Relationship Building

  1. How do we build relationships?
    • We build relations with patients when we don’t need them via:
      • Spending more time than necessary – investing extra time
      • Doing more than what is expected from you
      • Making concessions
      • Doing good – acting good even when “they don’t deserve”
      • Keeping relationship with your contacts live and warm – reaching out to just say Hi sometimes
    • We use relationships thn when we are in need:
      • When we make some mistakes
      • When we worry, or when we are anxious, the relationships do help in dispute resolutions faster and smoother
      • When we want to provide a premium service, – it is only possible with the proper relationship in place – it’s exactly a well-established relationship that make patients think the price they paid is justified and fair – providing them with both instrumental as well as affective satisfaction
  2. Just a call to say Hi
    • What do you think a patient reaction can be to a phone call after, say, a month from the doctor appointment when the doctor is just genuinely wondering how you feel with the treatment?
    • What do you think about the reaction a patient may have if it’s already few months after the treatment, well after all the post-decease check-ups – just a call to say Hi and hope all os going well?
    • What about your own reactions – when an acquaintance that you have not had any encounter with lately is calling you:
      • to ask you a favor?
      • to just say Hi?
    • Relationships are built when there’s contact even when we don’t need – when there is no obligation or expectation
  3. Relationship Tree
    • Think of your relationships as a tree – trying to have various branches supporting each other and creating a harmonious connections
  4. Developing Relationship Skills
    • Creating initial rapport
    • Understanding each patient’s needs and what they seek from the relationship
    • Noting down for yourself everything that the patient wants
    • Discuss the points you have noted down with the patient – provide this feedback to ensure there are no misunderstandings in the perception of needs
    • Drill down to each specific need via asking open questions to explore the details
    • Make sure you are then confirming the findings via some close-ended questions too for further clarity
    • Explore the patient’s opinions and pre-existing moods or assumptions
    • Provide empathy all along
    • Always summarize what you discussed to ensure all the primary messages are well understood and remembered
    • Always provide reasons why you may need to ask some additional questions – ensure the patient understands well your motivation and reasoning beyond those
    • Ask for any additional information that may help you in understanding the specific case at hand
  5. Verbal and Non-verbal Methods
    • Verbal
      • Extensions: I see, I understand, or relevant vocal sounds, etc
      • Confirmations: Naturally, Logically, Goes without saying, etc
      • Open questions: tell me more about this point, etc
      • Confirmations: As it seems, it seems to me, let me check if I understood that correctly, etc
      • Perephrasing: say in your own words, etc
      • Summarizing: summary of what was discussed, etc
    • Non-Verbal
      • Confirming attention: eye contact
      • Sensitivity: facial micro expressions
      • Concern: touching chin with your hand or other guestures expressing concern or interest
      • Openness: Showing the palms of your hands
      • Interest: Leaning towards the patient
      • Active listening: perhaps nodding slightly, etc
      • Focus: Show you are not going to be distracted by a computer or by the notes that you have to make, put all those aside for a while to listen. Also, not interrupting and not trying to finish their sentences.
  6. Tactics for understanding the patient’s thoughts
    • Emotions
      • It seems you feel…
      • It seems you think…
      • In this situation many would feel…
      • I see the way you feel because of…
      • I see that you may be thinking about…
    • Thoughts/Ideas
      • Anything particular that you suspect?
      • What do you think about it?
      • Perhaps you have thought of something that has an affect…
    • Worries
      • What makes you most worried about this situation?
      • Is there anything particular that you worry most?
      • Is there anything specific that you fear?
    • Decease Implications
      • How does that decease (those symptoms) affect your everyday life?
      • What do you have to deal with everyday because of this?
      • How does this affect your usual daily routine?
    • Expectations
      • What specifically do you expect – what do you want to do today (on your doctor appointment)?
      • Is there anything else that we can deal with today?
  7. Tactics for Providing Empathy
    • Naming
      • It seems you feel that…
      • It seems you think that…
      • Many would feel in this situation that…
      • I see you what you feel because of this…
      • I see that you may be thinking that…
    • Understanding
      • I understand how this is affecting you…
      • I’m thinking about how it feels what you are going through…
      • It may be difficult for me to even imagine what you are going through emotionally…
      • I know certain persons that were in somewhat similar situations and I understand the difficulties you are dealing with…
      • This is a difficult period for you…
      • I understand you in this very well…
    • Respect
      • It’s a lot of stress that you are trying to deal with…
      • I really appreciate your positive attitude despite all the difficulties…
      • You really are a very brave person that deserves respect…
      • It was indeed such a good decision that you decided to come…
    • Support
      • I want to help you as much as I can… That’s why I’m here…
      • Tell me if there’s any other way that you think I can help…
    • Researching
      • Tell me in more details how you feel…
      • How do you deal with that?..
      • Tell me what happened since our last meeting…
  8. Providing Diagnosis and/or Bad News
    • Environment/Settings
      • Ensure privacy and avoid noise or any other factors that affect perception.
      • Establish eye contact, or even inter-personal touch (subject to relevant local social norms / regulations)
    • Perception
      • Understand what is the information that the patient has about the specific decease.
      • Enquire how the patient understands his/her current condition.
    • Background and Delivery
      • Understand how the patient prefers to receive information.
      • Avoid slang and jargons.
      • Stay positive and ensure you nurture positivity in your patient as despite the specific conditions patients always have their personal goals and the life where they need help staying positive.
    • Empathy
      • Use the relevant tactics for providing empathy. Ensure you are creating some deliberate pauses when delievering news to ensure proper understanding and to emphasize specific points explained. When speaking, use the pace that is adjusted to the levels most comfortable for a specific patient
    • Strategy (words/phrases to use)
      • We…
      • We do the following…
      • We are going to deal with this the following way…
      • These are the options thay we have now…
      • Let’s discuss together the paths we can take…
      • This is something we can’t avoid, however we still have several options there…

No task to prepare for this reading – we will discuss these topics in detail next week.