How to Communicate to Gain Your Doctor’s Trust

Two tips to help you effectively communicate your chronic pain experience.

Depression. Anger. Off-the-charts pain. These are common emotions and experiences for people saddled with chronic pain. But how you communicate those feelings may make a difference in whether your doctor perceives you as trustworthy or untrustworthy. This was the main finding of a 2018 survey produced by Adam Swenson, PhD, a Philosophy Professor at California State University, Northridge, and his colleagues Steven Richeimer, MD, Director of the University of Southern California (USC) Keck Pain Center; Faye Weinstein, PhD, Director of Pain Psychology in the Division of Pain Medicine at Keck School of Medicine at USC; and, Dr. Doerte Junghaenel, PhD, a behavioral scientist at the USC Dornsife Center for Economic and Social Research.

Open, honest communication is the foundation of a strong doctor-patient relationship. But when you’re in pain—and in pain every day—it can be difficult to articulate pain’s impact on your life. Here, you’ll learn the communication traits that recent research has linked to higher trust. You’ll also get 2 tips to help you effectively share your experience with pain with your doctor.
Female Doctor listening to her patientOpen, honest communication is the foundation of a strong doctor-patient relationship. Photo Credit: Illuminates Traits Linked to Trustworthiness
The team sent an online survey to 727 adults—most of the survey respondents (626) of were chronic pain patients; the other 101 respondents were clinicians.

The survey contained 8 narratives written by people with chronic pain. These narratives were short accounts of the person's experience with chronic pain. Here is an example of narrative similar to those used in the study: "I've had crippling pain from a low back injury for the last 4 years. It makes my life really hard, and no one seems to understand. My grandchildren don't understand why grandpa can't play with them. Nothing seems to help.”*

The survey examined “psychological characteristics, trustworthiness and expressions of pain severity, desire for medication, and frustration with pain care.”

Below are the key findings:

  • The survey respondents associated the narratives categorized as “likable,” “stoic,” or “appreciative” with higher levels of trust.
  • Narratives that expressed “depressed,” “hostile,” or “histrionic” themes were associated with lower levels of trust.

A unique aspect of this study was that the same survey was sent to both patients and clinicians. In general, clinicians and patients responded similarly to the narratives—a fact that surprised Swenson.

“Our hypothesis was that the chronic pain patients would give higher ratings of trustworthiness than the clinicians across the board, but that's not what we found,” Swenson said. “The only place where the 2 groups differed was with narratives where the person who wrote the narratives expressed frustration with pain care. In those narratives, the clinicians gave lower ratings of trustworthiness.”

While Swenson hesitated to draw any specific advice for patients from his study, the survey revealed that certain ways of communicating may give your doctor pause. And when your doctor doesn’t fully trust you, that may affect treatment decisions.

“We did find that the clinicians attributed lower trustworthiness than the chronic pain patients when the person who wrote the narratives expressed frustration with pain care, but it's yet not clear why that was the case,” Swenson said. “I certainly wouldn't want to discourage anyone from advocating for their needs. Any human relationship has inherent communicative challenges; the doctor-patient relationship is not immune.”

Two Tips to Help You Effectively Communicate Your Chronic Pain Experience
The health care system is difficult enough for a patient with chronic pain to navigate—understanding the inherent challenges of communicating a subjective subject like pain only adds to the confusion.

As researchers continue to improve their understanding of what influences trust and other underpinnings of effective doctor-patient relationships, you can use the following tips to help you communicate your chronic pain experience to your doctor:

  • Be prepared: Arrive at your doctor’s appointment with knowledge of your medical history, how long you’ve been in pain, and the limits your pain puts on your life. Writing this information down and bringing it with you will ensure you cover everything you need without being sidetracked.
  • Ask questions: Questions You Should Ask About Pain and Pain Treatment provides great questions to ask your doctor related to the complex nature of pain. This resource also includes information about the numeric Pain Scale. The Pain Scale attaches a number (1 through 10) to your level of pain. Attaching a number to a subjective topic like your pain severity can help you discuss it objectively. This helps put you and your doctor on the same page, and increases the likelihood that you’ll receive the right treatment.

*This narrative was not used in the study. Included for example purposes only.

Updated on: 10/09/18
Continue Reading
Sciatica Self-care: 5 At-home Remedies for Low Back and Leg Pain
Continue Reading:

Sciatica Self-care: 5 At-home Remedies for Low Back and Leg Pain

These 5 at-home sciatica therapies are good options for people who recently started experiencing sciatic nerve pain or whose low back and leg pain is not severe.
Read More