Meeting Patients Where They Are

Introduction
Research has shown that the quality of the patient-physician relationship directly affects patient health outcomes.The character of this relationship can determine the amount of information exchanged, the nature of questions patients ask, the decision-making process, and other aspects of clinical communication central to care delivery. The impact of this relationship is reflected in its effects on important outcomes, including patient
satisfaction, physiological markers, adherence to treatment recommendations, and physician satisfaction. Many have reported that “meeting patients where they are” is a core strategy of building a strong relationship, however, how one achieves this is unclear. In this study, we sought to identify physicians’ conceptual and behavioral strategies for “meeting patients where they are.”
Methods
As part of a 3-year study on fostering humanism in the primary care setting, semi-structured interviews were conducted with ten exemplary primary care physicians at three diverse clinic settings: a family medicine clinic affiliated with an academic medical center, a safety-net clinic serving a low-income primarily immigrant population, and a Veterans Affairs outpatient primary care clinic. The interviews were approximately 25 minutes long and explored how providers build connections and trust with their patients. Using a general descriptive qualitative approach with two independent coders, we identified strategies that physicians utilize to meet patients where they are.
Results
Five themes emerged from the thematic analysis that physicians used to meet patients where they are:
1) Respect the expertise of the patient – recognize the validity of a patient’s beliefs, values, personal experience, and perspective.
2) Engaged curiosity – use statements and questions to demonstrate interest and understanding of what the patient is saying.
3) Attentive listening – give patient undivided attention and demonstrate this with body language and affirmations.
4) Mutual participation – ensure the interaction is based on equal power, mutual independence, and equal satisfaction.
5) Authenticity – conduct yourself in a manner that is consistent with genuine beliefs and values.
Conclusion
Primary care providers employ a number of strategies to “meet patients where they are.” The themes capture foundational behaviors which provide the groundwork for creating a safe space for patients by helping clinicians learn how to communicate their sincerity, respect of, and interest in the patient and his or her lived experience. This approach can encourage patients to disclose information that provides insight into their values, perspectives, goals, and other factors that are important for developing an effective treatment plan. The strategies proposed in this study, and the range of examples provided for how to personalize the approach, allow other physicians to adopt these conceptual practices using an approach that feels authentic and can be tailored to fit their clinical
style.