Medical School did not teach me bedside manner. In my Family Medicine residency program, they really stressed the role of the weight loss programs in mcallen tx and importance of communication. The fact of the matter is that bedside manner is really not universally taught. Some docs have it and some just plain don’t. In a recent clinical study it was demonstrated that:
While the United States is spending more than 2 ½ times more on health care than most developed countries around the world, it lags behind a number of nations in terms of patient health and longevity.
Could the solution be as simple as doctors ‘listening to patients?’ My opinion is: Yes.
Let me give you an example. What I call the ‘CYA & OT’ doctor. (Cover your ass and order tests). I was in practice in a rural town and one of my patients went to the ER with a headache. She didn’t have vision changes, trauma, migraine-type or neurologic symptoms in fact she really just had a dull pain and tightness in the back of her neck and forehead. She was stressed and it was a tension headache that always responded to either 800mg of ibuprofen or a shot of Toradol (anti-inflammatory). She told the nurse this. She told the doctor this. She told them both her diagnosis and treatment.
Somewhere between 40-55% of patients walking into an ER, primary care office or urgent care center will “tell you the diagnosis.”
She never received any treatment for her tension headache. She received an MRI, blood tests, an EKG and a neurology referral. Communication breakdown = ineffective and unnecessarily costly care. She missed work because she wasn’t treated. This is a total system failure.
There is absolutely no room to share every anecdote like this. Poor bedside manner means poor communication with patients and worse outcomes.
Maybe doctors should just listen to patients. In an analysis of 13 studies by the NORC Center for Research, 59% of Americans were shown to place value on physician-patient relationships and personality with only 11% placing value on accurate diagnosis and treatment. How much time a doctor spends with a patient is very or extremely important to 80% of people. One thing I learned early on was to “sit down and face the patient.” (Pretty basic I know but docs don’t all do this now do they?). This study demonstrated a positive doctor-patient relationship can have statistically significant effects on “hard health outcomes,” including obesity, diabetes, hypertension, asthma, pulmonary infections and osteoarthritis pain. The research looked at studies where doctors were randomly assigned either to provide their normal methods of care or to take additional training or steps to provide more empathetic and patient-focused care. The additional care made a measurable difference in medical outcomes.
