Connecting with patients
As is increasingly obvious to anyone working in pharmacy in 2022, time is precious. Patients and customers who are looking for help will find health professionals torn between dispensing, conducting consultations, managing a business and ensuring employees are focused and equipped to do their jobs. Given that accessibility is community pharmacy’s unique selling point, finding time to talk to patients and customers is essential. Making those conversations effective for both parties is crucial when time is precious – and the magic ingredient is rapport.
You may wonder whether you really need (or have time) to build rapport with patients and customers. However, it has long been recognised that a patient’s health and wellbeing are largely dependent on them receiving effective technical knowledge, supported by successful interpersonal communication.
Rapport is an incredibly powerful technique, in healthcare and in business. It can save you time. It can help you understand why someone is having difficulty with their medicines. It can be easy to develop, but it is even easier to break, and the impact of losing it is greater than you may imagine.
Rapport is, in essence, an emotional connection or relationship with someone else. You might also want to think of it as a state of harmonious understanding with another individual (or group). Building rapport is the process of developing that connection. Don’t confuse it with empathy – although empathy can be an element of rapport.
Sometimes rapport happens naturally. We all know what it’s like to ‘hit if off’ with somebody without having to try – it’s often how friendships start. But rapport can be built consciously by finding common ground in an experience or a view (or socially, in a shared sense of humour) and by being empathic.
Employers are more likely to hire someone who they think will ‘fit’ with the existing team. The small talk that happens when you meet someone new can be the start of building a bond – we all have a tendency to want to be with ‘people like us’.
In a pharmacy, how a patient views, talks, feels or thinks about their symptoms or condition is important. But establishing rapport with people we do not know, who are not ‘like us’ is likely to be harder, since we do not necessarily start with a shared frame of reference.
Crucially, creating rapport allows for a more relaxed setting where information can be productively exchanged. Take a look at the case study in the ‘Pause to Reflect’ exercise on the right.
Ultimately, in the case study, establishing rapport with the subject resulted in more pertinent information being provided.
Pharmacy faces many challenges; time pressures need to be balanced against government and public expectations. Increasingly, contracts across the UK feature individual patient services, where a person enters a pharmacy expecting an interaction or a more formal consultation, often because they have been referred in by another health provider or service. It’s unlikely, therefore, that pharmacy teams should be preparing to spend less time on communication, and more important that communication is as effective as can be.
Master communicators have one thing in common: amazing rapport. And it can be created on a one-to-one basis or with a group of people. Rapport is simply a process of matching or mirroring someone so that they accept, uncritically, any suggestions you might make to them. But, before we get to that, let’s briefly consider how you might kick off a conversation with someone you don’t know in a way that will ultimately help create the rapport you might need to have an impact.
In a pharmacy, you might not have time for lots of initial small talk, but you might want to break the ice with a safe topic – how the person got to you; the general state of their health, even the weather. It’s a good way to start establishing trust. Listen to the other person, try to maintain eye contact, relax and lean forward slightly to show you are listening.
Each person is unique in how we operate in our model of the world, with attached values, beliefs and attitudes. Rapport is about establishing a bridge whereby you can understand the other person’s model. You do not have to agree with their perspective, but you should respect it. For example, a patient may have a particular view about their medicine with which you do not agree. That’s fine, but if you do not recognise (empathise) with the patient’s point of view, any advice you provide will not be accepted by them.
Pause to reflect
In a training session, a young man with diabetes is speaking to a group of pharmacy students. As they ask questions about his experience of diabetes, it soon becomes clear that he is not at all happy. The young man’s face has reddened and the flow of information has stopped.
What do you think happened? What sort of things do you think the students were missing?
On investigation, the young man asked the students to stop referring to him as a ‘patient’. He also indicated that he found it difficult to answer a long list of questions.
The students were not creating rapport with their client. They talked in a communication mode that differed from his. They also failed to recognise changes in his body language – the cues that indicated that he was feeling uncomfortable.
Once they understood the young man’s communication model, the students were able to converse in his language and he provided more in-depth answers about his condition and how he felt about his diabetes. This had an immense impact on the flow of information. One thing the students discovered was that the young man needed to complete one task at a time – for example, giving up smoking, then giving up alcohol.
Consider the interactions you have with patients. How often do you give them lists of things they should do to manage their medical condition?
The students also discovered that the young man learned by walking through an issue, so a patient leaflet was not his preferred style of acquiring information. He indicated that he would like to know more about his medicines, but his pharmacist always appeared too busy. He revealed that he did not realise that he could ask his pharmacist about his medical condition.