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How important is bedside manner to the modern podiatric physician? How important is it to your patients? These may seem like no-brainer questions, but why is it that so many of us have terrible bedside manners? I’ll illustrate my point with a recent personal example. My wife is currently pregnant with our second child. Since she’ll be 35 years-old when the baby’s born, she’s considered “advance maternal age” and thus at higher risk for pregnancy complications. As such, my wife sees a perinatologist as well as her OBGYN. Although everything has been going well so far (knock on wood), we do have an underlying baseline level of anxiety. The other day, we went to her ultrasound screening appointment, where we found out the fetus’ gender (I’ll keep that one a secret).
During the appointment, I met Dr. A — for Dr. Amazingly Poor Bedside Manner. We walked into the ultrasound suite, and the doctor and his assistant were already present, with Dr. A facing away from us. The nurse told my wife to sit down and position herself appropriately. I could tell the visit was starting off poorly when Dr. A turned around, failed to introduce himself or shake hands, much less make eye contact with either of us. We didn’t even receive a “hello”, let alone a smile. The guy was like a robot. I actually wasn’t certain he was a physician until I saw his name tag! From a service standpoint, the visit declined in quality when he squirted acoustic gel on my wife’s belly and proceeded to make sounds that to the average person, may not have been significant, but to a worried mother-to-be and her husband, had unknown connotations. “Hmm,” he said. “Uh-huh,” he grumbled. He managed to mumble some incomprehensible statements to his assistant, presumably measurements of the fetus. My wife remained remarkably patient during the examination, although I could see the worry etched on her face.
The silence lasted about 10 minutes, punctuated only by Dr. A’s grunts. Finally, I couldn’t take it anymore. I’d been watching the ultrasound screen, and nothing looked abnormal to my untrained eyes. I started asking the guy questions, simple things like, “What do you see?” “Everything OK?” He answered in short sentences. I could see the effect his vague answers and nonconversational style was having on my wife. This kept up for another five minutes until the pivotal moment when everything changed. I asked a technical question. My question indicated to him some medical training, so he asked how I knew medical terminology. When I told him I’m a podiatric physician, his demeanor changed. All of a sudden, he became more communicative and started providing us greater detailed information. Now, his demeanor didn’t change markedly — he still failed to smile or make prolonged eye-contact — but after the last 15 minutes of grunts and one word answers, this was a new man! He did manage to explain to us the purpose of the visit was to screen for “syndromes”, although he didn’t see any with “this one”. Nice way to dehumanize your patient, Dr. A.
The rest of the visit went uneventfully, though we did have to ask him to tell us the gender. It would have been nice if he asked us if we wanted to know the sex of the fetus. We left the room, and my wife made what to me exemplified everything wrong with this doctor’s bedside manner: “I try to ignore their negativity and focus on the positive things.” How sad is it that out of what should have been an extraordinary experience, my wife had to deliberately focus away from her caregiver’s poor manner? My example should be instructive to all of us who provide healthcare to worried, nervous, and intimidated patients. Your bedside manner, encompassing eye contact, a friendly personality, and confidence, beside simple human decency, is a powerful tool for patient treatment. Remember, your patients are listening to all those offhand comments that you make. They have more significance than you realize. Keep writing in with your thoughts and comments. Better yet, post them in our eTalk forum. Best wishes.
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