To build a strong patient-clinician relationship, position your body with an open posture and make good eye contact.
Connecting with Patients | October 1, 2020 | 3 min read
By Adam Koenig, Medical Student, University of Toledo
When I was an undergraduate student, I had the privilege of participating in a medical mission trip to Argentina. I worked with Argentinian medical students to give care to people in remote towns, many of whom had no access to healthcare.
I interacted with hundreds of patients during the trip, but there’s one encounter I’ll never forget. I was shadowing a medical student who was giving a wellness exam. The patient was in her late 50s and had nodular growths covering most of her body. From the moment she entered the makeshift exam room, it was clear she was apprehensive. But as the exam continued, her anxiety visibly dissipated. Then she began to cry.
Concerned, the student paused the exam, held the patient’s hand, and asked if she was ok. With tears in her eyes, she glanced up at the medical student and offered a half-smile. She placed her free hand on top of the student’s and explained in Spanish that she couldn’t remember the last time a stranger had touched her without hesitation or disgust.
“Eres de Dios,” she said—you are from God.
Body Language and the Patient-Clinician Relationship
Our body language can influence our patient’s experience. Body language is a largely subconscious, unspoken form of communication that includes posture and eye contact. It’s the foundation of every in-person interaction. Body language communicates social cues and gives others insight into our intentions, feelings, and beliefs. In the patient-physician relationship, it can help to establish the trust from which the relationship can grow and deepen. Patients are more likely to follow through with treatment if they trust their doctor. Additionally, in the face of negative outcomes, patients are less likely to take legal action against a clinician they trust. Even a gesture as small as compassionate touch may strengthen the patient-clinician relationship.
Since body language is largely subconscious, it no doubt has a predilection to reflect our biases. Conveying these subconscious biases can harm the trust between patient and physician and potentially lead to poorer health outcomes. It’s also critical to know the implications of implicit racial biases in the context of body language. A 2013 study in “Social Science and Medicine” found that Black patients may perceive discrimination from a non-Black clinician’s physical cues even if the doctor’s verbal cues are friendly. This is in contrast to comparable white patients who perceived no prejudice from the same physician’s non-verbal behavior. This perceived discrimination—the patient’s interpretation of the clinician’s subconscious behavior—has negative implications for the patient-doctor relationship and can worsen health disparities.
Unlearning biases is a lifelong process and beyond the scope of my training and this article. But one thing that you can do today is to take conscious control of your body language to ensure you’re conveying silent signs of empathy and compassion. Here are three helpful tips:
1. Make eye contact.
Eye contact is a critical part of building relationships. It lets your patient know they have your full attention and are listening to their concerns. Shifting glances may indicate that your attention is divided.
2. Be mindful of your movements.
We all have extraneous movements, whether it’s fidgeting our thumb or tapping our foot. Be mindful of how your subconscious actions may be perceived. Excessive movement might indicate to the patient that the time for the visit has ended.
3. An open body is an open mind.
An open posture shows you’re receptive to the speaker. Crossing your arms or legs, as well as leaning backward, may signal to the patient that you’re not interested in what they’re saying.