Intended for healthcare professionals


How can I gain a patient’s trust?

BMJ 2024; 386 doi: (Published 08 July 2024) Cite this as: BMJ 2024;386:q1444
  1. Abi Rimmer
  1. The BMJ

While the relationship between doctor and patient is a delicate balance there are ways you can make your patients feel more comfortable, Abi Rimmer hears

Honesty is essential

Jazz Sethi, founder and director of the Diabesties Foundation, says, “Language and communication are fundamental. Beyond words, non-verbal cues such as body language, eye contact, and genuine smiles play pivotal roles. Patients should feel a sense of equality, fostering confidence to ask questions, voice concerns, and engage openly.

“Time is a precious commodity. Patients feel most at ease when they don’t perceive a ticking clock. Rushed appointments can leave us feeling dismissed and unimportant. Convey that our time together is invaluable and that our concerns are your priority. Assurance that there is room to ask, re-ask, and discuss without hurry is immensely comforting.

“Building personal connections also enhances trust. Share glimpses of yourself to humanise these interactions. This transforms the encounter from a clinical transaction into a meaningful dialogue. Start consultations with light conversation to build rapport and ease into more serious discussions.

“Honesty is essential. Don’t hesitate to admit when something is beyond your current knowledge. We appreciate the transparency and understand that doctors are human. Admitting uncertainty can strengthen trust, especially when coupled with a commitment to find answers together.

“Assurance, particularly during challenging times, is vital. We need to feel that our doctor is a steadfast ally, dedicated to navigating difficulties together. This sense of partnership alleviates feelings of isolation and fear.

“Furthermore, active listening and empathy significantly enhance patient comfort. Reflecting back what you hear demonstrates understanding and validates our feelings. Avoiding medical jargon and ensuring explanations are clear and accessible is also crucial.

“We ultimately seek a partnership grounded in mutual respect and understanding. By fostering open communication, dedicating ample time, sharing personal insights, acknowledging uncertainties, and providing unwavering support, you can make us feel valued and secure in your care.”

Make me feel like I matter

Sibylle Erdmann, doctor of professional studies in organisational change, and parent representative in healthcare, says, “I was recently asked about my experiences of receiving diagnoses for my children. As the parent representative in a training session for early intervention practitioners, my response was that receiving a diagnosis is hard and takes time to process. I also said that the usefulness of a diagnosis is somewhat 50/50.

“What I mean by this is that 50% of what the healthcare team predicts will happen, will happen—and 50% won’t. And equally 50% of what I as a mother think will happen, will happen—but 50% won’t.

“So, as a parent of two teenagers who both require ongoing medical and developmental support, I go into any meeting with a consultant with a 50/50 mindset. We’ll have a conversation, exchange information, and make predictions. These might not all happen, however.

“The level of trust I feel in our healthcare teams is not based on a need for a future proof, 100% accurate prediction. Rather it is based on how well we negotiate the level of uncertainty that we share when we are in a room together.

“I feel trust when I’m made to feel that we as human beings matter and that we are unique people (not ‘other people’), when our context is taken into account, and when we’re spoken to respectfully and with clarity.

“My level of trust increases when I feel that we are actively building a trusting relationship. I pledge to hold up my end of the bargain—I will attend our appointment, I will be on time, and I will act respectfully and be attentive.

“Over the past decade of representing parents in healthcare, I have not witnessed this way of working as the norm. EiSMART,1 an early intervention framework designed to give high risk babies the best start in life, is an exception to this rule—parents contributed both to its conceptual development and its application in practice, building up an understanding of what matters together with parents.”

Don’t treat me like a tick box exercise

Sarah Blake, who is researching the impact of online access to patient health records, says, “Healthcare professionals often introduce themselves when we first meet during a consultation. I rarely remember their names. Having something to take away with their contact details would help create transparency. I probably won’t remember everything discussed in the consultation, so verbally summarising or writing down key points at the end would be useful.

“I sometimes feel like a tick box exercise, so it’s always great when the professional listens to what I’m saying and takes it seriously, even if it is not what they expect. Recording my perspectives and views in the notes would help, even if the healthcare professional does not see them as relevant.

“I’m interested in my results, and sharing them by offering the figures and data, rather than just writing them down in an inaccessible document or saying they are satisfactory, makes a difference.

“Understanding a patient’s life and context is important—rather than trying to understand their support needs through test results and scans. I have type 1 diabetes and it felt like a very different condition to manage when I lived as a single parent with a young dependant, compared with living with my husband and an older child.

“My GP asks some fantastic questions on their triage form—such as what I’ve already done to help myself. Self-management of conditions with non-prescribed tonics, foods, or peer, family, and tech support can be an invisible area in healthcare. They may complement or conflict with any statutory support, so it’s important to understand alternative provisions.

“They also ask if there’s anything I’m worried about and how I would like them to help. This opens a window of opportunity to learn more about patient expectations and to receive input. A patient may have had a bad experience with NHS care, and it might be difficult for them to have blind faith in the system and those who represent it.”