Breaking the Ice: How to Approach a New Patient
By Juan Fuentes, MD

Dealing with a new patient can be challenging. There is anxiety on both parts, from the patient trying to establish a good connection with the provider and from the provider trying to establish a good rapport with the patient. What works for me might not work for other providers; however, there are a few simple techniques that will help make the patient feel more at ease on his or her first visit. One cardinal point is to be prepared for the appointment. First, try to obtain the medical records beforehand and study the case. Then, obtain as much information as possible from the records and prepare to present yourself to the patient with a solid idea of what is going on. Next, prepare a plan to meet patient expectations.

Additionally, it is important to review previous diagnoses, medication list, possible interactions, and diagnostic test results. Doing this, you may be able to find out any work up that was left incomplete due to patient relocation.

Once you have introduced yourself, establish eye contact and make the patient comfortable by sitting at their eye level. Due to the pandemic, we cannot shake hands anymore, but an “elbow bump” can establish a connection. Furthermore, if you start talking about a patient’s chronic conditions, they will feel more comfortable knowing that you are prepared. 

We all know that taking a good history and a detailed physical exam will give us 90% of the diagnosis, so there is no need to rush to discuss the diagnosis. Instead talk about the patient’s lifestyle, hobbies, and daily routines. We have to diversify our conversations with our patients and encourage the patient to talk freely without any interruptions.

During the physical exam, it is important to explain every step of the exam, so the patient is aware of what to expect. 

  1. Make them feel comfortable: This is a good time to ask questions and review so you do not miss anything. Once you are done with the exam, explain your findings, confirm your diagnosis, and elaborate on a diagnostic work up and a treatment plan. 
  1. Be honest and realistic with the patient: Establish a working diagnosis. Order targeted tests based on your findings, and if the patient has many complicated issues, manage the most appraising and bring the patient back in a few weeks to continue working on the rest. That will give you time in getting additional records, obtaining labs, and corroborating diagnosis. If you are not sure about the diagnosis, tell the patient what you suspect and explain your conclusion in lay terms that will be easy for them to understand, avoid technical terms. 
  1. Make sure to ask if the patient has any questions: Allow some time to remember any untouched subjects. If you are prescribing medications, make sure to discuss possible side effects and realistic expectations about when they should see an improvement in their symptoms. 

Remember to encourage patients to call you if any topic of discussion is not clear or something additional comes up. If you follow these steps, you will have a satisfied patient and a good source of referrals. In the end, breaking the ice does not have to be such a daunting task when the right approach and steps are taken.

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