- When it comes to building a positive patient-provider relationship, it’s true that laughter is the best medicine, found a recent study published in the Journal of the American Board of Family Medicine.
Positive patient-provider relationships are the bedrock of a good care encounter, the researchers said.
“Adequate and open communication between patients and clinicians can have a positive effect on the outcomes of care,” the research team explained. “Positive interactions between patients and physicians in the medical encounter helps build a relationship, establish trust, and support the exchange of accurate and relevant information, all of which may contribute to achieving favorable health outcomes.”
Numerous elements go into quality communication and good relationships. While certain clinical strategies such as patient education and motivational interviewing will yield a meaningful patient interaction, the researchers posited that humor could bear with it another key piece of the provider relationship puzzle: a relaxed patient.
“Humor can be a mean for physicians to surface difficult or uncomfortable topics, subtly express dissatisfaction with the patient's behavior, provide reassurance, or get the patient's attention,” the team said.
“In addition, it can invite patients to comfortably express anxiety or discuss frustration with their diagnosis, treatments, or with the medical system,” the researchers continued. “Humor has the potential to decrease power imbalance and cultural differences between patients and physicians, which can otherwise hinder open communication.”
However, it is difficult to understand the role that humor plays in the patient-provider interaction because humor is difficult to quantify. In an assessment of patient-provider communication during 112 care encounters, the researchers consulted the knowledge of four different medical experts to define what constituted a humorous exchange.
“Humor was defined as a statement made with the intent to make others in the room laugh or react positively (i.e., deemed humorous by reviewers) and to which a positive response was elicited,” the team explained. “Therefore, unacknowledged humorous comments or statements that were not intended to be funny (i.e., deemed not humorous by reviewers) but were laughed at nonetheless were not included (e.g., nervous laughter within a generic conversation).”
In all, humor occurred in 60 care encounters at a rate of approximately two jokes per encounter. Humor occurred at similar rates in primary care and specialty care. Jokes were also instigated by patients and providers at similar rates – 63 jokes and 66 jokes respectively.
Patients and providers who were concordant genders also tended to joke more often compared to patients and providers who were not the same gender.
“It may be due to an increased level of comfort sensed between individuals of a similar gender. In addition, those of concordant gender tend to have more similar senses of humor, thus may feel more comfortable introducing humor into an interaction,” the researchers posited.
The researchers also hypothesized that same-gender pairs were more humorous because they were in the primary care setting, which often yield more long-lasting and familiar relationships.
Thirty-one percent of the time, jokes centered on the patient’s medical condition. Sixty-two percent of the time, humorous encounters occurred during the counseling portion of the encounter. In those cases, humor may have served to diffuse otherwise tense situations.
“The counseling portion of the medical encounter is commonly when discussions of diagnosis, treatment, adherence, and other potentially difficult topics surface, thus necessitating some of the key functions of humor,” the researchers said. “It is possible that humor allows patients and physicians to more openly broach these otherwise-uncomfortable topics and helps maintain a productive interaction.”
Positive relationships and good patient-provider communication is an essential part of the care encounter. As medical professionals increasingly focus on patient satisfaction, it is essential that they focus on building a positive rapport with patients as well as clinical quality.
Humor may be one tool to help overcome a number of communication and relationship-building barriers patients and providers currently face, the researchers suggested.
“Patients and physicians experience a network of roadblocks that can ruin efforts of communication. Power imbalance, gender differences, age discrepancy, and varied cultural and socioeconomic backgrounds can all lead to hindered communication,” the researchers concluded. “In turn, this can affect the patient experience and the efficacy of the clinical encounter. Humor may help to overcome those roadblocks by connecting people on common ground.”