Doctors in Residency Fail Tests of Common Courtesy

Cheryl Clark, for HealthLeaders Media , October 24, 2013

"With internal medicine in particular, especially these days, it's all about chronic medical problems and chronic care, where much of what we need to do is motivate the patient to provide self-care and self-management to improve their health over the long term," he says. "You can't do that if you're not connecting with the patient very well."

These courteous steps might be alright if all the doctor is doing is giving a patient with pneumonia a prescription for antibiotics. "But if you want to figure out why the patient has pneumonia, perhaps an occupational exposure or some underlying issue," he says, "then having a good doctor-patient relationship probably matters."

Without that connection and encouragement, Feldman says, the hospitalist physician or intern is merely treating the acute illness, which may lead to a readmission, or worse. "We should be trying to treat them and send them on a road to a healthier lifestyle."

So who's fault is it that these new doctors in training aren't extending common courtesies to their patients? The problem, Feldman says, is generally the fault of the attending physicians, or what he calls "role modeling."

"Often, we as attending physicians role model behavior that I would consider —if you want to call it rude, I think that would probably be reasonable. We're not being polite, not showing common courtesy."

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7 comments on "Doctors in Residency Fail Tests of Common Courtesy"

Pamela D. Simons, MD, MBA, FACOG (10/31/2013 at 11:03 PM)
Given the time limitations of service pressure, the frequent lack of a place to sit down, especially in patient rooms, and the emphasis on EHR, which slows down documentation and prevents eye contact, none of this is surprising. Most residents went into medicine to care for and "be with" patients, but the system increasingly prevents this. It was hard enough 20 years ago when I was in training. Now, it's near-impossible. The practice of medicine increasingly resembles working the front counter at McDonald's. Every layer of administrative demand forced on clinicians increases the cost of providing care and forces us to work faster and gives us less time to think or "be with" our patients in order to generate the same compensation.

JS (10/30/2013 at 2:51 PM)
Healthcare is a customer service business, like it or not. In the event of a poor outcome, the provider who showed genuine caring and concern throughout his/her relationship with the patient is less likely to face a law suit than the provider with poor bedside manner. Treat me well as a patient, yeah I probably won't advertise that to all of my friends, but treat me rudely or make me feel like my issue is unimportant, then I will tell all my friends.

Robert Modugno MD MBA FACOG (10/29/2013 at 4:03 PM)
We are a rude society. I am not surprised.




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