I had a clinical consultation with a very well-educated patient who had an existing diagnosis of schizophrenia with manic tendencies. Because of his psychological diagnosis, he had visited quite frequently with his psychiatrists, and his resulting mood disorder, secondary to his diagnosis, was well controlled on psychotropic medications. He also frequently consulted other various medical specialists because of several underlying medical problems. He visited with an endocrinologist for his diabetes management, a pulmonologist for his chronic obstructive pulmonary disease diagnosis, and some surgeons because of other minor surgical procedures he’d had a few years prior.
He came to my practice with a common complaint of ear pain following a head cold. When I enquired about his medical history, he appeared very anxious and spoke so fast that he stumbled over his words. Seeing this, I gently asked him to take his time and tell me about his medical history because I needed to know the full history to make the best medical decision for him.
The look on this patient’s face was priceless as he stated, “Wow, no doctor has ever said that to me before. Usually, no one listens attentively to me because I have such a lengthy medical history from seeing so many different doctors.” I assured him that I was listening and encouraged him to proceed, and with only occasional flights of ideas, he spoke for about 80 percent of the visit time, stopping intermittently to clarify any points per my request as I took down notes. Although he still spoke at a fast pace, he no longer stumbled over his sentences, and I observed that his anxiety was markedly reduced as he spoke. I obtained a very thorough history, performed a physical exam, and treated him for a minor bacterial infection. He was much more at ease and trusting during subsequent visits to the clinic.
The question of trust is one we all find difficult to answer. Probably because Trust is a feeling that is hard to achieve but easy to lose. In any relationship-couples, colleagues, or patent clinician, the question of trust is pivotal and shouldn’t be overlooked.
While some people are very much open to the notion of trust, others are ladened with fear that probably may have been spurred by a broken trust in the past.
According to John Gottman, a feeling of trust is built in those small moments and sacrifices we make that place our partner’s interest first. “Trust is central to what makes human communities work”. Just like what we saw between my patient and me, saying those words of empathy gave him a sense of belonging and succeeded in reducing his anxieties.
The feeling of distrust arises when we are faced with insecurity that suggests that what is important to us is now at risk or not valued by the other person. And in such situations what comes to our mind is either to flee from that relationship or resent the other person.
When you trust, it places you in a position of vulnerability and courage. knowing that even at odds you feel safe with the other person.
The absence of trust can bleed to anything that does not enhance the human experience. Communication that results in trust development remains the backbone of productivity in all life settings, especially in healthcare.
The relationship between a patient and a clinician cannot exist without trust. Trust is essential to building a patient-clinician relationship. Because the extent to which a patient can reveal vital information about her health and state of being is dependent on the level of trust that exists in that relationship. And there is no better way to achieve this than improving the way we communicate.
When you communicate better, you can achieve your goals including building trust.
In my book “Tips for Effective Communication: A Vital Tool for Trust Development in Healthcare“, I explored various strategies you can adopt to become more effective in your communication.
