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Doctors in Residency Fail Tests of Common Courtesy

Cheryl Clark, for HealthLeaders Media, October 24, 2013

Interns observed interacting with hospitalized patients exhibited five basic behaviors associated with etiquette-based medicine during only 4% of all encounters.

Medical interns rarely bother with common acts of courtesy when they meet their patients in the hospital, but are often unaware of it.

That's according to a study of how 29 interns interacted with 732 patients hospitalized at Johns Hopkins Hospital and the University of Maryland Medical Center during one month, January, 2012.

"I don't think the interns are actively trying to be rude or mean," says Leonard Feldman, MD, principal author of the paper published in this month's Journal of Hospital Medicine. "I just don't think they're thinking about the fact that they should be courteous and polite, especially when they're worried about their patients' issues of morbidity and mortality, like a possible heart attack or pneumonia."

In the study, interns failed to introduce themselves at the start of 60% of their patient encounters, failed to explain what role they play in their care with 63%, and failed to touch 35% of their patients either with a handshake or other reassuring gesture or with a physical exam. They failed to sit down to talk with 91% of their patients, and failed to ask 25% standard open-ended questions to elicit conversation that reveals more about the patients' problems and makes them feel more comfortable.

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7 comments on "Doctors in Residency Fail Tests of Common Courtesy"


Pamela D. Simons, MD, MBA, FACOG (10/31/2013 at 11:03 PM)
Given the time limitations of service pressure, the frequent lack of a place to sit down, especially in patient rooms, and the emphasis on EHR, which slows down documentation and prevents eye contact, none of this is surprising. Most residents went into medicine to care for and "be with" patients, but the system increasingly prevents this. It was hard enough 20 years ago when I was in training. Now, it's near-impossible. The practice of medicine increasingly resembles working the front counter at McDonald's. Every layer of administrative demand forced on clinicians increases the cost of providing care and forces us to work faster and gives us less time to think or "be with" our patients in order to generate the same compensation.

JS (10/30/2013 at 2:51 PM)
Healthcare is a customer service business, like it or not. In the event of a poor outcome, the provider who showed genuine caring and concern throughout his/her relationship with the patient is less likely to face a law suit than the provider with poor bedside manner. Treat me well as a patient, yeah I probably won't advertise that to all of my friends, but treat me rudely or make me feel like my issue is unimportant, then I will tell all my friends.

Robert Modugno MD MBA FACOG (10/29/2013 at 4:03 PM)
We are a rude society. I am not surprised.