Specific interpersonal skills can enhance the doctor patient relationship, and are important in working with patients to resolve ethical dilemmas. These include skills which can enhance data gathering and those that communicate empathy.

In general, patient satisfaction and compliance improve when clinicians express concern, allow patients to express problems and concerns in their own words, and discover patient expectations. Patient satisfaction also has been related to clinicians expressing friendliness, interest, and a non-judgmental attitude.

Here are some of the concrete skills that help accomplish all of this:

Use open ended questions to begin your inquiry:

An open question is one that requires more than a "yes" or ""no" answer. For example, "What did you hope that I could do for you today?"

For example, "Can you tell me what you're worried about?" or "What are your concerns?"

You can use "continuers," such as "tell me more", "uhm hum", or nodding while remaining silent. It's not unusual for patients to refrain from discussing some fundamental concerns while they're assessing how much they can trust their doctor.

Helping patients with decisions should build on a patient's existing knowledge. Patients often have misconceptions or fears which clinicians can then address.

Many patients won't ask important questions or admit they don't understand something unless specifically invited to ask. You should probably ask patients if they have any questions about in the middle of the interview, rather than at the end when patients feel that their time is almost at an end.

Dilemmas may not be resolved in the first meeting, but you can state your understanding of the patient's concerns, acknowledge the difficulty of the predicament, state your position, and search for a middle ground, an acceptable compromise, or acceptable next steps.

Though many relationship skills can be defined, five skills are now widely taught. These skills help the physician to verbally communicate empathy, concern and understanding and promote patient trust. They encourage patients to reveal their concerns in greater depth. While it is true that empathy can be communicated wordlessly, by voice tone, manner, or one's style of asking questions, clinicians can communicate empathy more reliably in words. Naming or reflecting the patient's emotion:

The first, and perhaps most powerful, of the relationship skills is naming or reflecting the patient's emotions. When a patient expresses an emotion, either in words or in manner, the clinician makes a statement acknowledging recognition of that emotion. For example, saying something like "You seem sad". When you make reflective statements, it often elicits important information connected with that emotion.

Another skill is legitimizing a patient's feelings by making comments such as "I can understand how that might upset you." Making ligitmating comments may help reduce the patient's feelings of isolation by communicating that it's normal to have such a feeling.

A fourth skill is expressing respect for the patient's coping efforts. This may help reduce a patient's perception of power asymmetry in the doctor patient relationship. Experiencing a physician's regard may help patients feel treated as equals. An example would be "You're doing a remarkable job dealing with the stresses of this illness."

The fifth skill is expressing partnership or willingness to work together. Patients who take an active role in planning their care have better health outcomes. An example of this skill would be saying something like "Let's work together to try to solve these problems."