The Program to Enhance Relationship Centered Communication (PERCC) was launched at Legacy Wake Forest Baptist Health in November 2015 in response to growing evidence that physician communication is a critical driver of patient experience, quality outcomes and value-based reimbursement. Grounded in the principles of Relationship- Centered Communication (RCC), the development of PERCC was led by Peter R. Lichstein, MD and designed in conjunction with the Academy of Communication in Healthcare (ACH).
Atrium Health Wake Forest Baptist physician educators were trained by ACH in facilitation skills and included Peter R. Lichstein, MD, Raghava Nagaraj, MD, Greg Waters, MD, Jennifer Helderman, MD, Andora Bass, MD, Marcia Wofford, MD and Billy Rice, MD, who established PERCC as a provider- led, skills based approach to improving clinician-patient communication across the continuum of care. Debbie Smothers, FNP later joined as a facilitator and became the first APP in the role.
PERCC 101 for clinicians is structured as an interactive, small group communication skills program, typically enrolling eight participants per session and intentionally mixing physicians, nurses, advanced practice providers and other clinical team members. The curriculum focuses on three core skill areas: beginning the visit by connecting and setting a shared agenda; building rapport through active listening, empathy, and understanding the patients’ perspective; and closing the encounter with clear explanations, teach back, and effective visit closure. Sessions emphasize brief didactic content paired with demonstration and facilitated practice, allowing participants to apply skills in realistic clinical scenarios.
As the program grew, Northwest AHEC became a key partner in supporting PERCC’s reach and sustainability by providing accredited continuing education credit and assistance with participant registration, ensuring clinicians could more easily access training while meeting professional requirements. PERCC eventually expanded to include Leadership PERCC, a program focused on developing practical communication skills for leaders and fostering stronger team connections. It enhances existing leadership strengths and is suitable for leaders at every stage.
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PERCC Participation and Reach
Since its inception, PERCC has engaged a wide and varied group of healthcare professionals. Through 2025, 2,296 people have completed PERCC training. This diverse group includes 779 attending physicians, 600 leaders and officers, 480 nurse practitioners and physician assistants, 80 registered nurses, and 357 resident physicians. These figures reflect the program’s ability to attract participants from multiple disciplines, underscoring its relevance and appeal across different roles within the healthcare team . Early data showed that overall physician communication scores increased and most of the individual communication measures (5 out of 6) also improved.
The current PERCC facilitators include Greg Waters, MD, Andora Bass, MD Marcia Wofford, MD, Billy Rice, MD, and Debbie Smothers, NP, who continue to deliver both foundational and leadership PERCC sessions.
Over the past ten years, PERCC has demonstrated that relationship-centered communication skills can be taught, practiced, and sustained in complex healthcare environments. From its 2015 launch to its broad adoption by 2025, PERCC has contributed meaningfully to patient experience, clinician development, and organizational culture.
As healthcare continues to prioritize human connection alongside clinical excellence, PERCC stands as a model for how intentional communication training—supported through strong partnerships like Northwest AHEC—can help shape safer, more compassionate care.
Article written by: Beth Hickman, Patient Experience Advisor at Wake Forest University Baptist Medical Center
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