I vividly remember the conversation that changed the way I practice medicine today.
Dr. Swati Mehta
During my medicine residency rounds, my attending at a Veterans Affairs hospital stated: “Remember Swati, there are three simple steps to gain your patients’ trust. The three questions they have are: No. 1, who are you? No. 2, are you any good? No. 3, do you really care about me?”
The first two questions are easier to address. The third question requires us bare our authentic human self often hiding behind our white coat and medical degree.
Who are you?
- Introduce yourself (everyone is wearing scrubs/white coats – state your full name and title)
- Describe your role in patient’s care plan
- Hand them your card (your name, photo, and a short description of the role of a hospitalist)
Are you any good?
- Briefly address your professional experience
- Explicitly state all the hard work you have done prior to entering the patient’s room (reviewing past medical records, hand off from ED provider or prior hospitalist)
- State your aim to collaborate with all people involved – their primary care provider, nurse, consultant
“Hello Mrs. Jones, my name is Dr. Swati Mehta. I will be your physician today. As a hospitalist, my role is to take care of your medical needs & worries. I will coordinate with your consultants, primary care physician, and other care teams to get you the answers you need. I have been working at XYZ Hospital for 6 years and have over 12 years of experience in medicine taking care of patients. I have reviewed your medical records, blood work, and x-rays before coming in. How are you feeling today? Do you mind if I ask you a few questions?”
Addressing the third question – Do you really care about me? – is the foundation of every human interaction. Answering this question involves addressing our patients’ many fears: Do you care about what I think is going on with my disease? Will you judge me by my socioeconomic status, gender, color of my skin, or addictions? Am I safe to open up and trust you? Are we equal partners in my health care journey? Do you really care?
A successful connection is achieved when we create a space of psychological safety and mutual respect. Once that happens, our patients open up to let us in their world and become more amenable to our opinion and recommendations. That is when true healing begins.
The “6H model” is an aide to form a strong human-centric connection.
The 6H model: Human connection with patients
Looking back at each patient interaction, good or bad, I have had in my almost 2 decades of practicing clinical medicine, the 6H model has brought me closer to my patients. We have formed a bond which has helped them navigate their arduous hospital journey, including medical and financial burdens, social and emotional needs. Utilizing this model, we were fortunate to receive the highest HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) Survey scores for 3 consecutive years while I served as the medical director of a 40-provider hospitalist program in a busy 450-bed hospital in Oregon.
In 2020, we are in the process of embedding the 6H model in several hospitalist programs across California. We are optimistic this intuitive approach will strengthen patient-provider relationships and ultimately improve HCAHPS scores.
To form an authentic connection with our patients doesn’t necessary require a lot of our time. Hardwiring the 6H approach when addressing our patients’ three questions is the key. The answers can change slightly, but the core message remains the same.
While we might not have much influence on all the factors that make or break our patients’ experience, the patient encounter is where we can truly make a difference. Consider using this 6H model in your next clinical shift. Human connection in health care is the need of the hour. Let’s bring “care” back to health care.
Dr. Mehta is director of quality & performance and patient experience at Vituity in Emeryville, Calif., and vice chair of the SHM patient experience committee.
