Diagnosis for Democracy
Insights into the State of Our Union
A Blog by Rob Tenery, MD


March 10, 2014: Does Bedside Manner Matter Anymore?

By Rob Tenery, MD on March 10, 2014

“My doctor is really good.” Contrast this to another comment, “My doctor must be good.” The former statement is positive, while the latter conveys a lingering doubt. Both quotes connote a continuing ownership in the relationship. In the latter, the doctor has failed to make a connection and the patient is looking for reassurance. If the physician’s competence is also in question, patients often look elsewhere. The bridge to make that connection is what is called the ‘art' of medicine. This art, which takes the relationship to a higher level, is often referred to as the physician’s bedside manner.

The term compassion is frequently used to describe this art of medicine. Caring not just about the malady, but caring about the patient. Caring that they do not suffer, caring that they do not recover alone and caring that those who love them are also suffering. Compassion without outwardly demonstrating that sensitivity is without meaning.

The art is in being able to show this higher level of involvement. It is a willingness to be more than just a scientist by giving of one’s self rather than just a ‘peddler of pills.’ It demonstrates an investment in one's patients and not just in what is wrong with them. That ability to practice this art is often the single most important factor that elevates one physician above another.

The art is more encompassing than just showing compassion. It is about showing respect. It is about remembering that each physician is also a representative of the medical profession--- those who have gone before and those who will come after. It is not just about commitment to one’s patients, but to the patients of others as well. It is an appreciation of being part of the medical profession.1

Although much is written about medical ethics, very little mention is given to medical etiquette. The two disciplines are similar and frequently overlap, but clearly not the same. Although open to interpretation, medical ethics predominately deals with the concerns of right versus wrong. While etiquette is the discipline that addresses the variances in the individual’s personal approach, it is best framed with terms such as demeanor, conduct, body language and deportment. It is about how physicians act, react and the manner in which they dialogue not only with their patients, but everyone they encounter in their role as a physician.

The pioneers of medicine were introduced to this profession in an era when taking care of patients was considered an act of beneficence and not just a transaction. When undesirable outcomes were accepted as ‘acts of God’ and not misdiagnoses. When medicine was a calling to most and not just a vocation. Advances in the science, third-party payment systems, marketing and fear of reprisals have changed all that. Unfortunately, there is no going back!

What have not changed are the patients. Although they are no longer all accepting, they are still afraid. They still are in pain. They still want their physicians and the other medical professionals who care for them to care about them too.

The term bedside manner is not just about making the correct diagnoses and prescribing the most appropriate treatments. That is the science. It is also not just about the ethics of ‘right versus wrong.’ Bedside manner is more about how physicians conduct themselves and how they relate to those that they are around. Their demeanor and how they adhere to the rules of etiquette. How they connect! Bedside manner is about the ‘art' of medicine.


In the broader sense, bedside manner is not just about one patient, but realizing that physicians are part of a community of patients and other caregivers. What they say and do reflects on all of those who are part of the family of medicine. It is about not losing sight of the lessons they have learned from those who came before them. Finally, it is about giving back to this noble profession that has given so much to them.


 


  1. Tenery, R., Bedside Manners: A Compendium of Physician Relationships. CreateSpace Independent Publishing Platform, 2014.*



 

* Now available through Amazon books in paperback and eBook, my hope is that Bedside Manners will find its way into all sectors of the medical community, especially into the hands of those who are beginning their journey into medicine. Cover-to-cover, the ‘little book’ takes no longer than a short seminar to read, but lays out a lifetime of lessons and experiences that can guide physicians and all caregivers in their roles as practitioners, mentors, teachers and role-models.




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