Bioethics Discussion Blog: “Bed-Side Manner" is Just Acting

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Saturday, July 02, 2005

“Bed-Side Manner" is Just Acting

Kevin, M.D. Medical Weblog reports on an article in the Health Behavior News regarding a study regarding how the public selects a physician: “bed-side manner” vs technical skill. Kevin has a number of interesting comments regarding the matter. Go to the site to read them after reading the original article. I posted a comment there that I am reproducing below. I express my disagreement with the term “bed-side manner” as a description of the personal interaction between doctor and patient.. What do you think? ..Maurice.

"Bed-side manner" is currently considered in medical school definitions as a dramatic acting behavior and which is scripted and learned. We don't teach bed-side manner. True empathy is NOT scripted. Attempts at understanding the bio-psycho-social aspects of the patient and the illness is NOT scripted. Attempting to simply care for the patient, rather than acting like the physician cares is NOT scripted. And there is no script of acting regarding how to make that all important intellectual and spiritual connection with the patient. Students learn that the goal is to become a trusted, understanding and caring physician. They attempt to reach that goal by trial and error with patients under mentoring by role model teachers through expressing the student's own personal qualities, behavior and technical skills. The technical skills are all part of the goal to provide care to the patient. Each physician will appeal to the patient in different ways regarding trust, understanding and care and it is up to the patient to select, if possible, that physician whose behavior is most comfortable to the patient. ..Maurice.

4 Comments:

At Saturday, July 02, 2005 7:54:00 PM, Blogger MARYBETH said...

Dear Dr B
I Appreciate you sharing your views and insights as an experienced practicioner. By no choice of my own, I have beome highly experienced at dealing with medical professionals; not to mention big wig insurence companies that make decisions AS IF, they are doctors.
I would summise from reading your post that you to are a gem among many tumbling rocks.
Namaste,
MB

 
At Saturday, July 02, 2005 9:41:00 PM, Blogger Maurice Bernstein, M.D. said...

Marybeth thanks for your compliment. I try to be that "role model teacher" to the medical sudents. When I interact with my own patients I always have in the back in my mind the concern whether I am behaving in the understanding and caring way, I have guided my students to behave.

As I have written in previous posts here,
unfortunately as the first and second year medical students move on to their third and fourth years and beyond, some of their supervisors in their clinical activity are not necessarily the ideal role models and the ethical crafting that we in the earlier years have accomplished may be degraded later on.
Not always, though since this depends on the strength of character of the student, intern or resident. ..Maurice.

 
At Sunday, July 03, 2005 7:26:00 AM, Blogger Dave Schuler said...

As George Burns said, “"The secret of acting is sincerity. If you can fake that, you've got it made."” (closely following Jean Giraudoux statement “"The secret of success is sincerity. If you can fake that, you've got it made.")

You can't fake sincerity—that's why it's sincerity. Feigning non-existent concern is the surest way to disrepute for physicians.

 
At Sunday, July 03, 2005 1:11:00 PM, Anonymous Anonymous said...

Great topic. I think true empathy develops through experience. If one hasn't had an experience, attempts to sympathize come off as insincere. Young docs (and nurses) should learn to listen to their patient's thoughts and feelings rather than try to guess at them. Pregnancy loss is an example. For years, women who had lost pregnancies were advised to forget about it, not allowed to see their babies, and basically treated as though it had never happened. To someone who has never experienced expectant parenthood, that seems very humane. To someone who has, it's insanity. When doctors and nurses finally started listening to families who had lost babies in pregnancy, they learned that ackowledgement of the child's existence was important, and mourning was essential. The skill of listening to what the patient's concerns are rather than treating what we think they should be will go far toward establishing a working relationship. Increased compliance is a great bonus.
Didn't a study establish a link between how well a patient liked his/her physician and the likelihood of malpractice suit?
5in9years

 

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