Building trust and rapport early in the new doctor-patient relationship: a longitudinal qualitative study

dc.citation.journalTitleBMC Medical Educationen_US
dc.contributor.authorDang, Bich N.en_US
dc.contributor.authorWestbrook, Robert A.en_US
dc.contributor.authorNjue, Sarah M.en_US
dc.contributor.authorGiordano, Thomas P.en_US
dc.date.accessioned2017-02-02T07:05:06Zen_US
dc.date.available2017-02-02T07:05:06Zen_US
dc.date.issued2017en_US
dc.date.updated2017-02-02T07:05:06Zen_US
dc.description.abstractAbstract Background New patients are a particularly vulnerable population because they are at high risk of missing a subsequent visit or dropping out of care completely. However, few data exist on what new patients value in the beginning of a relationship with a new provider. Persons with HIV infection may be an ideal population to study the drivers of a positive initial patient-provider relationship, as it is a chronic and serious condition that requires a reliable, ongoing relationship with a provider. Informed by patients’ real experiences, this study aims to identify what patients see as the most critical elements for building trust and rapport from the outset. Methods We conducted longitudinal, in-person interviews with 21 patients new to the HIV clinic at the Michael E. DeBakey Veterans Affairs Medical Center in Houston, Texas, from August 2013 to March 2015. Patients were interviewed across three time points: once before their first provider visit, a second time within two weeks after the first visit, and a third time at 6 to 12 months after the first provider visit. Results We conducted 61 h of patient interviews. The mean age was 53 years; 52% were non-Hispanic white, 23% were non-Hispanic black and 19% were Hispanic. Patients described significant anxiety and vulnerability not just from HIV itself, but also in starting a relationship as a new patient to a new provider. Our analysis of these experiences revealed five actions providers can take to reduce their patients’ anxiety and build trust early in the first visit: 1) provide reassurance to patients, 2) tell patients it’s okay to ask questions, 3) show patients their lab results and explain what they mean, 4) avoid language and behaviors that are judgmental of patients, and 5) ask patients what they want [i.e., treatment goals and preferences]. Conclusions Our study incorporates direct input from patients and highlights the unique psychological challenges that patients face in seeking care from a new provider. The actionable opportunities cited by patients have the potential to mitigate patients’ feelings of anxiety and vulnerability, and thereby improve their overall health care experience.en_US
dc.identifier.citationDang, Bich N., Westbrook, Robert A., Njue, Sarah M., et al.. "Building trust and rapport early in the new doctor-patient relationship: a longitudinal qualitative study." <i>BMC Medical Education,</i> (2017) BioMed Central: http://dx.doi.org/10.1186/s12909-017-0868-5.en_US
dc.identifier.doihttp://dx.doi.org/10.1186/s12909-017-0868-5en_US
dc.identifier.urihttps://hdl.handle.net/1911/93839en_US
dc.language.rfc3066enen_US
dc.publisherBioMed Centralen_US
dc.rightsThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.en_US
dc.rights.holderThe Author(s).en_US
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/en_US
dc.titleBuilding trust and rapport early in the new doctor-patient relationship: a longitudinal qualitative studyen_US
dc.typeJournal articleen_US
dc.type.dcmiTexten_US
dc.type.publicationpublisher versionen_US
local.sword.agentBioMed Centralen_US
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