The Significance of Good Bedside Manners

The Significance of Good Bedside Manners

Human beings are just that – human.  They can think and feel.  Doctors (as well as most other learned professions) are trained to think objectively, methodically and logically in their respective fields.  It has been said that the common link among all professions is the ability to critically analyze.

Such analysis often does not entail the assessment of emotions.  In fact, the inclusion of emotional aspects to any problem entails the risk of reaching inaccurate conclusions.  It is obviously difficult to explain to a patient the existence of adverse test results or the need for invasive treatment.  But many doctors do it every day, recognizing that regardless of the emotional aspects, the best interests of the patient are served by full information and appropriate measures.

There are a good number of physicians who have become involved with the treatment of a patient for injuries or worsened physical condition that resulted from a “hothead” or abnormally egotistical mentality on the part of the patient.  Whether it was emergency room care arising out of youthful indiscretions or a debilitating condition that could have been avoided had the patient followed recommended procedures, the same basis existed for each – the patient’s decision that was based on emotional, rather than rational, reasons.

It is also the case that, if pressed, patients are not primarily interested in the emotional makeup of their physicians.  Rather, they are principally focused on the

expertise, training and whether their doctors are “one of the best” professionally.

However, this is not to say that they do not care about such emotional makeup on the part of their caregivers.  Many believe that the manner the message is given is tantamount to the message itself.  Thus, while the patient is interested in intellectual acumen, no one likes to hear bad news delivered with indifference.  Physicians readily recognize that the manner of delivery has little, if anything, to do with the quality of the care being provided.  Patients would likely ultimately recognize that as well.  But, it does not mean they are not concerned with it.

In the legal profession, there is an old saying, which is “people don’t sue people they like.”  This is nearly always the case.  It has nothing to do with educational pedigree, professional memberships or financial standing.  It is a rule derived from actions taken (or more accurately, not taken) on the basis of emotion.

Imagine if a neighbor’s automobile was accidentally damaged by their next door neighbor they liked.  Now imagine if the same neighbor’s vehicle was damaged in exactly the same way by someone they didn’t like.  In nearly all cases, the person suffering the damage would be more likely to pursue a vigorous claim against the latter.

So where does the balance between the obvious need for rational and unemotional thought relative to a patient’s condition converge with the emotional needs and wants of the patient?  It does so in this way:  while the physician’s professional assessment and opinions should never be sacrificed in any respect out of deference to the patient’s emotional expectations, the physician must nonetheless get the patient to like them.

How this is done depends on each case; some cases will require very little, but others will require more.  If the doctor is successful in getting the patient to like him or her, many inadvertent mistakes that could occur will be of no import.  On the other hand, just as with the hypothetical involving the automobile scenarios, the outcome can be disastrous for the physician to the extent the patient has concluded he or she is unlikable.

Many physicians have little difficulty in this area.  They are genuinely concerned about the welfare and condition of their patients, and that concern is evident to those patients.  (The exhibition of such concern is one of the best ways in which to cultivate a favorable view on the part of the patient.)  However, there are some practitioners who, for a variety of both legitimate and illegitimate reasons, neglect or refuse to generate a likeable view of themselves.  To the extent this is intentional, the results will be conceptually similar to the outcome on a medical basis of those patients who made cavalier or “hot headed” decisions without forethought.  If the case is not treated perfectly, a malpractice claim should be expected.

A related risk management issue is the fact that many practitioners who fail to create a likeable impression with their patients will also fail to do so with any jury deciding a malpractice case against them.  This means, therefore, that not only is the filing of a claim more likely, but also that the claim will likely be decided adversely to the doctor.

In short, while it may have little to do with the actual practice of medicine per se, it is imperative that physicians create and cultivate a favorable impression with their patients.  Patients want expertise above all else.  But they feel it should be done with care.  This means remembering that the manner of delivery is of equal importance to the message itself.  It also means ignoring any tendency to treat patients in a cavalier, hurried or disrespectful manner.