RESUMO
The physicianpatient relationship is a complex consensual association based on trust, vulnerability, authority, empathy, and compassion1. Its main objective is to achieve the best patient health outcomes possible. Nonetheless, factors affect how the goal is achieved, such as ineffective communication and low emotional intelligence2. Historically, health professionals have recognized how relevant the physicianpatient relationship is and the patient's experience. Accordingly, patient satisfaction positively impacts clinical effectiveness, health outcomes, patient safety, and adherence to preventive care actions, medication, and clinical practice3. That is why we consider that physicians must use different strategies to improve patients' experiences in consultation. Consequently, we aimed to describe a few tips for improving a patient's experience in consultation. Good communication is the main issue in the doctorpatient relationship, significantly affecting patient safety and satisfaction. According to Burgener, using the AIDET technique to communicate with patients will enhance their relationships with them. AIDET includes five communication behaviors: acknowledge, introduce, duration, explanation, and thank you. The technique consists of first acknowledging the patient by his name; also, the patient's companion, in the case, there is one, smiling and making eye contact (acknowledge). Second, the physician introduces themselves with their name, professional certification, and role in the patient's care (introduce). The next step is letting the patient know which phases of the consultation and the approximate duration of each. Furthermore, explaining to the patient what is next, seeing other physicians, the treatment to receive, laboratory tests, other issues, and answering questions (explanation). Finally, thank the patient for their communication and cooperation and thank the patient's companion for support4. Learning cultural metaphors of illness that is part of the cultural group is another vital strategy to improve communication5. Furthermore, explain the diagnosis and treatment options in a common language, using some active listening strategies to show the patient that you are paying attention. Using questions, affirmations, and non-verbal manifestations of attention, summarizing what they have said to make sure that you understand correctly6, and using the teach-back method, which consists of asking the patients to explain in their own words what they understood about their diagnosis, treatment, and self-care. These tools will also make communication more effective for both7. Other ways of enhancing the patient's experience are being empathetic by recognizing and understanding the patient's feelings, concerns, and situations. This will communicate that you know and care about what they need8 starting the appointment at the scheduled time. Furthermore, if this is not possible, informing the patients about any delays will reduce anxiety and increase tolerance. Apologizing for the delays can positively impact emotions arising from the patient, such as irritation, anger, and frustration. Some ideas may include offering entertainment options such as magazines or televisions in the waiting room to make it more enjoyable9. Being empathetic is the foundation of the patient experience. We understand empathy as the ability to connect with others and see their situation from their perspective and context rather than from our values and life view. It begins with a warm and kindly initial contact, represented by direct eye contact, a respectful greeting appropriate to the patient's cultural background and age, and a welcoming statement that makes the patient feel comfortable and shows our genuine interest in helping them10. Following that, we ask the patient, in the most open-ended way possible, about the reasons for their visit to the clinic. This moment is crucial, but we recommend approaching it like news headlines. In other words, we only need a brief phrase that describes the different concerns of the patient. This moment may be intimidating for doctors, as we might think the patient will go on without limits, but 50% of patients will not take more than 90 s, and 90% will not take more than 3 min. The task, then, is to prioritize that list of issues and collectively determine if we can address all of them in this visit or if we need to defer some points from the list11. Next, we proceed to ask open-ended questions, actively listen, maintain a good posture, be mindful of our gestures, and, as mentioned before, use sounds and gestures to indicate that we are attentive and fully present with the patient. During this conversation, we pay attention to the emotional tone and cues regarding underlying concerns that may not be immediately apparent to respond empathetically. Finally, we summarize the information and ask the patient to clarify or provide further details on anything that may not have been fully understood. A third critical strategy is involving the patients in the decision-making process, which can be done by explaining the alternatives and the pros and cons. According to other authors, greater patient involvement in decision-making is associated with higher patient satisfaction12-14. Patient-reported outcome measures (PROMs) can also help improve patients' experiences. PROMs are standardized, validated surveys that can be used to assess various health-relevant concepts, including patient care experience. Using this tool, physicians and care providers can learn more about the patient's preferences and values, valuable information for shared decision-making, allowing the physician to propose treatment options that match the patient's preferences. It will also be possible to assess patient reports about their actual experiences with health-care services, giving them the opportunity to recognize which aspects need to be enhanced15. In addition, physicians who wear white coats are perceived as more reliable, experienced, friendly, and professional than those who do not wear white coats. This will impact patient satisfaction16-19. Accordingly, we suggest wearing white coats during consultations. Nevertheless, we may highlight that patients' preferences can vary according to different sociodemographic characteristics, such as age19. To conclude, we might like to emphasize that patients' well-being must be a vital physician's goal, which is why we encourage health-care professionals to put into practice the tips we describe in this document. Finally, thank the patient for their communication and cooperation. Furthermore, you may thank the patient's companion for their support