The Relationship Between the Person Seeking and the Person Providing Care
Unhappy patients describe poor listening and feeling dismissed. The sense that the diminished hope/increased despair was intentional can motivate someone to complain (1).
Perceived empathy (the sense that the clinician is genuinely interested) creates trust and adherence. A good relationship between the person seeking and the person providing care can foster the flexibility needed to get from how things seem to how things are–a key aspect of health.
Our research on satisfaction with the process of care points directly to a strong relationship with the patient measured as perceived empathy.
Technology will increasingly take over some of the cognitive aspects of medicine, but the key relational aspects provided by clinicians will likely be irreplaceable (2).
Our research on care relationships is focusing on several areas:
- Our consortia of Austin area clinicians and research volunteers have completed a that identified surgeon self-rated empathy did not correlate with patient-rated empathy (In peer review)
- We also compared the CARE and Jefferson measures of perceived empathy and found both to have substantial ceiling effects, fewer with the Jefferson instrument (In peer review). The measures were highly correlated. We know that we need a measure of empathy with less censoring (bunching of scores at the highest empathy levels) because the distinctions at those higher levels of empathy represent learning opportunities.
- We are video-recording visits and having them rated by the Center for Health Communication graduate students for the effectiveness of communication strategies. We can then see how these ratings correspond with patient rate empathy and learn from any divergence.
- We also plan to use these recordings to develop more specific measures of clinician communication strategies. The current measures are designed for medical student testing with actor patients.
- We could also have patients watch the videos and tell us what they think works and where there are opportunities for improvement.
- Along these lines, in collaboration with Kasey Claborn (Director of Qualitative Research for Comprehensive Care), we are doing qualitative studies of what helps create an effective relationship between the person providing and the person seeking care.
- We are also doing qualitative research into clinician facilitators and barriers of effective relationships.
References
- King JD, van Dijk PAD, Overbeek CL, Hageman MGJS, Ring D. Patient Complaints Emphasize Non-Technical Aspects of Care at a Tertiary Referral Hospital. Arch Bone Jt Surg. 2017 Mar;5(2):74-81. PubMed PMID: 28497096; PubMed Central PMCID:PMC5410748.
- Ring D, Johnston SC. Your Best Life: Resiliency and the Art of Medicine. Clin Orthop Relat Res. 2018 May;476(5):937-939. doi: 10.1007/s11999.0000000000000268. PubMed PMID: 29601392.