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    Scrambling to make a meaningful connection

    2016 Physician Writing Contest Honorable Mention

    Practicing medicine in the 21st century is hard. Demands on doctors are nothing new, but inevitably the expectations of every player in healthcare continues to evolve.

    My clinic expects me to meet my productivity threshold, earn high patient satisfaction scores, be available for coverage on weekends and evenings, and put forth a collegial and positive presence in the office.

    Insurance companies expect me to document thoroughly and bill accurately for each clinical encounter using the most current version of the ICD, justify the medical decisions I make and represent the disease burden of my patient panel with HCC coding and RAF scoring and meet current quality measures for complex diseases like high blood pressure and diabetes.

    But today’s specific topic (not unlike a good physician) focuses on patients. What do they expect?

    An appointment at their preferred time with minimal waiting. Free parking. They expect to be able to talk about each of their concerns in the allotted time, and expect to leave with adequate diagnostic and prognostic information. They expect to be guided on a path to feeling and living better. And the only way I can adequately rise to that challenge is by creating a real connection within the doctor-patient relationship.

    As a primary care doctor, connecting with patients is my most important job. And that connection is where the joy of medicine is really found. It’s a feeling of genuine trust and mutual respect. It requires patience, active listening, clear and useful information, and providing real emotional support.

    Take a second and imagine the satisfaction a quarterback must feel when he completes a perfect throw to a wide-open receiver in the end zone. It’s a great feeling when things come together that way—that’s why he chose to play football.

    In this healthcare environment, the act of making that type of successful connection sometimes feels less like an easy perfect spiral and more like a wild hail Mary—while running sideways full-speed, away from a swarm of 300-pound linebackers. 

    Don’t understand football? I know how you feel: sometimes I don’t understand the healthcare system. 

    In any case, I don’t want to make it seem like connecting with patients is a lost cause. In fact, here are two strategies that have helped me get better at this.


    Create a game plan 

    I’ve found the habit of “agenda-setting” right at the start of the visit is an effective tool to optimize the use of time. Before I even get into the details of a single problem, I want to know everything that’s on my patient’s list of issues to discuss. I’ll often encourage them to write that list down before the visit. Some items may be very simple and addressed with a very quick answer to their satisfaction.


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