Table 4.

Themes on Facilitators and Barriers to Healing

Caring and connectionAbility to make the patient feel heard and cared for Communicating warmthLack of respect for patients
Responsiveness to patient needsPoor listening
Knowing the patientClinicians having an in-depth knowledge of their patient’s historyPoor medical records
Clinician’s ability to intuitively assess the patient’s desired level of personal connection, information, and involvement in care planningPoor interpersonal communication skills
Continuity of careRelationship over time with one clinician or a teamLack of communication systems among clinicians
Contributes to “knowing the patient”Inattention to the medical record
Clinician turnover
Time“Time to heal”Time pressures
Quality time during appointments to get needs met
Seeing one clinician over a period of months or years (continuity of care)
Social supportHaving friends, family and extended communities that are supportiveIsolation
Lack of social support
Office functionEase and pleasantness of arranging, receiving, and providing carePoor front desk experience
Scheduling difficulties
Staff unhappiness
Lack of resources
Poorly designed roles
Patient behaviorPatient’s attitudes toward health and motivation for healingUnrealistic expectations on part of patients
Difficulty of behavior change.
Unhealthy behaviors (smoking, drinking, etc)