Establishing rapport is to do with making the patient feel at ease. Ascertaining the name the patient likes to be called is useful; it may well be different from the names given at registration. ‘Matching’ is a technique which may be needed early on to get in touch with the patient; for example, adopting the patient’s tone of voice or posture can be a powerful signal that one is adjusting to their wavelength. A patient’s diffidence is reduced by these means and worries are thus less likely to be held back.
Does it matter what sort of clothes the doctor wears? Instinctively, one would say that ordinary dress would be more welcoming than white coats. The fact is that GPs tend to wear ordinary clothes in their surgeries and clinic and hospital doctors white coats, and the public are used to this. In one study about clothes in family planning consultations (Stewart and Woodhouse, 1987), the majority of patients in a community clinic setting thought that the doctors should wear white coats. This view extended throughout all age groups, although the majority was not quite so large among the under-20s.
Once rapport has been established, the consultation can proceed more effectively because the doctor/patient relationship is in harmony (Freeling and Harris, 1984). When doctor and patient get to know and trust each other, the first phase of the consultation may become redundant. However, as with all relationships, rapport may have its ups and downs and work may be needed to rebuild rapport from time to time.
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