example, typical script questions such as type of pain, functional difficulties, and prior treatment will always be staples – but they rarely give you the whole picture. Ask questions that delve deeper. Ask them about themselves as a person. Ask them more subjective questions about their diagnosis. Why do you think you have this problem now? What do you think you need to help you get better? What do you hope to accomplish through physical therapy? We are not psychologists and we shouldn’t try to be (refer out!) but making the effort to learn more about the patient aside from what’s on the surface gives you a clearer picture on what they need for treatment and helps establish trust in the patient-therapist relationship.

*** Be careful though - depending on a patient's culture or personality type, they may not like you getting too personal too quickly. In which case, be patient and look out for better opportunities down the road to find out more.

Be a Positive Force

One of the more effective ways I find to be helpful in connecting with a patient is simply through smiling. Sometimes it may be difficult to maintain a smile with a patient because you could be busy figuring out what’s going on, the patient may be pessimistic, or you may be having a bad day yourself. But being optimistic during your interactions can go a long way when dealing with patients. They may be going through tough times themselves and seeing you upbeat may change the mood of their day. Overall, bring a positive attitude to each treatment session and they’ll look forward to seeing you every time.

Remember The Finer Details

Things they tell you about – their family, places they’ve been to, interests, dislikes – remember that information. Even small things that happened during previous treatment sessions. Write it down somewhere if you need to. This way you can reference it later on and make it known to a patient that you remember more than just what is written in the objective notes section of their chart. It gives you the capability to convey the message, “I remember and know who you are” vs. “I vaguely remember working on your bum shoulder last week.” A big difference that I believe will keep them coming back for more treatment.

What have you done to build rapport with your patients? How do you vary your strategy with different types of personalities and/or diagnoses? Let us know what you think!