Improve Your Communication Skills, 2nd Edition

Building rapport: a doctor’s best 
practice
Dr Grahame Brown is a medical consultant who wondered 
why his sessions with patients were so ineffective. He began 
to realise that the problem was the way he conducted the 
interview. Getting the relationship right is, he believes, the 
key to more effective treatment.
My first priority now is to build rapport with the patient in the 
short time I have with them.
Instead of keeping the head down over the paperwork till a 
prospective heartsick patient is seated, then greeting them with 
a tense smile (as all too many doctors do), I now go out into the 
waiting room to collect patients whenever possible. This gives 
me the chance to observe in a natural way how they look, how 
( c) 2011 Kogan Page L imited, All Rights Reserved.

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15 What is Communication?
For most of us, starting a conversation with someone we don’t 
know is stressful. We can be lost for words. ‘Breaking the ice’ is a 
skill many of us would dearly love to develop.
The key is to decrease the tension in the encounter. Look for 
something in your shared situation to talk about; then ask a 
question relating to that. The other person must not feel 
excluded or interrogated, so avoid:
• talking about yourself; and
• asking the other person a direct question about 
themselves.
Doing either will 
increase
the tension in the conversation. As will 
doing nothing! So take the initiative. Put them at ease, and you 
will soon relax yourself.
they stand, how they walk and whether they exhibit any ‘pain 
behaviours’, such as sighing or limping.
I shake them warmly by the hand and begin a conversation 
on our way to the consulting area. ‘It’s warm today, isn’t it? Did 
you find your way here all right? Transport okay?’ By the time 
we are seated, the patient has already agreed with me several 
times. This has an important effect on our ensuing relationship 
– we are already allies, not adversaries…
Next, rather than assuming the patient has come to see me 
about their pain, I ask them what they have come to see me 
about. Quite often they find this surprising, because they 
assume that I know all about them from their notes. But even 
though I will have read their notes, I now assume nothing. I ask 
open-ended questions that can give me the most information 
– the facts which are important to them.
(From Griffin, Joe and Tyrrell, Ivan, 
Human Givens
, HG 
Publishing, Brighton, 2004)
( c) 2011 Kogan Page L imited, All Rights Reserved.

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