Grouchy Bedside Manner: Is There Hope for Ill-tempered Doctors?
Millions of television viewers enjoy the arrogant, often rude, disposition of physicians portrayed in medical dramas. House, M.D., a popular TV series, features a brilliant, but irreverent doctor who diagnoses bizarre medical conditions. The lead doctor, who bluntly expresses no interest in patients' feelings, has no qualms about aggressively stabbing a patient with a syringe, shooting a corpse to test a theory, or calling patients liars.
Though Dr. House's character entertains television viewers, actual encounters with rude physicians are far from enjoyable. Several studies suggest ineffective doctor communication contributes to a variety of problems, such as patient dissatisfaction, misdiagnosis, medical error and malpractice suits (Blue, 2007; Bonvicini, et al., 2008).
A longitudinal study by the Journal of the American Medical Association (JAMA) found a communication assessment was able to measure a new doctor's future patient complaints. Researchers found that physicians with low communication scores early on had significantly more patient complaints years later. In particular, patients seemed to judge a doctor's empathetic skill, the "way a doctor tells a patient he has cancer, for example, or whether a doctor ignores a mother's description of what ails her child" (Blue, 2007, para. 3). New physicians who were perceived as condescending or flippant on the communication test had the highest number of patient complaints about 10 years later.
The results of the JAMA study suggested early evaluation of a doctor's communication may improve the identification and training of effective medical professionals. In particular, Robyn Tamblyn, the Professor of Medicine at McGill University in Montreal, who led the JAMA study, said a communication assessment should be given in medical school (cited by Blue, 2007). Continued Blue, "Why have doctors slog through med school only to be pushed out of the profession afterward because their bad bedside manner?".
As a doctoral candidate at University of Phoenix, K.A. Bonvicini evaluated audio tapes of actual physician-patient encounters with doctors who received training to improve their expressions of empathy. Trained physicians' empathy scores improved between 37% and 51%. (Bonvicini, 2007); This physician empathy research received the Quantitative Dissertation of the Year Award from the School of Advanced Studies in 2007 and was published recently in an article in Patient Education and Counseling (Bonvicini, et al., 2008).
Chief Executive Officer for the Institute for Healthcare Communication, Bonvicini (2007), suggested a doctor's expression of empathy is particularly important to patients' perception of a doctor's bedside manner. Empathetic providers, Bonvicini suggests, have the ability to ‘walk in the patient's shoes' and put themselves in the other person's place.
As long as television ratings are high, it is unlikely medical dramas will show outrageous characters like Dr. House becoming more empathetic. Fortunately, however, health care educators, like Bonvicini, continue to research ways to humanize doctor-patient encounters.
Bonvicini, K. A. (2007). Physician empathy: Impact of communication training on physician behavior and patient perceptions. Retrieved February 27, 2009, from ProQuest Dissertations and Theses - Full Text database.