Do You Feel Respected By Your Doctor?
Physicians learn a lot about many different topics, both in medical training and in practice. However, there are some life lessons that we never learn as well as when we become patients ourselves.
When I was 13 or 14 years old, I regularly interacted with 2 different physicians with disparate interpersonal styles. Little did I know then that these seemingly meaningless encounters would indelibly shape my own beliefs about how people should treat each other. Ironically, many years later the experiences would help guide me as a physician in my interactions with my own patients.
For a couple of years I was the regular patient of a dermatology clinic. Two dermatologists ran the practice together, and in order for me to get an appointment that worked with my family’s schedule, occasionally I would need to alternate seeing each of them. I’ll refer to one of them as “Dr. A” and the other as “Dr. F.”
I was somewhat shy as an adolescent, and sitting in an exam room wearing only a gown and underwear always made me a little anxious.
However, any unease I may have experienced evaporated when Dr. A entered the room. He politely knocked, awaited my response, and entered the room with a smile on his face. “Hi ___, how are you today?” he’d say as he put out his hand to shake mine. He didn’t spend an excessive amount of time with me, but he did put effort into making small talk. He never examined me without first talking with me for a couple of minutes. He asked me about the medication I was taking and how it was working. He asked me if I had any questions.
Even though I was only a kid, he treated me as if I were an adult. He seemed genuinely interested in me as a person. I felt respected.
I mattered. He cared.
My experience with Dr. F was quite the opposite. Sitting in the cold examining room feeling vulnerable and dreading the encounter, I’d hear a quick knock on the door, and without delay, it opened. Dr. F would waltz into the room with a face devoid of expression. He’d robotically mumble an incomprehensible monosyllabic greeting resembling caveman-speak. He never extended his hand to shake mine. Other than briefly asking me about my progress, he barely spoke. Within 30 seconds of entering the room he examined me. He then wrote out more prescriptions and made his exit.
I would leave my appointments with him feeling disappointed and disrespected.
He didn’t care. I didn’t matter.
Now, I do realize that physicians are fallible human beings. We all make mistakes, and we all have our bad days. I’ve noticed that for myself, I’m most likely to have difficulty emulating Dr. A when I am overwhelmingly busy, behind schedule, and stressed. When a person is sleep-deprived and doesn’t have time to go to the bathroom or eat, he or she tends to get into survival mode, and exhibiting a compassionate demeanor seems to require the selflessness of a long-deceased saint.
Despite the challenges of modeling Dr. A’s style all the time, I believe that some of us practicing medicine could gain a lot for ourselves and our patients by attempting to do so. In my opinion, our patients would feel more at ease and more satisfied with our efforts to help them. They would probably be more likely to follow our medical advice. We doctors, I believe, would probably be more satisfied with our work as well. All because of treating them respectfully as though they mattered…
So, what I would like to know from you, whether you are a patient and/or a doctor: Do you feel respected by your doctor?
I’d really like to hear your honest feedback about this topic. I would like for you to imagine that many physicians will read your comments.
What specifically have you liked or not liked about how some physicians have interacted with you? What advice do you have for how physicians could improve their interactions with patients?
In order for this to be constructive, please refrain from personal attacks and name-calling, foul language, mentioning doctor’s real names, and from making broad generalizations (doctors always do this or never do that, etc.)
As always, thank you for reading. I look forward to hearing from you!
Update 2/24/10: This article was a guest post on KevinMD. Click here to go to KevinMD to review the comments.
Very good post. As a doctor – and fellow shrink – I’ve found that a respectful and basically human interaction can make all the difference. I’ve even had patients maintain a good relationship with me despite bitterly-contested Mental Health Act hearings, simply because our interactions (including said hearings) have always been honest, open, and respectful.
While I like to think I’m basically inclined to treat people respectfully anyway, I also credit one patient in particular with my conscious realisation of just how important that interaction is (no matter what pills or therapies we might have in our armamentarium). As a junior doctor I was asked to see this patient late on a Friday, when all the other doctors (including the regular team) had gone home. This patient (described as “a huge borderline”) was angry. Why? Well as it turned out, because something had been promised that couldn’t and wouldn’t happen. I decided that all I could do was approach them as I would a completely rational person and explain the situation. Funnily enough, the patient responded as a completely rational (of course still – understandably – angry) human being.
If you treat people with disrespect, they are likely to respond in kind, and the flipside is also true. That goes for all interactions – including the doctor-patient one.
Funny you should ask about this. I was just telling someone yesterday that my daughter and I share a primary care physician. He loves her. He hates me.
She’s a “good” patient. She sits quietly while he tells her what to do, thanks him, and leaves. I, on the other hand, want answers. I want test results, I want to discuss treatment options, and I want to be spoken to as though I have a brain in my head.
He’s still my doctor of record, but I haven’t seen or spoken to him in my past three visits. He won’t even respond when I say “Hello” in the hallway.
Guess I’m just not his kind of patient.
(And yes, I have had doctors who were happy to do those things for me… but I moved out of state and am now stuck here in nowhere land)
Well, I am still only 17, or an adolescent as you would call it. I have had some serious fun with heath issues for the past 3 years and I have seen more doctors than I can count (and I am pretty good at math).
Some just walked in and started palpating my stomach, with out even introducing themselves, and then when I asked a question they would just ignore it and continue on with their agenda. I’m not stupid, I got into Harvard…my questions are usually quite pertinent and important.
Then there is my small town family doctor, Dr.L, whom I would always end up going back to, he was my rock when my world started to fall apart. He listens, genuinely cares about my life and it is safe to say that he saved my life when specialist were baffled. How? because he not only listened to me, but he talked to me, he made the connection.
The only doctor I have felt comfortable saying anything to without having to fear being judged is Dr. L. Maybe it is because he is one of the only people in my town that understands the sports I play, and why they are so important to me. He is the only one who understands how much I want to be a doctor some day, he understands me. (Cliche teen thing to say, sorry.)
I want to be a doctor more than anything in the world, and my inspiration is Dr. L, it is safe to say that I “want to grow up to be like him.”
My PCP runs an excellent practice. When I phone for an appointment, the receptionist is clear whether I’ll be seeing the doctor or his NP. Same-day appointments are available for urgent issues. Phone calls are usually returned the same day. Whether I’m the first appointment in the morning or the last appointment of the day, the doctor is pleasant, calm, and acts as though he has all the time in the world. When it’s my turn to see him, he gives me his full attention and doesn’t act like he can’t wait to escape and move along to the next patient. He listens without interrupting, then asks pertinent questions and listens to my answers (without interrupting). He leaves the room while I undress for an exam. He often uses a scribe so that he can focus on talking with me instead of writing in the chart. When he doesn’t remember details on something, he pauses and looks back through the chart to refresh his memory. He explains things so thoroughly that he usually answers most of my questions before I voice them. He asks if I still have questions (sometimes I have a list), and he answers them fully. He explains abnormal test results clearly and offers me a copy. He reads the letters sent by my specialist and asks me how that treatment is going. Sometimes we just chat. He treats me like a person, not like one more item to mark off his to-do list.
This is a great post, thank you! I think its telling that a doctor that treats incarcerated people posts something about being a respectful doctor. As a patient, I feel like I am very forgiving of doctor’s bedside manner and that might bug someone else doesn’t get to me. However, it bothers me when doctors touch me without telling me what they are going to do first. A simple, “I am going to palpate your abdomen now” is fine. It doesn’t have to fluffy, it just gets on my nerves when they touch me without letting know why before hand. Usually doctors are really good about this, and in my opinion its only in specialties where they might assume they wouldn’t need to ask, like a foot doctor, that don’t ask. But yeah, it gets me a little. I really like the thought behind this post. What would you say to doctors to get them to start thinking about being more thoughtful, if you were talking to them directly?
-Aurora @ http://www.mditv.com
Thanks to everyone who has commented so far. I’m very pleased to see that the comments have been what I had hoped: constructive feedback, both positive and negative. I haven’t received any hostile doctor-bashing comments yet!
Aurora: to your question of what to say to doctors to help them to be more thoughtful (I assume you mean if you are in an exam room with your own doctor), I realize that it’s an awkward moment for many people, but saying something polite but direct such as, “I get a little nervous when I go to the doctor; it’d be really helpful to me if before you touch me you tell me what you are going to do.” I believe that most doctors are reasonable people, but we all can easily get busy with our own work and routines, and what is just another day at the office for us is actually a compilation of very big events for many patients. Sometimes we need to be reminded of this. If you have a doctor who simply seems insensitive regardless of your requests, you may want to find a different one.
So far I’ve found two other bloggers who have written about this post. There are comments to those posts as well:
http://pensandneedlesblog.blogspot.com/2010/02/warmsocks-post-in-response-to-lockup.html
http://warmsocks.wordpress.com/2010/02/02/what-works/
Thanks to both of you. I feel honored!
I’ve been to maybe 8 doctors over the past 3 years for a “mystery illness” that turned out to be a thyroid problem and some vitamin deficiencies. The biggest problem I encountered was a ridiculous amount of skepticism about everything I said. All of my pain was dismissed as normal/fake with half of these doctors, I was strongly encouraged to see a psychiatrist twice, no one believed me when I said my bp was normal at home (I’m a CNA, I know how to take bp!) since it was always super high with the doctor (doctors obviously made me nervous by this point), and I was always spoken to rudely if I made it known that this visit was to get a second opinion (I was very obviously misdiagnosed by my 1st doctor with fibromyalgia! Eek!). In general I was treated like a stupid liar that was up to something sneaky… So doctors, please take a few minutes to talk to your patients and realize that any weird vibes you get from them might be fear or nervousness, not them trying to pull something over on you.