Building Rapport With the Pediatric Patient

Chapter 107 Building Rapport With the Pediatric Patient


A Retrospective Perspective



Deena K. Roemer


The extraordinary progress in medicine has largely been due to tremendous advances in science and technology over the past few decades. However, before surgical robots and lasers in the operating room, and before millimeter-size incisions became the norm, the practice of medicine relied more heavily on the time-tested commodity of skillful rapport. Although mastering medical knowledge and clinical skills has been a major focus until this stage of your medical education, consider that your capacity to build rapport can effectively bring the art to the science, and this is what can make a good physician great.


Having spent the better part of my teenage years and well into my twenties dealing with a chronic illness, I now realize that disappointments in my physician relationships during my early years as a patient remained with me for 15 years. As I approach my thirtieth birthday and yet another bout with ulcerative colitis, I welcome the opportunity to share some thoughts, hoping to transform my previous disappointments into a reflection that may be useful to the next generation of caring physicians.


Establishing rapport is essential to the healing relationship. Though some physicians may have more innate skill than others, the best ways to develop rapport can be taught. Its mastery may, at times, seem as difficult as decoding the Rosetta stone. You speak one language, “Doctor,” while the patient speaks “Kid,” and far too often the intended message is lost in translation. Medical jargon can sound sterile to a sick child and can be the fast track to disengagement and feelings of defeat. On the other hand, good communication skills will make life easier for both doctor and patient from the initial encounter through the phases of diagnosis and disease management. There is tremendous power in doctor-patient collaboration when you have successfully recruited the patient to be an active participant in his or her care.


The key to “how to” lies in focusing on one’s interactions with the patient as much as one focuses on the desired treatment outcomes. By concentrating effort on the specific practice of interpersonal skills and communication, the real physician partnership based on rapport can be created.



How to Make a Good First and Caring Impression


Most articles that highlight the value of building rapport focus on making a good first impression and stress the importance of introducing yourself, making eye contact, smiling, and addressing the patient by name. All are true. My perspective as a patient is that in a high-anxiety setting like a hospital, rapport requires more than a handshake: it requires offering up your humanity. How can you let your humanity shine through?


1 Acknowledge the child’s hardship. Diagnoses and doctor’s orders are often met with resistance. Ordering a child to complete a battery of medical tests or ingest daily medication is easy. Getting the child to comply is a different story. Tests and treatments may come with unpleasant prep activities and side effects. Thus it may be perceived that the child is being asked to choose an unknown pain or discomfort over the pain and discomfort that is already familiar. It is a good idea to acknowledge the anticipated hardship and validate the child’s fears, anxiety, and discomfort. Be honest and forthright. Downplaying anticipated side effects may diminish your future credibility. Honest information can be delivered with carefully chosen and sensitive words.
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Jul 18, 2016 | Posted by in PEDIATRICS | Comments Off on Building Rapport With the Pediatric Patient

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