The Healing Touch: Keeping the Doctor-Patient Relationship Alive Under Managed Care
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The Healing Touch - David L. Cram
Plato
1
The Influence of Bedside Manner
The concept of bedside manner dates back 2,500 years, when Plato wrote the earliest known description of the doctor-patient relationship in The Laws. Plato writes that the best clinical medicine is practiced when the doctor and the patient have concluded a fully human relationship in which the technical aspects of care are placed in the human context (Siegler 1993). However, throughout much of history, doctors would not always fully inform patients of their conditions. This code of silence
still exists today in some cultures. For example, a physician might not inform a cancer patient of his or her condition, believing that not knowing will enhance the patient’s immunity, decrease anxiety and therefore extend life.
Fortunately, in the United States today, medical professionals recognize patients’ need to know and understand their conditions. We realize that, especially with a serious or chronic disease, patients are vulnerable. What doctors say and how they act toward these patients can have a major effect on both the patients and their diseases. The will to get better and to remain upbeat irrespective of the illness can be a direct result of a sympathetic physician playing a significant role in the patient’s life. S.H. Kaplan (1989) states, The physician-patient relationship is a primary bond that may act as a social support to influence the patient’s health status.
Good physicians realize that patients expect answers from their doctors. The manner in which a physician talks to the patient can affect the long-range outlook of the disease. Incorrectly done, it can result in such undesirable effects as noncompliance with therapy, more complicated testing, the need for higher doses of medication, more frequent office visits, longer hospital stays, or an increase in medical lawsuits. The patient may also decide to seek another doctor. If the goal of our society is to achieve better health care at reduced costs, a good bedside manner from health care providers obviously will play a significant role in reducing these costs.
Qualities of a good doctor
I believe the following are the qualities of a good doctor and the foundation of a good bedside manner:
Intelligence
Altruism
Honesty
Inquisitive mind
Sense of humor
Empathy
Self-confidence
Patience
Sincerity
Good memory
Compassion.
Genuine concern for the welfare of others
How is bedside manner best applied?
To have medical knowledge and skill alone is not enough. To be truly effective in treating the sick, doctors and nurses must have good communication skills. In one sense, they are educators. Education helps patients make decisions. Doctors should allow patients to make shared decisions and be willing to walk the road to recovery with them (Herman