What makes a great healthcare provider?

What Makes a Great Healthcare Provider

A great healthcare provider actively listens without interruption, demonstrates genuine empathy through both verbal and nonverbal communication, builds trust through cultural humility and respect, and maintains therapeutic presence while balancing clinical competence with compassionate care.

Core Communication Skills

Active Listening and Patient Narratives

• Resist interrupting patients for the first 1-2 minutes of the encounter and fully focus without looking at computer screens 1
• Allow patients to share their narrative in a safe setting, which makes them feel heard, valued, and more hopeful 1
• Patients permitted to tell their illness narrative experience shortened symptom duration (e.g., common cold shortened by almost 1 day) and view clinicians as more empathic 1
• Use nonverbal signs of active listening including nodding, eye contact, leaning in, and mirroring 1
• Paraphrase and reflect on what patients say while withholding judgment and advice 1

Empathy as a Therapeutic Tool

• Empathy—understanding the patient's experience and attempting to "walk in their shoes"—is essential for effective care and improved patient outcomes 1
• Look for empathic openings and offer verbal or nonverbal expressions including reflection, legitimization, respect, support, and partnership 1
• Patients with diabetes have reduced hemoglobin A1c levels when their clinician demonstrates empathy 1
• Use simple and complex reflections to demonstrate empathy and build connection 1
• Recognize and respond to both implicit and explicit expressions of negative emotions from patients 1

Building Trust and Respect

Establishing Mutual Trust

• Treat all persons with respect and regard for individual worth and dignity, including sensitivity to gender, race, and cultural differences 1
• Make professional qualifications, profile photos, affiliations, education, and experience readily available to patients 1
• Demonstrate active listening, patience, and careful attention to make patients feel heard 1
• Maintain patient confidentiality appropriately 1

Cultural Humility and Awareness

• Develop sociocultural understanding of the community being served, including social roles, interactions, and specific community practices 1
• Avoid assumptions and actively seek clarification about culture and community 1
• Recognize that cultural awareness and sensitivity along with demonstrated respect and caring are more important than technical aspects of the visit 1
• Use professional medical interpreters (not family members or untrained staff) when patients have limited language proficiency to reduce miscommunication 1

Clinical Competence and Presence

Demonstrating Clinical Abilities

• Maintain accountability to patients, families, other physicians, and society by accepting responsibility for errors and discussing them openly with families and peers 1
• Commit to lifelong learning and self-improvement 1
• Recognize when problems involve knowledge or technical skills beyond your experience and ask for consultation 1
• Conduct thorough clinical evaluations including history-taking, visual examination, and clear treatment recommendations 1

Therapeutic Presence

• Demonstrate social, clinical, and therapeutic presence through active engagement in the interaction 1
• Both provider and patient must be involved and willing to take part for therapeutic connection to occur 1
• When presence is lacking, the overall relationship and treatment effectiveness are impacted 1
• In telehealth settings, develop "video presence" with exaggerated facial expressions, awareness of surroundings, eye contact, and body language 1

Practical Implementation Strategies

Time Management Under Pressure

Even when time-constrained, invest in the first impression with eye contact, smile, greeting, and small talk 1

• Acknowledge the role of psychological factors even if unable to address them fully 1
• Do not ignore "emotional openings" from patients 1
• Do not underestimate the therapeutic effect of touch, physical examination, and medical rituals 1

Collaborative Decision-Making

• Include patients in decision-making and come to agreement on treatment goals 1
• Provide appropriate information regarding benefits, risks, and costs of all reasonable treatment alternatives 1
• Answer patients' questions and encourage them to seek second opinions when appropriate 1
• Elicit concerns and questions, providing opportunities for patients to state specific behaviors to carry out treatment recommendations 1

Environmental Considerations

• Create a suitable environment that facilitates interactions, allows recognition of verbal and nonverbal cues, and limits distractions 1
• Be aware that face-to-face time has dropped significantly (from 54.9% to 27% of office hours) due to electronic health record demands 1
• Balance ethical obligations to develop therapeutic relationships despite time pressures from administrative tasks 1

Relationship Building Over Time

• Relationships between providers and patients develop over time, requiring sustained effort and adaptation of behaviors 1
• Patients feel more connected when providers demonstrate caring, listen, clarify information, collaborate, and show competence 1
• Small investments toward establishing connection can make patients feel comfortable and empowered to discuss health care needs 1
• Building relationships includes effective communication, cultural awareness, mutual respect, and caring 1

Common Pitfalls to Avoid

• Avoid clinical inertia by titrating medications and reinforcing lifestyle modifications when patients are not at goal 1
• Do not allow electronic health records to diminish dialogue, particularly in psychosocial and emotional realms 1
• Avoid delayed responses, lack of initiative, lack of emotional comfort, and unfriendly tones which lead to patient dissatisfaction 2
• Do not dominate conversations or have difficulty interpreting patients' emotional cues 1