Many Hospital Interns Lack Bedside Manners, Common Courtesy
October 24, 2013 by UPI - United Press International, Inc.
BALTIMORE (UPI) — Despite research suggesting courteous bedside manners improve patient recovery, many U.S. doctors-in-training lack courtesy or are rude, researchers say.
Study leader Dr. Leonard S. Feldman of The Johns Hopkins Hospital and The Johns Hopkins University School of Medicine found doctors-in-training are unlikely to introduce themselves fully to hospitalized patients or sit down to talk to them eye-to-eye, despite research suggesting treating patients with dignity and respect improves medical recovery along with patient satisfaction.
“Basic things make a difference in patient outcomes and they’re not being done to the extent they should be,” Feldman said in a statement. “These are things that matter to patients and are relatively easy to do.”
For the study, trained observers followed 29 internal medicine interns — physicians in their first year out of medical school — at The Johns Hopkins Hospital and the University of Maryland Medical Center for three weeks during January 2012.
They witnessed 732 inpatient “encounters” during 118 intern work shifts. The observers used an iPod Touch app to record whether the interns employed five key strategies known as etiquette-based communication: introducing oneself, explaining one’s role in the patient’s care, touching the patient, asking open-ended questions such as “How are you feeling today?” and sitting down with the patient.
The study, published online in the Journal of Hospital Medicine, found the interns touched their patients — which could be either a physical exam or just a handshake or a gentle, caring touch — during 65 percent of visits and asked open-ended questions 75 percent of the time.
However, they introduced themselves only 40 percent of the time, explained their role 37 percent of the time and sat down with the patient during 9 percent of visits, the study said.
Worse, interns performed all five of the recommended behaviors during just 4 percent of all patient encounters, and were only slightly more likely to introduce themselves to patients during their first encounter than a later one, the researchers said.
Study co-author Dr. Lauren Block, a former general internal medicine fellow at Johns Hopkins, said in a follow-up study six months later, the researchers surveyed nine of the 10 Johns Hopkins interns, asking how often they used the five communication strategies.
The interns estimated they introduced themselves to their patients and explained their role 80 percent of the time and that they sat down with patients 58 percent of the time — far more often than they actually did, Block said.
“Our perception of ourselves is off a lot of the time and that’s why it is so important to have data,” Block said.