What Happened to Bedside Manner?

bedside

It’s happened to most of us at least once: you’re sick, worried, or confused and standing in front of a doctor or nurse who just doesn’t seem to care.

When a person decides to go into medicine, they’re devoting – and sometimes risking – their life to make others well.  So why do so many healthcare professionals seem indifferent towards their patients?  It turns out there are several factors that can make bedside manner disappear – or prevent it from developing in the first place:

1. Insurance and expenses.  In a compelling essay, Dr. Christopher A. Iobst writes, “Medicine is transitioning away from an era where physicians had the time to develop strong interpersonal bonds with their patients to a more sterile, business-like model where patients are ‘customers’ or ‘clients’ and physicians are ‘providers.’”  Part of the reason, as this article explains, is that insurance companies and higher expenses for things like rent often force doctors to see as many patients as possible in a given day in order to earn more money, sacrificing things like friendly conversations, which are less essential than diagnoses and prescriptions.

2. Technology.  While technology has brought about amazing progress in medicine, it’s also often considered a problem when it comes to human relations in the same field.  A recent New York Times article reveals that many doctors are so distracted by having to transcribe their consultations or fill out computerized patient information forms that they often forget to do things like make eye contact during examinations.  Some doctors now use medical scribes so that they can connect with patients again.

3. Thinking of cases instead of faces.  Because of factors like the way they’re trained, many medical professionals look at a patient’s file or x-rays and see a problem to be fixed…but not necessarily a person.  This can lead to a lack of sympathy when they give diagnoses, and a lack of patience when patients have questions or concerns.  Interestingly, small changes could help.  This article cites an experiment in which a photo of a patient’s face was attached to his or her CT scan printouts.  The radiologists who received these personalized images were more attentive and seemed more invested in the results.

4. Language barriers.  I’ve written before about how medical jargon confuses many of us laypeople.  Some doctors don’t realize this and won’t stop to explain or “translate” terms into everyday language unless you ask – and even then, they may not seem overly eager to spend time doing that.  In some cases, linguistic barriers are another issue. How can you even hope to communicate with a patient if you don’t speak the same language?  Luckily, an increasing number of hospitals now have on-staff translators to help solve this problem.

5. Psychological disconnect.  Whether it’s an effect of the stressful environment of a hospital or clinic, or a subconscious way to protect themselves from having to feel the full emotional impact of  suffering or death, many doctors experience what’s called dehumanization, which makes them less likely to relate to or feel empathy for patients.

6. “Bedside manner can’t be taught.”  This is a phrase many medical students hear from doctors and teachers.  It seems to make sense at first – after all, in life in general there are people who are more empathetic or demonstrative than others.  But a number of experts in the healthcare field don’t believe it.  Today, there are many initiatives in universities and hospitals to teach or re-teach bedside manner.

It’s great that this issue is being studied and, hopefully, improved.  But changes won’t happen overnight.  Still, maybe a generation from now, bedside manner will be as much a requirement for healthcare workers, as medical skill.

Alysa Salzberg

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