Does your neuro have good manners?

[doublevision1]

There is a new essay in the New England Journal of Medicine by Dr. M. Kahn called “Etiquette-Based Medicine.”  

The author says that the presumption is that patients are most comfortable with a doctor who is compassionate.  However, in reality the criticism that many have of their doctors often has nothing to do with feeling misunderstood or not empathized with.  Rather, it seems a lack of basic good manners and common courtesy is what’s missing.  The author’s suspicion is that patients may care less about whether their doctors are reflective and empathic than whether they are respectful and attentive.

Some examples he gives of good doctor etiquette include such basics as: asking permission to enter the room, and waiting for an answer; introducing themselves; shaking hands; smile if appropriate; making eye contact; explain their role; and generally being polite, courteous and attentive.

He goes on to say that while there have been many attempts in medical education to foster empathy and compassion, there have been none to his knowledge that teach and evaluate good manners.  He makes the point that while it is very difficult to influence a change in attitudes, you can teach and measure behaviours.  

He recommends that medical schools implement ‘etiquette’ training along the lines of some basic customer service principles, and focus more on how the physician should behave, and perhaps less on how they should feel.  He feels that an etiquette-based approach should be added as a complement to training, not as a replacement for current approaches.  However he does believe an argument could be made for etiquette based medicine to take priority over compassion-based medicine.

When I considered all of this I realized that my neurologist seems to come from the etiquette-based school of thought.  I wouldn’t describe him as compassionate, but he not not compassionate either, if that makes sense.  He’s not warm, but he’s not cold.  He is very professional and kind of formal, but courteous and attentive.  I cannot imagine him ever holding my hand or patting my back.  But he looks me in the eye and listens carefully when I speak and answers questions in a very even tone of voice that never conveys smugness or impatience or superiority.  When the author described his surgeon’s style as being a gentleman, that fits for my doc as well.  I realize this is what I want in a neuro, I don’t need or want him to hold my hand.  I need him to know what he’s doing and tell it to me straight, and treat me like an intelligent woman throughout the process.

I should add that when I need a good dose of empathy, my GP is wonderful for that.  She’s courteous too, but a lot less formal than my neuro and very engaging and warm.  I get the best of both worlds.



This made me curious about what others think.  Would you describe your doc as distinctly one style or the other?  Which do you prefer?  What do you think of the premise of this essay in terms of training of new doctors to have good manners?  From what I've read here, it sounds like many of them need it!!!

db

[ohwild]

also just a little thing my doc walked over to me and pulled my arms up causing me much pain and declared frozen shoulders, pulled me around by shoulders and declared back pain, I told her to stop it hurt like hell,then to add insult to injury, when i told her about muscle pain in legs she pointed to my leg and said she didnt remember what 'that was called' so i said leg and thigh, i guess she wanted me to call it a muscle  but i didnt think of that for a few days, then i started laughing and asked her if she was having a senior moment , at leeast she laughed, did i appreciate the sudden onslaught . no not for one min, It was very rude

[jensequitur]

I like a professional attitude from my specialists.  I want them to not be distracted by the need to be liked!  From my PCP, friendly professionalism is fine.  I'll be seeing them for all sorts of personal things, so might as well be friendly.

[spastic]

Wow, so they really try to teach them some manners? hehehe  I have to admit, I would rather have an empathetic, compassionate dr than one that looks at me like I'm a cow in line for the slaughter house.  My current dr's treat me with respect and care.  I feel like I have a great working relationship with my rheumy because he hugs me before I leave.  He is such a wonderful doc, I just love him to death.  Great article db!!!!

Many Hugs & Love,

Ada

[ohwild]

I just want straight answers if possible, but i am put off of talking to agressive people, my doc is  firm polite and matter of fact, so i dont say all that i should, maybe thats good or bad, but im starting not too care after 2 years, gonna get her to sign me back on for work next week, cos need to live so i will just say im fine, maybe its just me, i dunno anymore