"With internal medicine in particular, especially these days, it's all about chronic medical problems and chronic care, where much of what we need to do is motivate the patient to provide self-care and self-management to improve their health over the long term," he says. "You can't do that if you're not connecting with the patient very well."
These courteous steps might be alright if all the doctor is doing is giving a patient with pneumonia a prescription for antibiotics. "But if you want to figure out why the patient has pneumonia, perhaps an occupational exposure or some underlying issue," he says, "then having a good doctor-patient relationship probably matters."
Without that connection and encouragement, Feldman says, the hospitalist physician or intern is merely treating the acute illness, which may lead to a readmission, or worse. "We should be trying to treat them and send them on a road to a healthier lifestyle."
So who's fault is it that these new doctors in training aren't extending common courtesies to their patients? The problem, Feldman says, is generally the fault of the attending physicians, or what he calls "role modeling."
"Often, we as attending physicians role model behavior that I would consider —if you want to call it rude, I think that would probably be reasonable. We're not being polite, not showing common courtesy."