It’s Not You, Doctors Are Just Rude

New study shows young docs need to work on bedside manner

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Doctors-in-training are in need of a dose of compassion.

That’s according to a new study from Johns Hopkins University showing that young doctors in their first year out of medical school are unlikely to take the time to introduce themselves to hospitalized patients, or to sit and have an eye-to-eye conversation with patients. That’s concerning, considering research shows that how a doctor treats patients at their bedside can improve a patient’s recovery and lead to greater patient satisfaction.

Trained observers monitored 29 internal medicine interns who were in their first year after medical school at The Johns Hopkins Hospital and the University of Maryland Medical Center for three weeks. The observers recorded whether the interns used five valued communication skills like introducing themselves, explaining their role to the patient, touching the patient, asking open-ended questions like, “How are you feeling today?,” and sitting down with the patient for a conversation.

In some areas, interns scored high. For instance, they touched their patients 65 percent of the time (though that was sometimes in the process of giving physical exams) and asked open-ended questions 75 percent of the time during hospital visits. But interns only introduced themselves 40 percent of the time and explained their medical role 37 percent of the time. The interns sat down with their patients only 9 percent of the time.

In total, interns only performed all five behaviors during just 4 percent of their visits.

“It’s no wonder patients don’t feel connected to what we are telling them, because many times we are not doing as much as we could to make that connection,” said study co-author Dr. Lauren Block, a former general internal medicine fellow at Johns Hopkins in a statement. The research was published online this month in the Journal of Hospital Medicine.

7 comments
BethBoynton
BethBoynton

With communication, leadership, and human factors consistently in the root cause date from the Joint Commission re: preventable and catastrophic medical errors,  we need to look at innovative ways to impact this phenomenon as well as related issues like workplace violence and medical errors!

The good news is that a new concept, "Medical Improv" shows promise for building communication, emotional intelligence and collaboration skills among healthcare professionals.  As a teacher in these areas and a healthcare professional for many years, I am very excited about the potential.  Here are a few resources for anyone interested in exploring it. Beth

100 min YouTube

Medical Improv: Exploring Learning Experiences that Promote Safe Care, Patient Satisfaction, & Rewarding Careers

http://www.youtube.com/watch?v=uG0jRAQWOVQ

Testimonials from 5/13 Workshop Pilot in Cape Neddick, ME

http://www.confidentvoices.com/improv-testimonials/

Medical Improv

A Ripple in Cape Neddick, ME and a Wave in Chicago:Medical Improv On the Rise (Note Professor Katie Watson's work at NWUFSM)

http://www.confidentvoices.com/2013/06/13/a-ripple-in-cape-neddick-me-big-wave-in-chicago-il-staying-tuned-to-medical-improv-on-the-rise/

Related youtube using improv to teach:Interruption Awareness:A Nursing Minute for Patient Safety

http://www.confidentvoices.com/2013/10/21/grassroots-project-by-portsmouth-nh-consultant-nurse-leads-to-patient-safety-youtube-with-over-8400-views/

11/12 Webinar with Surgeon Ken Cohn

Medical Improvisation for Harried Healthcare Professionals

http://www.confidentvoices.com/2013/10/07/medical-improvisation-for-harried-healthcare-professionals-new-webinar-111213/

“Perspective: Serious Play: Teaching Medical Skills With Improvisational Theater Techniques”, Professor Katie Watson, JD, Northwestern University Feinberg School of Medicine, Academic Medicine, Journal of the Association of American Medical Colleges, October 2011 – Volume 86 – Issue 10 – pp 1260-1265

mollymel
mollymel

The study also ignores the fact that many interns/1st year residents are scared out of their wits and may have actually forgotten their own name at that point in the patient interview. They are so busy learning how to doctor that they can't get around to bed side manner, yet. Try it again with 3rd years or attendings and then make generalizations. 

WallStreetWeed
WallStreetWeed

Doctors and cops have become insulated against the very folks they have sworn to heal and protect.  An elitist attitude now yawns across a chasm of indifference, and neither of them brook questioning or disobedience...

thecrud
thecrud

One of these doctors made my ill wife say " f it if I die I die lets go." And we got up and left and told them we were never coming back. And never have.

AvangionQ
AvangionQ

"Doctors-in-training are in need of a dose of compassion." No, they don't.  All that's necessary for being a doctor is comprehensive skill sufficient to diagnose a patient's ailments and to have the ability to remedy or to forward the patient to a specialist that can.  Compassion is secondary, bedside manner is nice to have, but not essential.

Eaddyage
Eaddyage

Yes I know some drs are rude.. But that study is pretty poorly powered to make such generalizations.. I mean 29 interns (of all things! Who prob haven't peed, eaten, or drank anything in over 12 hours or more). That's like saying no one learns how to read in school and only looking only kindergartners! The media needs to be more responsible about the studies they choose to broadcast.

MichaelW.Perry
MichaelW.Perry

Oh great! Research has shown what almost everyone who's worked in a teaching hospital has noticed--that most first-year residents don't know how to relate to their patients. I give several illustrations in two books I've written about my experience at one of the nation's top children's hospitals.

I'd add a sixth item to the skills that new residents need to learn: 6. Apologizing when they do something wrong. They often stalked off without a word, leaving me to straighten matters out.

--Michael W. Perry, My Nights with Leukemia: Caring for Children with Cancer & Hospital Gowns and Other Embarrassments: A Teen Girl's Guide to Hospitals