Building Trust in Patient-Provider Relationships

Creating a Supportive Environment

The American Academy of Pediatrics recommends sitting down at the patient's level to convey you have time and are not rushed, ensuring privacy with an unobstructed path out of the room, maintaining two arms' length distance to respect personal space, and making eye contact and keeping hands visible and unclenched to avoid appearing threatening, in order to create a safe space for patients to disclose their concerns 3
The Journal of Clinical Oncology suggests using open-ended questions combined with empathic responses to create a safe space where patients feel heard and understood, starting with questions like "Tell me what's going on at home" or "What's been the hardest part for you at home?" 1, 2

The American College of Physicians recommends asking patients about their understanding and agenda before diving into concerns, using questions like "What are the things you want to make sure we discuss today?" to give the patient control over the conversation, and "Tell me what you understand about why you're here" to assess their perspective 1, 2
The American Academy of Pediatrics suggests using reflective listening, acknowledging emotions explicitly, and holding silence until the patient is ready to continue speaking, in order to demonstrate active listening and empathy 3, 4
The Journal of Clinical Oncology recommends avoiding assuming quiet patients don't want to participate, and asking directly, "I'm wondering what you're thinking or if I'm missing something?" to encourage patient engagement 4

The American College of Physicians recommends responding with empathy when patients reveal difficult home situations, by naming the emotion, using partnership statements, validating their experience, and exploring what's behind strong emotions, in order to build trust and establish a supportive relationship 2, 3
The Journal of Clinical Oncology suggests being cautious about providing solutions when patients are highly emotional, as they often cannot process information well in that state, and instead focusing on empathic responses and support 2

The American Academy of Pediatrics recommends establishing clear expectations and mutual respect, setting boundaries respectfully, assuring availability, and being honest, genuine, and respectful throughout all interactions, in order to build ongoing trust with patients 1, 3, 4
The Journal of Clinical Oncology suggests avoiding information overload, providing information in small doses, stopping frequently, and checking for comprehension using "teach back" (e.g., "In your own words, what does this mean to you?") to ensure patient understanding and engagement 1, 2