Thinking Thursdays TIPs
Improving Bedside Manner Despite COVID-19 Limitations
Practice Makes Better
There’s a ton of research out there regarding the benefits of good bedside manner including reducing the risk of litigation, influencing a patient’s health for the better, and improving physician rapport. While communication (both verbal and non-verbal) comes more naturally for some of us, it’s a real pain point for many, especially considering the current circumstances of the pandemic. COVID-19 has definitely created obstacles to connect with patients, yet patients’ needs for compassion and empathy have only increased during these difficult times. However, like most other skills healthcare workers have fostered and developed to deliver quality care, with intentional practice, bedside manner can be improved.
Words Matter More Than Ever
Dr. Shahdabul Faraz offers his own insightful testimony on how he has made efforts to improve his bedside manner despite the COVID-19 related obstacles to do so. He writes in his article, “My Bedside Manner Got Worse During the Pandemic. Here’s How I Improved,” “Since the start of the pandemic, our bedside interactions have had to be radically different. Against our instincts, and in order to protect our patients and colleagues, we tend to spend only the necessary amount of time in our patients’ rooms. And once inside, we try to keep distance. I have stopped holding my patients’ hands. I now try to minimize small talk. No more whimsical conversational detours.” (1) He goes on to offer a solution: “As always, we must adapt during tough times. If we want to preserve the bedside manners that can help our patients heal, our words matter more than ever.” He lists several example statements that can really go far in connecting with patients such as:
- “I am here for you.”
- “I want you to know that I will do everything I can to make you better.”
- “What can I do to make you more comfortable?”
- “Did what I just talked about make sense? Did you want me to repeat anything?”
In addition to choosing intentional words to connect with patients, he also has incorporated several gestures, such as greeting his patients by introducing himself and showing them his ID badge with his picture on it, and leaving the room more ergonomically helpful for his patients. (1) These seemingly small details go a long way with patients.
Bedside Manner Throughout History
Good bedside manner has been a high priority in the practice of medicine throughout history. Dating back to the fourth century BC with the Greeks in the Hippocratic corpus, take a look at this snippet highlighting physician bedside manners:
“Be solicitous in your approach to the patient, not with head thrown back (arrogantly) or hesitantly with lowered glance, but with head inclined slightly as the art demands. He ought to hold his head humbly and evenly; his hair should not be too much smoothed down, nor his beard curled like that of a degenerate youth. Gravity signifies breadth of experience. He should approach the patient with moderate steps, not noisily, gazing calmly at the sick bed. He should endure peacefully the insults of the patients since those suffering from melancholic or frenetic ailments are likely to hurl evil words at physicians.” (2)
No stone was left unturned, no detail failed to be mentioned. Skilled physicians have recognized from the very beginning that almost every detail, both verbal and non-verbal, is an opportunity to communicate with the patient. We can learn from those who have gone before us. For a closer look at the historical evolution of good bedside manner, I encourage you to check out Baylor University Medical Center’s article, “Physician Behavior and Bedside Manners: The Influence of Williams Osler and the John Hopkins School of Medicine.”
9 Tips for Doctors
St. George’s University published an article titled, “Developing Good Bedside Manner: 9 Tips for Doctors,” in which Dr. Bernard Remakus and Dr. Lisa Doggett provide some helpful insight for physicians looking to improve their bedside manner: (3)
Strong Communication is Key
Dr. Remakus states, “The ability to communicate is probably the most important skill a physician can possess… The ability to convey genuine concern about and interest in a patient is an integral and inseparable part of the medical communications process.” Notice he used the word convey. It’s not enough to simply have those feelings, physicians need to be able to connect the dots to express what they feel for their patients in a way that can be effectively interpreted.
First Impressions with Patients Really Do Matter
- Know the patient’s name and how to pronounce it correctly. If unsure, ask the patient.
- Be overly courteous, avoid calling a patient by their first name
- Greet any accompanying family members.
Sitting Down Means More to Patients Than You Think
Sitting down during the appointment communicates you’re not rushing. Even if you are rushed, sitting is a simple action that communicates otherwise to your patients.
Speak Professionally and Accurately, but in a Way the Patient Can Understand
Dr. Remakus sums it up nicely, “Physician communication is most effective when a doctor speaks honestly, professionally, and confidently, and discusses a patient’s condition and proposed treatment in language the patient can easily understand.”
Master the Art of Leading a Productive Conversation
A skilled physician can listen well to their patients, while keeping the conversation on task. Dr. Remakus suggests using sound interviewing skills to help keep the visit on track and make sure time isn’t wasted.
Be an Active Listener and Present in the Interaction
Practically speaking, even if having to take notes on a computer screen, position your body towards your patients and occasionally look up to make eye contact with them. Be mindful not to cut patients off with another question, especially in the beginning of the conversation. Minimize distractions.
Don’t Overlook the Power of Body Language
It’s important to be mindful of your body language, in addition to staying attentive to your patients’ body language and interpreting any non-verbal cues.
Value Your Patient’s Time as Much as Your Own
If you’re ever running late and can’t honor your patient’s time, acknowledge that.
Validate Your Patient’s Concerns
Oftentimes, physicians have to be the bearers of bad news to their patients. It’s important to approach such conversations with sensitivity, validating their emotions and giving them time to process what they’re feeling.
A physician can have good intentions or well meaning, but good bedside manner all depends on how their patients perceive them. A helpful exercise to practice good bedside manner is to role-play the patient-physician interaction on video. Physicians can watch the interaction back, observing their body language and choice of words carefully. A helpful question for physicians to ask themselves when watching the video is, “Am I delivering the quality of bedside manner I would want my spouse, parent, or loved one to receive?” There’s no doubt the pandemic has made connecting with patients difficult. However, with a little practice and intentionality, physicians can make improvements in their bedside manner.
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Jerry L. Stone