A Framework for Building Rapport and Empathy

The initial patient interview can often be a challenging encounter, where patients may diverge from discussing their dental concerns or may be reticent in sharing essential information, making it arduous to grasp their complete story, motivations, and needs.  For some patients, this encounter can feel like an interrogation, with the doctor or team member methodically running through a checklist of questions to ascertain the primary issues or purpose for the visit.  Doesn’t sound very rapport building does it?

I want to alleviate any undue pressure on the doctor or team member conducting these interviews. It is improbable to uncover the entirety of a patient's story during the first meeting. Therefore, it is vital to allow the patient to share their narrative in their preferred manner. While it is acceptable to pose questions to gain clarity and insight, expecting to unearth all details, motivations, unchanging desires, and obstacles during this initial interaction is unrealistic.

Rather, focus on understanding the other, visualizing their story, developing empathy for them and using the 6 box model I first introduced in Through The Red Sea, A Path to Private Care, you will have a framework to build rapport and connection, and one that gives you enough detail to build a working relationship.

To show empathy rather than contempt for people in despair during the new patient experience or any patient interaction is a crucial aspect of providing compassionate and effective care. It is hard for many because the past decisions or lifestyle choices have often brought the other to this point in life.  So how do we maintain empathy for the other and treat them with dignity and respect as another individual, just like you, having a human experience?

Empathy involves understanding and sharing the feelings of another person, while pity and contempt can create distance and dehumanize the individual. Dr. Edwards' 6 box conversational framework offers a structured approach that allows space for empathy to flourish without overshadowing the patient's own narrative.

First and foremost, empathy requires active listening and genuine engagement with the patient's story. Instead of approaching the interaction with preconceived notions, judgments and biases, doctors and hygienists, and other members of the team can use the 6 box framework to focus on understanding the patient's motivations, obstacles, and emotional state. By actively listening to the patient's narrative without imposing one's own agenda, your team can learn to create a safe and supportive environment for the patient to express themselves openly.

Moreover, the structured nature of the 6 box framework provides a foundation for the conversation while allowing flexibility for the patient's unique experiences to unfold. The framework guides the conversation through key areas of inquiry, such as medical history, symptoms, and concerns, without overwhelming the patient with excessive questions or technical jargon. In short, it will feel less like an interrogation and more like an interview.  This balance between structure and flexibility is essential in fostering empathy, as it demonstrates a willingness to meet the patient where they are emotionally and provide individualized care.

Empathy also involves validating the patient's emotions and experiences without judgment. By acknowledging the patient's feelings of despair or distress with compassion and understanding, dental teams using the 6 box framework can establish trust and rapport. This validation can help alleviate feelings of isolation and foster a sense of connection between the patient and the provider.

Lastly, conversations with patients in despair are often a dance, where the patient presents feeling ashamed, humiliated, and often a low level of emotional, energetic state.  They don’t see options that are available to them, lack hope, and often “edit” their history to gain the compassion of the doctor.  This further should be an instance to exhibit empathy because it is a result of being in this state, and any of us who found ourselves in this state would likely behave in the same way.