Doctors in Residency Fail Tests of Common Courtesy
The five actions are components of what is termed "etiquette-based medicine" by Michael Kahn, MD, in a 2008 article in the New England Journal of Medicine.
Interns performed all five of these behaviors during only 4% of all encounters.
Feldman and his co-authors studied encounters between 29 interns and 732 patients with the use of 22 undergraduate pre-med student observers, most of whom were paid about $10 an hour to watch those encounters and document the five behaviors.
Interns at Johns Hopkins were then asked to estimate how frequently they performed those same five behaviors. And for three of the five, the interns overestimated the percentage of times they complied by more than 50%. For example, interns said they introduced themselves to their patients 80% of the time but student observers saw them doing it during only 40% of their patient encounters. Interns said they explained their role 80% of the time, but observers found they did so in only 37%.
Feldman, an associate program director of the Johns Hopkins internal medicine residency program, says that apart from perhaps helping the hospital score better on patient experience surveys, how well interns engage with their patients may very well be a quality of care issue that might be linked to better patient outcomes.
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