4 essential elements of a healthy doctor-patient relationship

Female doctor holding application form while consulting patient

It’s easy to focus on the basics when evaluating your doctor: Did he go to a good medical school? Does she have a good reputation with colleagues and patients? Is he in your insurance plan’s network? These questions are an important part of your calculations.

But there’s another equally important — and somewhat intangible — factor to consider: Will the two of you be able to build a relationship that works to keep you healthy?

Recent research shows a good doctor-patient relationship can improve health outcomes, so it’s worth investing the effort to determine how your connection with your doctor stacks up.

This process can take time, possibly several appointments. Whether you’re seeing a new doctor or evaluating one you’ve had for a while, weigh your exchanges against the following four elements, which are the keys to any healthy doctor-patient relationship.

1. Communication: A Two-Way Street

Communication with your doctor begins the moment she enters the exam room. Appropriate diagnosis and treatment depend on your ability to share your symptoms and concerns, along with her ability to listen. If she doesn’t listen, you may feel like she’s not interested in what you have to say and therefore say less. As a result, your doctor could end up making uninformed decisions.

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“One of the greatest frustrations of a patient is feeling that he is not being heard,” says Dr. Maggie DiNome, director of the Margie Petersen Breast Center at Providence Saint John’s Health Center in Santa Monica, California. “If a physician doesn’t take time to listen to her patient and to understand what’s going on, not only will her ability to care for the patient be compromised, but also a great opportunity for developing a trusting and meaningful relationship will be lost.”

Likewise, your ability to understand and follow treatment recommendations depends on your doctor’s translation of complex medical topics into understandable, actionable advice. On both sides, if communication skills are lacking, the relationship suffers.

READ MORE: Could Your Doctor’s Distraction Be a Good Thing?

2. Physician Empathy

Empathy is the ability to share someone’s perspective, to mentally stand in their shoes and see the world from their point of view. Simply listening isn’t enough; a doctor who fully understands where a patient is coming from is better able to build trust and provide advice and treatments that align with the patient’s needs. Physician empathy is such a valuable part of the doctor-patient bond that some hospitals  are training doctors for it.

“Doctors must always take time to understand not just the physical ailment the patient is suffering from, but their emotional state,” says Dr. Peter LePort, medical director of the MemorialCare Center for Obesity in Fountain Valley, California. LePort says the ability to empathize is the most important quality in a healthy doctor-patient partnership. “This (empathy) is the most effective way to gain the trust of a patient and to achieve a truly open, mutually respectful relationship.”

3. Trust

Even though only 23% of Americans have confidence in the health care system, more than two-thirds (69%) trust doctors’ honesty and integrity, according to a 2014 paper in the New England Journal of Medicine . Trusting that your doctor will deliver ethical guidance best suited to your particular health needs is another must-have in a healthy relationship.

“As part of that trust, physicians need to present patients and family members with an honest assessment of the risks and realistic success rates with any recommended treatment or therapy,” says Dr. Guy Mayeda, cardiologist at Good Samaritan Hospital in Los Angeles.

But your doctor must trust you, too, to follow her guidance, take your prescribed medications and follow up as needed.

READ MORE: Your Guide To Getting a Second Opinion

4. Professional Boundaries

If you and your doctor need good communication, empathy and trust, should your doctor be your friend? Not so fast, experts say. Your doctor must walk a fine line between trusted confidant and friend, always keeping within professional boundaries.

“To be an effective care provider, physicians need to communicate with patients honestly and without the fear of generating hurt feelings that might sever a typical friendship,” Mayeda says. For this reason, you wouldn’t want your doctor to see you as a friend, who might be inclined to protect you from bad news or hard truths.

And if your doctor was your friend first, you may be better off looking for someone else; the American College of Physicians and the American Academy of Pediatrics have both cautioned doctors against taking on patients with whom they have a close, personal relationship.

READ MORE: Your Guide To Getting Your Medical Records

Being a good doctor depends on many factors, not the least of which is the ability to maintain strong, healthy relationships with patients. When you’re assessing your doctor, remember: Your ability to connect may be just as important as her insurance affiliation, office location and credentials. If the relationship falls short on any of these valuable measures, it may be time to look elsewhere.

Elizabeth Renter is a staff writer at NerdWallet, a personal finance website. Email: elizabeth@nerdwallet.com. Twitter: @ElizabethRenter.