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Doctors and the “bedside manner”

November 1, 2011

There’s a lot of talk these days about creating more compassionate doctors. About a year ago I wrote a post about a medical school that allows humanities students to join its ranks without taking the MCAT.

A friend of mine is actually one of them. She dabbled in the world of radio before she became a doctor. One of the best listeners I know,  she’ll start her residency next year, hopefully in Rhode Island.

As a touchy-feely humanities type myself, I’m drawn to the idea that things like kindness and compassion make for better health outcomes.

That’s why I was interested in this  New York Times opinion piece by Dr. Lisa Rosenbaum. Titled “The downside of doctors that feel your pain,” Rosenbaum’s essay opens with a anecdote from her father, who is also a doctor.

…when he was an intern, the competence of his colleagues was inversely proportional to how much their patients liked them.

Rosenbaum goes on to describe her dread at realizing she’s prioritized being liked by her patients. She’s great at eye contact and empathy. But what about treating illness? Perhaps this whole movement to recruit personable doctors is just a ill fated fad.

Proponents of weeding out students who lack interpersonal skills argue that communication errors are at the root of medical mistakes. But we have no data to suggest that medical students who sit close but not too close make any fewer mistakes than their less-communicative colleagues. The awkward student in the corner who obsessively follows a checklist may make fewer procedural mistakes than his charming friend who lights up the room.

Rosenbaum cites a study from the Wharton School of the University of Pennsylvania showing that when extroverts work together, they compete and decrease productivity while introverts are better listeners and get more done.

As an introvert myself (most people don’t believe this, but I do get my energy from being alone) I think Rosenbaum is confusing two issues. It’s one thing to be a flashy, charismatic doctor. It’s another thing to show compassion for your patients. Extroverts and introverts can both do that. You can treat your patient as a human being without drawing a lot of attention to yourself.

I can’t speak to the rest of her concerns. Doctors out there- how important is this thing we call the “bedside manner”? Does it make a difference in patient care? Are medical schools over emphasizing these traits?

Patients- do you care about how a doctor treats you, or are their skills the most important quality? Do these traits  have to be mutually exclusive?

2 Comments leave one →
  1. ninjanurse permalink
    November 1, 2011 10:48 pm

    I think you’re right that both introverts and extroverts can be competent and compassionate. Or not. Extroverts kind of get on my nerves. And it is a strange assumption that lack of social skills means more technical skills. Unfortunately some doctors have neither.
    I’d mistrust a doctor who doesn’t seem to care, because some of them truly don’t care. But niceness is not a substitute for competence.
    I’m pretty happy with my doctors. They are pleasant and respectful and don’t rush me, they’ve done right by me medically. There’s lots of good doctors, no one should have to settle for a bad one.

  2. November 2, 2011 4:46 pm

    Thanks for writing Ninjanurse! Glad you like your doctors. What do you think about the argument that med schools are overemphasizing the need for compassionate physicians?

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