I've got a good doctor, and one of the reasons I like him as much as I do is his "bedside manner"—the shorthand we all use for describing whether or not medical professionals are able to connect with their patients emotionally. But pulling off a good bedside manner isn't just about being kind and empathetic, it's also about time. Part of why I think he had good bedside manner is that he spends time talking to me when I go in for an appointment. He answers questions. He asks about my life. He takes the time to empathize, even if, sometimes, that means that a problem that could have been dealt with in 5 minutes became a 20 minute appointment.
It's hard to make people feel valued and cared about if you've only got a couple of minutes to see them before you have to move on to the next person. Unfortunately, packing as many patients into a day as possible is more efficient in a business sense. A 2005 study of 11 doctors found that they spent an average of 13.3 minutes on each patient—if you combined both face-to-face time and time spent working directly on the patient's case outside the exam room. The next year, anesthesiologist Peter Salgo wrote an op-ed in the New York Times about the pressure put on doctors by hospital administration to see as many patients as possible and move them on through with conveyer-like efficiency.
Now there's a new study that suggests the pressure to behave in a business-friendly way makes doctors more likely to have a brusque bedside manner.
Read the rest
A key component of antibiotic resistance is the over-use of antibiotics. We talk about this a lot in the context of over-the-counter antibacterial cleansers, but there's a doctor's office side to this story, as well.
When sick people come into a doctor's office, part of what they are looking for is psychological wellness. They want to feel like somebody has listened to them and is doing something to treat their illness. Sometimes, that means they ask their doctor for antibiotics, even if antibiotics aren't the right thing to treat what they have.
In the past, and sometimes still today, doctors go ahead and prescribe antibiotics almost like a placebo. It's hard to say no to something a patient really wants, especially when it's likely to make them feel better—just because taking anything, and treating the problem, will make them feel better. But that is definitely not a good thing in the long term.
At KevinMD, family physician Dike Drummond offers some really nice advice for doctors who are struggling with how to make a patient feel better, but also want to avoid contributing to the growing antibiotic resistance problem. What I like best about Drummond's advice: It starts with empathy.
If you have a major challenge working up some empathy one of two things is happening.
You are experiencing some level of burnout. Empathy is the first thing to go when You are not getting Your needs met. This is a whole different topic and “compassion fatigue” is a well known early sign of significant burnout.
You are not fully present with the patient and their experience. In many cases this can be addressed by taking a big relaxing, releasing breath between each patient and consciously coming back into the present before opening the door.