Building Authentic Rapport

Genetic counseling, like many other healthcare professions, involves a lot of explanations and discussions of complex concepts, often interwoven with very serious and life-impacting medical decisions. These conversations also happens in a very short period of time. If a patient is going to trust me enough to listen to what I have to say and then let me help them reach the decision that fits with their desires and values, they need to feel that I genuinely respect them and will act in accordance with their wishes. Essentially, I need to build authentic rapport, and I need to do it quickly. Sound daunting? It can be, but it’s also a skill that can be practiced and improved.

What surprised me most as I learned to develop rapport in my training and career is how much depends on my own outlook and awareness of my internal self and reactions. Being intentional, open, and observant of myself sets me up for a respectful, healthy, and genuine interaction with a patient who is about to trust me with their medical history and care.

Here are a few tips from my training and practice that may help you in yours:

1.) Set the agenda WITH your patient.

Tell your patient what you plan to cover – for example, taking a family history, talking about the specific condition the patient was referred for, and how we will discuss options for testing.

Then ask your patient if this is okay, as well as asking if there is anything THEY would like to make sure to talk about.

2.) Give unconditional positive regard.

Coined by Carl Rogers, this is accepting the patient for whoever they are and whatever they bring to the session that day. It doesn’t mean you have to like them, or agree with their decisions, but when you aim for unconditional positive regard, you are respecting the patient as a person with autonomy, who is doing the best they can with the information and resources (physical, emotional, financial, etc.) that they have that day. Check your judgments at the door, and you will improve the the interaction with your patient.

3.) Watch out for your “emotional antibodies.”

“Emotional antibodies” are the unexpected emotional reaction we may feel in response to a patient, rooted in our own past experiences and within the realm of transference/counter-transference. If you realize you’re feeling inexplicably angry or frustrated with a patient, or that you feel the need to please them or make them happy, recognize you may have been primed by a prior interaction with someone similar, whether in your work or personal life.

Once you acknowledge this, it’s easier to mentally set aside your feelings for processing later, while being aware that you may need to work harder at being objective in this particular encounter. And remember, this happens to everyone at some point – having these reactions is normal and being conscious of them will help you be a better clinician that day. Observe, recognize, and keep going.

Building rapport isn’t about trying to get your patient to like you or agree with your point of view. It’s about meeting them where they are and showing that you’re putting their concerns first and foremost. It shapes a clinical interaction into a human interaction, which is the heart of patient-partnered care.