Strategies for building trust with your DPC patients

Strategies for building trust with your DPC patients October 20, 2022

The patient-provider relationship is an important factor in positive patient outcomes. Developing that relationship depends on a certain level of trust. Direct primary care (DPC) providers are well-positioned to establish trust through communication and community outreach. There are a number of effective strategies for building trust with DPC patients.

Trust in the healthcare field is a topic that has gained an increased amount of attention in recent years, with the uncertainty of the pandemic, a renewed focus on racial justice, and the spread of disinformation and misinformation across social media platforms. Research on the issue of trust is focused on interpersonal relationships, such as the provider-patient relationship and community-level interventions.

Healthcare providers, particularly those offering care through the DPC model, have a unique role in shaping healthcare delivery and can potentially serve as a key center point of change in regard to building trust. These organizations can make changes that create healthcare environments focused on building trust between the clinical team, patients, and patients’ caregivers and support structures.

Trust is a key factor in higher patient satisfaction scores as patients who feel they can trust their healthcare providers will perceive that their care is more effective. They believe that their providers are competent and will make decisions that are in the best interest of the patient based on their diagnosed condition.

Two critical strategies for building this trust with DPC patients are:

• Communication – Communicating in language that the patient understands and that makes patients feel more comfortable and confident will create a positive, non-judgmental environment.
• Honesty – The very foundation of trust depends on the DPC provider being forthcoming with important medical information, including the potential consequences of therapies and medications as well as expected outcomes. For example, if the prognosis or odds of recovery are concerning, being honest about the situation helps patients and their families make better decisions.

In contrast, when the patient or their caregiver does not trust the healthcare provider, they are typically less likely to adhere to medical advice or to take medications as they are directed. They may also not follow through with certain preventive health measures such as screenings.

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Laura Bogart, Ph.D., a social psychologist and senior behavioral scientist at the RAND Corporation, in a recent interview with the Commonwealth Fund’s Transforming Care, stated that some signs of mistrust can include patients:

• Not asking questions or saying much at all
• Not making eye contact
• Seeming physically uncomfortable in the exam room
• Being more direct and stating that they don’t believe their medications will work.

Dr. Bogart recommends strategies for building trust, such as:

• Asking open-ended questions, particularly if the patient seems to mistrust recommendations for vaccines or diagnostic tests.
• Provide detailed, objective information about medications, including vaccines, focusing on research findings on the vaccines’ side effects and long-term effects, relayed in language the patient can clearly understand.
• Acknowledge experiences the patient may have had previously with discrimination or mistrust of healthcare providers.
• Tackle mistrust at the community level, partnering  with community groups and churches for example.
• Act on the feedback received from patients, their caregivers, and community members to improve the trust level and, subsequently, improve patient outcomes.