Communication Implications in a Doctor's Bedside Manner

A doctor's bedside manner may be considered one of the most important forms of communication for the patient because the doctor is the important link between illness and health. Because it is such a vital link between well-being and illness, it is constantly in question. If the doctor does not care for anything but the patient's disease and not the patient as a person, will that person's will to get better be affected? The following abstract will explore the theory that bedside manner and communication between the doctor and the patient are vital to the patient's desire to improve.

Bedside Manner as Communication

Bedside manner is defined as the "proper way of behaving when dealing with a patient" (Arsani 2000). Within this proper behavior is the ability to properly communicate information to the patient. According to Arsani (2000), communication is the "art of imparting knowledge or exchanging thoughts, feelings and ideas by speech, writing and gestures." If the doctor is unable to communicate to the patient, the patient may not feel trust for the doctor. According to Grieco (1998) there does appear to be a problem with bedside manner in hospitals today. She believed that a doctor only "sees a disease that must be identified, catalogued, controlled," instead of a whole patient. This creates a problem when trying to maintain assurance with the patient that he or she will get better.

Arsani gives seven important aspects to the appropriate bedside manner.

1) Manner of dressing - decent, clean clothes to maintain sufficient decorum.

Should not be such that makes a patient uncomfortable. Footwear is also important.

2) Manner of questioning about intimate problems - at no time should your patient especially of opposite sex feel that this particular question was not warranted. If you feel a particular question may embarrass/annoy the patient, please state that it is not your intention to do so.

3) Manners of examining a patient of opposite sex especially when doing ECG, examining breasts etc.

4) Manner of examining a private parts PV/PR.

5) Tendency to moralize for their deeds. It is your duty not to moralize. You have to treat and counsel. If someone is sleeping with his neighbour's wife, you may tell him the hazards of such an action but don't treat him like a lousy person.

6) Tendency to patronize for status, speech, money, and physical characteristics. It is very tempting more so in the beginning of practice where you feel you should be known by the company you keep. If you get a patient from TV/Media/Movies don't charge because you feel obliged. Resist a temptation.

7) Tendency of amorous relationship with patients. (2000) Though the many aspects of bedside manner are useful to all doctors, it is important to remember that doctors may not hold the personality trait complimentary to the rules of bedside manner. Though this may be true, Billings (2000) believed that bedside manner, at least for terminal care can be taught. This article, which focused on palliative care, a "comprehensive, interdisciplinary care of patients and families facing a terminal illness," discussed the importance of bedside manner in such a crucial time in a person's life. But terminal illness does not have to be the only reason for a doctor to need to have a bedside manner.

Psychology of Ill Patients

Why is it so important that a doctor hold a certain rapport with a patient? Why is it not good enough to simply walk in, tell the patient what is wrong and how they will be treated, then leave? According to Block (2000), psychological distress often causes suffering in terminally ill patients and their families and poses challenges in diagnosis and treatment." She believed that that increasing the attention given to the patients may improve their ability to cope with the illness. Due to the uncertainty to an illness, it is important to understand all that is occurring and feel assured that the doctor not only fully understands the illness, but cares enough as a person to want the patient to fully recover, or at least feel at ease if recovery is not possible.

According to Block, psychological distress in the hospital, especially in terminally ill patients is prevalent, but can be treated. Psychological distress is a major reason why a doctor should have the ability to relate to the patient as a patient. The illness alone is enough to discourage the patient's confidence, so having a bedside manner is especially important in this situation.

Bedside Manner and Well-Being of Patient

As mentioned before, the ability of the patient to recover from an illness may be affected greatly by the doctor's ability to communicate in a caring fashion to the patient. Some believe that the sex of the doctor may affect the patient more, especially in specific situations. According to O'Donnell (2000) research has shown that women doctors are better communicators and spend more time with their patients. "Research finds male doctors are more likely to interrupt their patients and less likely to answer all of their questions, while women doctors are credited with emphasizing preventive care." Does this mean then that most patients are better off finding a female doctor? Not necessarily. Though it is important to establish a good relationship and communication base with the doctor, the most important aspect is the doctor's know-how and ability to cure the patient despite their personality. The problem is that many doctors understand this and feel that their only duty is to cure the patient and not explain and establish a relationship.

Then how important is it to find the appropriate doctor? It is probably the most important step when choosing a doctor, especially when considering the overall care that will be provided. According to Spencer (2000), "a person may initially contact a complementary practitioner for purely pragmatic reasons, but later be impressed by the superior communication skills and bedside manner of the practitioner."

Research Question 1: Does bedside manner affect the patient's ability to improve physically and emotionally?

Research Question 2: Should there be more rules or aspects to bedside manner to better improve not only the communication between doctor and patient but the comfort level of the patient?

References

Arsani, C.H. (2000). Art of Communication: Bedside Manners- Counseling. BHJ Hospital Journal.

Billings, Andrew J. Pallative Treatment. British Medical Journal,321 (1) 555-559.

Block, Susan. Assessing and Managing Depression in the Terminally Ill Patient. http://www.acponline.org/ethics/block.htm.

Griego, Tina. Reshaping bedside manner. Scripps Howard News Service.

O'Donnell, Kelly. Women docs relate to patients better. Nightly News Homepage

Spencer, Wayne. Don't Believe Everything You Feel. http://www.goethe.de/br/sap/macumba/spe21on.htm.