Tuesday, December 11, 2012

Caring is expression, not feeling

Ken Stanfield — This is not exactly a “bedside manner” discussion. I’m actually unhappy with the term “bedside manner.” The phrase has been around long enough that it comes with certain assumptions, some of which seem rather silly. For example, a 2009 New York Times article asked, “Can Better Bedside Manner Be Taught?” This sounds like a noble question, but at the very heart of it is the idea that doctors need to be taught how to care properly for patients.

I don’t think people need to be taught how to care for other people. They might need to recover the ability to care for people (i.e. to see them as people and not just as diagnoses), but the original impulse should be there already, however dormant. There are some things, on the other hand, that med students may need to learn:

How to Show that You Care

I know that you care for and about people. That’s one reason you’re training to be an MD, even if it’s not the main reason. The problem has more to do with conveying that you care to your patient.

Just Because You Care Doesn’t Mean That It Shows

I took a theatre course back in college. I only remember one thing from the class. The professor said she was going to tell us what makes good acting. She stood in front of the class, eyes closed with her arms crossed, for about 45 seconds. Then she opened her eyes, dropped her arms and asked, “How’d I do?” We looked at her like she was an idiot. She explained that she “was really feeling it,” but that it didn’t count because she didn’t communicate it to us.

Patients don’t assume you care about them just because you’re trying to help them. They could be too focused on their own pain to notice. Also, they could have too many pre-developed biases (“Doctors are just in it for the money,” etc.) to see past their own nose and realize that you care. So, if you want to go beyond just helping people—if you want to connect with them and create an experience where the patient actually feels like you care—you may need to work out a plan for doing so.

Here are my suggestions:

1. Have a life outside of med school.

Learn to engage with people outside of your studies. How you deal with others in your everyday life feeds into how you treat them as their doctor. Cultivate your relationships with your friends and family. A well-rounded personal life will have a positive impact on your professional life.

2. Don’t “get to know the person”; get to know their story. Stories connect people. If you ask a patient to tell you about themselves they’ll feel like you’re just focusing on their ailments. Instead, ask them about their life. What have they been up to? Any cool experiences lately? Coax them into telling you a story (the first suggestion can help you practice this).

3. Just be honest.

If and when you screw up, just acknowledge it and move on. Practice humility and give apologies. I once sat in a doctor’s office for two hours. The next time the doctor made a point of seeing me right away and was clear that he was making an effort to correct last time’s mistake. He’s now my favorite doctor. In truth, the same “rules” apply to everybody. However, if a mechanic doesn’t come across as caring, it may not bother you as long as he knows what he’s doing. With MD’s, it’s very different. If you want succeed as a doctor – if you want to attract business and people to you – use these principles.



About the Author

Ken Stanfield researches and writes on healthcare, geriatric health, respiratory health, and humanitarianism.