The Key to Creating Patient Trust: Extravagant Hospitality
By Toni Gitles, Harriet Cavanah Dart, CPed "The interface between people may be as important as
the mechanical interface around tissues." - Paul Brand, MD,
orthopedic surgeon and pioneer in the field of pedorthics,
Veterans Journal of Rehabilitation, 1983.
 Much pedorthic, orthotic, and prosthetic education
is spent on managing the mechanical interface around tissue. What
energizes the professional, however, is often the trusting
relationship with patients that leads to compliance, improved
mobility, and a better quality of life. What frustrates and
fatigues professionals is when a connection with the patient cannot
be established.
To create the premier O&P and/or pedorthic facility,
practitioners must go beyond having a high level of technical
expertise. Experience from some of the more successful facilities
suggests that a high level of relationship skills and extravagant
hospitality in combination with exceptional technical skills
creates patient trust and helps overcome patient resistance.
Providing patients with a caring and hospitable environment is
not so much a matter of what we know as it is a matter of our
skills in human interactions and how we treat others.
This brings us to our concept of "Extravagant Hospitality."
Providing extravagant hospitality includes four skills:
(1) positive attention, (2)
generous listening, (3) authenticity, and
(4) acceptance.
Positive Attention
By showing positive attention to all who enter your practice,
you begin to create a safe and caring space for patients so they
may let down their defenses, dissipating skepticism and concerns.
Create a welcoming environment from the moment the patient makes
the initial contact with any of your staff. When you notice people
and greet them in a friendly manner, they begin to sense your
caring. You can tell people you care or post your mission statement
on the wall, but it is not as convincing as showing them that you
care.
The first step and the quickest access to building rapport and
breaking down resistance is the positive attention that is given to
the patient by all your staff. These skills include:
(1) being present in the moment and not letting
your attention wander; (2) establishing eye
contact; (3) expressing warmth and friendliness
through your facial expression and meaningful gestures;
(4) phrasing conversations positively;
(5) and letting people know your name and using
the patient's name. For example, a patient walks into your
facility. Scenario A: A staff person may or may
not look up at the patient, does not smile, and asks rather
pointedly, "Do you have an appointment?" The question is almost an
accusation, suggesting, "If you don't, you'll have to wait or come
back another time." In addition, it focuses the attention on the
staff member's own convenience in the moment.
Contrast this with Scenario B. A staff person
notices a patient entering the facility and turns her full
attention from what she was doing to establish eye contact with the
patient. She then greets the patient with a friendly smile and
says, "Good afternoon; my name is Deborah. How can I help you
today?" Perhaps you set appointments, and it is 1PM, and you see by
your book that Mr. Rosen is due in for an appointment. Your staff
person says, "Good afternoon; my name is Deborah. You must be Mr.
Rosen here for your 1 o'clock appointment. We're happy to see you.
Please have a seat. We will be with you shortly."
 Although a poor initial impression can be
overcome, the goal of extravagant hospitality is to make the
patient feel comfortable, welcome, and happy that he chose you for
his professional right from the start. Especially important is the
use of people's names, as this single factor serves to give people
a sense of being known for their uniqueness and value. With added
hospitality, the feeling builds to the point that they look forward
to their visits and being in the presence of your warm, welcoming
staff.
Interruptions should be kept to a minimum or handled courteously
in a way that is respectful. Excuse yourself from the conversation
with your patient, put your full attention on the person that needs
your help, and then return graciously to your client, apologizing
for the interruption and encouraging him to continue talking.
Generous Listening
Most people believe they are good listeners, yet new research
suggests we interrupt the person we are talking with every 17
seconds. Likely, in a professional environment we have developed a
good ear for letting the patient tell his story. But, could we do
even better? Here we are talking about full, active listening with
all of our attention on the patient and what he is saying. From our
listening, we formulate meaningful questions to deepen our
understanding of the patient's desires and needs and help establish
realistic and measurable outcomes. This is where the patient begins
to feel understood--and greater trust is established.
Because our minds are so busy interpreting, analyzing, and
planning a solution for our patients as they present their
problems, even the most experienced professional may find his
attention wandering at times. That's normal. As soon as you notice,
re-focus. Also, after helping people for many years, we start to
act like, "Oh, I've heard this story before," and forget that the
person in front of us is unique and deserves our complete attention
as he shares his very personal story and complaints. Professionals
may have noticed that people blossom in miraculous ways when they
feel fully seen and heard. It is as if their self-esteem improves
and a weight is lifted off their shoulders. They so appreciate a
good listener that they start to like and feel comfortable with the
person listening. In addition, listening is a key to instant
rapport. When we listen to others, they are more apt to listen to
us. A practitioner is also an important patient educator. Listening
thus encourages compliance.
Listening includes the ability to be still and silent and to be
comfortable not talking. Often we are so eager to let a person know
we understand that we end up interrupting, breaking the silence
with great regularity. Our intrusions into their speaking, however,
only serve to distance us from the patient.
Our patients are vulnerable as they come to us with disease and
discomfort. Often grief and worry accompany their condition. They
actually may need to go through a healing process as they reveal
their history little by little. Extravagant hospitality supports
healing. Sometimes healing happens the first time someone shares
and receives the support and listening of the practitioner;
sometimes it takes longer. But eventually, the wound is bound to
heal in an accepting and supportive environment where listening is
given priority. When patients heal, they reclaim a part of
themselves that they didn't have before.
Authenticity
Magic occurs for both the practitioner and the patient when
professionals approach their interactions with patients from
passion and commitment. Meeting people passionate about their
profession, who enjoy serving people, is always an uplifting
experience. Letting people sincerely know this is what you love to
do can turn an individual's distrust into admiration. Authenticity
has been called one of the most effective leadership tools, because
in an age of cynicism and distrust, it is one of the few things
that inspire people to action. What we say doesn't count for much
if people don't believe us. The absence of authenticity affects all
our relationships and prevents the very connectedness that we all
yearn for as human beings.
Practitioners want patients to appreciate their training,
knowledge, and expertise. Steer clear of appearing arrogant or
overconfident, which will distance you from your patient. Do this
by using words the patient understands and by presenting options
and educating the patient in an unhurried manner. Honor each
patient's questions; they provide a critical opportunity for
gaining compliance.
Acceptance
The extraordinary journey to becoming our real selves provides a
freedom to be with people--human beings just like ourselves--and
freedom to express and appreciate who we are with all our
imperfections, while still accomplishing the job of helping people.
If we can be relaxed enough to stand in all our greatness and all
our vulnerability, then our patients will also feel comfortable
with their greatness and weaknesses. Accepting others starts with
accepting yourself.
Now, the question here is: "Can you love and accept your grumpy,
complaining patient and provide extravagant hospitality as much as
you can to the friendly, likeable, compliant patient that you
thoroughly enjoy serving?" This is perhaps the practitioner's
greatest challenge. Can you consistently exert a calming and
accepting disposition with this person? If so, you are
extraordinary in your professionalism and truly understand what it
is to provide extravagant hospitality.
Trust and Compliance
Trust and compliance come from incorporating finely tuned
relationship skills and this model of extravagant hospitality.
People have a basic need to be fully seen and heard and to be
accepted for who they are. People also yearn for connection. In
addition to offering technical expertise, practitioners who provide
positive attention and generous listening, accept their patients,
and bring their genuine self to the appointment provide what people
want most. It is not only acceptable, but also good business to
acknowledge our humanity. Toni Gitles is a professional speaker, consultant, and writer who has spent over 30 years in the healthcare industry. She is the author of numerous articles and co-author of the anthology, Happiness is a Decision of the Heart. Contact her at www.tonigitles.com and tgitles@cfl .rr.com
Harriet Cavanah Dart is a certified pedorthist for Scheck & Siress Advanced Orthotics & Prosthetics in Bannockburn and Arlington Heights, Illinois. In 2002, she was awarded the Seymour Lefton Award, PFA’s most prestigious honor, and was included among the “Prominent Women in O&P” by O&P Almanac, March 2003. She is president of the Pedorthic Footwear Foundation. Contact her at harriet.dart@scheckandsiress.com 
Table Of Contents - March 2005
|
