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On Doctoring Etiquette

The patient was a woman in her mid-twenties recently diagnosed with lupus. She was clearly anxious about her prognosis and treatment. The rheumatologist I was shadowing that day entered the room, made some casual conversation intermingled with medical questions, and proceeded with the physical exam. She was attentive to the patient’s needs and accommodating with her questions. The rheumatologist’s confidence, compassion and ability to sooth the patient’s worries made a lasting impression on me. During the brief 15 minute encounter, she not only listened to what the patient had to say, answered every question she had, and communicated her thoughts clearly, but she also made small talk, which made the visit more like a casual encounter with an acquaintance and less like a doctor’s appointment.

Bedside manner and customer service skills have been climbing up the ladder of importance in health care and physicianship. In Western culture in particular, patient satisfaction and customer service are highly valued because they are great marketing strategies. From restaurants to car dealerships, businesses rely on customers’ satisfaction and devotion. Hospitals, likewise, are businesses that need an influx of customers and depend on profits. Many websites, such as vitals.com and healthgrades.com, provide physician information to the public along with reviews of physicians by patients. This provides patients with the transparency required to make informed decisions on choosing the right physician.

Physicians are not only healers that alleviate physical discomfort. They also act as social workers and psychiatrists to care for the mental health and emotional states of their patients. I have seen very intelligent physicians being turned away by patients due to their subpar bedside manner. Clinical competency is a must, but qualities like clear and effective communication, ability to connect with other people on an emotional level, and negotiation skills have become equally important. Studies have shown that patients are less likely to sue physicians with better bedside manner than those with inadequate bedside manner when clinical competency is equal.

However, this is not to say that customer service should actually replace clinical competency. After all, would you rather be seen by a physician of great intelligence and expertise but mediocre bedside manner, or by an extremely charismatic physician with limited experience? The first and foremost duty of any physician is to ease patients’ pain and discomfort, and this is usually performed best with sufficient knowledge. A great physician is someone who can incorporate both qualities with every patient.

Despite the glamour and importance of bedside manner, it is easier said than done. For example, look at our day-to-day conversations with friends and families. We often feel the urge to intercept another person’s sentence because we feel strongly about a point they just made, or our body language may give away some of the feelings we prefer to hide. Similarly, throughout a visit, the physician needs to attentively listen to the patient’s history while appearing sympathetic, be aware of any body language, and yet still formulate a clinical plan. Many physicians are even able to conduct a full physical exam at the same time. Truly, this takes multitasking to a whole new level.

Recognizing the importance of exhibiting interpersonal skills among physicians and teaching doctoring etiquette to medical students, most medical schools in the United States have included “Physicianship”, “The Art of Medicine”, or “Preceptorship” in the first-year curriculum. As a result, medical students are able to shadow physicians interacting with patients early in their training so that they not only learn and practice obtaining a solid patient history and conducting physical exams, but are also ingrained with the do’s and don’ts in medical settings.

Clearly, all the necessary qualities of excellent physicians are not easily obtained. It requires dedication and compassion, as well as years of experience and practice. Hopefully, one day we may all reach our goal of being fully competent, compassionate and caring physicians.

Qing Meng Zhang Qing Meng Zhang (9 Posts)

Reporter and in-Training Staff Member

Rush Medical College

Meng Zhang is a medical student at Rush Medical College, Class of 2017, in Chicago. Meng obtained her bachelor degree in Biological Science in 2010 from University of California - San Diego. Her professional interests are writing, underserved communities, and holistic medicine.

When she's not being a 5/8th of a doctor and writing patient notes "for educational purpose only", she likes to sleep until sunrise, eat a healthy meal, and enjoy every bit of sunshine Chicago offers. Reading, watching TV shows/movies, froyo-ing, and shopping are always welcomed when possible.