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Bending time to benefit patients

A Stanford study finds that the kinder a health provider seemed to a patient, the more time the patient felt was spent on them.

Patients want more time from their doctors, but doctors have less and less to give. Can this gap be bridged?

A new Stanford study offers an intriguing idea.

Drawing on the notion that the perception of time is fluid, the researchers set out to see what physicians can do to make their minutes with patients seem longer, and therefore, more satisfying.

“One thing that we hear a lot is that in order to build rapport with patients, you have to invest more time with them,” said Lauren Howe, PhD, a postdoctoral scholar who is the study’s lead author. “We’re interested in exploring whether there are simple things that providers can do to build a sense of warmth, so both patients and providers derive the benefits.”

In the study, Howe and her colleagues tasked 13 medical and nursing students with taking health history and standard measurements, such as weight and blood pressure. They were instructed to act in a neutral manner and given exactly 10 minutes with each patient, timed by stopwatch.

The 187 participating patients had no access to a timekeeper: they were temporarily separated from their cellphones, with no visible clocks nearby.

Afterward, the patients rated the provider’s warmth — friendliness, whether the provider made the patient feel at ease — and competence on seven-point scales. The patients also provided an estimated length of the encounter.

The result? The kinder the provider seemed to the patient, the more time the patient felt was spent on them. In fact, each additional point on the warmth scale corresponded with an 86-second increase in the perceived length of the visit. And those seconds added up: the interactions rated the least friendly were estimated to last 9.33 minutes on average, compared to 14.39 minutes for providers considered the warmest.

Howe said she was not surprised by the results, given prior research on the malleability of time perception. But she was encouraged: “That’s something that can improve health care for patients without costing providers more of their valuable time.”

But how can doctors inject more warmth into their practice? There’s no list of “do’s” and “don’ts,” Howe told me:

Some providers might feel really comfortable using physical touch, or humor, or eye contact as a way to develop rapport with patients. For some providers those same things might make them uncomfortable or not work as well… There’s a lot of ways that providers could achieve this goal of building warmth, and they can choose a strategy that they feel fits their values or preferences and matches the specific patient’s needs.

Beyond the customer satisfaction element, Howe says a provider’s warmth can affect how much a patient responds to their medical treatment. In a prior study, she and colleagues found that patients’ physical responses to a placebo treatment were amplified when they considered their providers more likable and more competent.

In the new research, patients’ perceptions of a provider’s competence were unrelated to their perception of time. Howe told me this could be due to a general, overall assumption of competence in health providers. It also may indicate that patients’ judgement of a provider's warmth comes first.

She explained:

The way that many scholars in the literature on person perception have thought about warmth and competence is that warmth is a question of what are this person's intentions toward me? Do they have positive or negative intentions? And then competence is a question of does the person have the ability to enact these intentions?

From that perspective, warmth is a very important staring point. Does this person actually want what’s best for me? And then are they going to use their competence to achieve that goal?

Photo by Agê Barros

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