CHEST Physicians are Repairing Patient Trust in the First 5 Minutes®: Here’s How You Can Too!

"Every 15 minutes, a medical provider is expected to see another patient," says Past President of the American College of Chest Physicians (CHEST), Stephanie Levine, MD, FCCP. Time is always of the essence for medical providers who are tasked with assessing a patient’s condition, forming a diagnosis, and deciding on an appropriate course of treatment, all in one visit. Unfortunately, in the frenzy of checking the boxes, it is becoming apparent that this approach is not meeting the needs of building rapport and trust, especially with patients from underserved communities.

To address this lack of trust-building, CHEST -- with the support of Sanofi and Regeneron as founding members – developed a training program for physicians to learn how to best utilize the first few minutes a provider has with a patient, aptly called the First 5 Minutes® (F5M).

Learning that trust was an issue for underserved communities proved to be the foundational step in developing this program. In fall of 2020, CHEST embarked on what they called a “Listening Tour”, which consisted of real-time virtual sessions with five communities disproportionately impacted by the COVID-19 pandemic. The objective was to learn about the realities of health inequities directly from communities that are suffering the most and give them space to share what needs to be done about it. The message was clear: marginalized communities are not able to live their healthiest lives due to feeling dismissed, misunderstood, and underappreciated by their providers. They undeniably feel the impacts of implicit bias among their clinicians stemming from “cultural and philosophical differences.”

“At first, I thought, ‘What can they tell me about how to do a job which I've been doing effectively for many years?’ But you can always learn something else and having a structure … in the critical first five minutes, can only strengthen the relationships we have with our patients.

In the end, the patients get a better experience and [the providers] get better patient outcomes.”

Diego Maselli Caceres, MD, FCCP
University of Texas at San Antonio provider specializing in critical care medicine and pulmonary disease F5M participant

In the Listening Tour, it was emphasized that providers play a key role in bridging these differences to ensure the healthcare system is worthy of the trust of patients. Given the perception of healthcare shared during the tour, it was clear that providers may benefit from formal training on how to provide empathic care for their patients. CHEST and the experts from the Academy of Communication in Healthcare developed an evidence-based training program that focuses on enhancing cultural competency, strengthening clinician-patient rapport, and encouraging patients to be active participants in their care. The strategies are built to fit within the first five minutes of a clinician-patient interaction. Available in-person or through free online learning modules, the program includes small group discussions and activities, role-playing exercises, relationship-centered interviewing, and techniques to better understand the steps to successful patient interviewing. Two in-person trainings have been conducted in San Antonio and New York with 19 and 23 clinician leaners respectively. In addition, the online learning modules launched in April 2023 trained 50 clinicians within the first month of launch and will only continue to expand its reach. 100% of trainees agree that their practice will change to implement early alignment on clinician and patient goals, active listening, validating patient primary goals, more open-ended questions, and more. Convenient pocket skill cards are also available for download.

“Before my participation in the First 5 Minutes, I assumed that – because of the CHEST involvement – it was going to be focused on pulmonary/critical care and centered around that specialty. However, after going through the course, this is so applicable to any specialty inpatient or outpatient because of the communication pearls and tips provided.”

Megan Rau, MD, MPH,
NYU Langone provider specializing in geriatrics and palliative care F5M participant

CHEST developed this program in response to community voices urging better patient-clinician relationships to build deeper trust. Ultimately, this will lead to improved patient care and outcomes. Sanofi and Regeneron support CHEST’s First 5 Minutes because of the shared belief that listening to patients is critical but must be accompanied by behavioral change based on what patients share. CHEST understands that this training is not only valuable for pulmonary clinicians but for all healthcare providers and looks forward to sharing their learnings with professionals of all specialties. Sanofi and Regeneron are proud to support a program that gives providers a safe space to practice humility, listening, and learning in service of the health of their most vulnerable patients. It is our hope that this program inspires healthcare providers across the board to continue strengthening trust to improve health. Learn more about the First 5 Minutes program on the CHEST website.