Etiquette-based Medicine
If you can’t train physicians to be more empathetic, at least you can train them to be courteous according to Michael Kahn, MD. This simple act lays the foundation for building a satisfying relationship between the provider and patient. In this New York Times article, Kahn discusses his “etiquette-based medicine” which proposes a simple 6-point checklist for physicians who follow hospitalized patients. This check-list can be adapted to any first encounter with a patient.
Although my initial reaction when I read this article was to shake my head in disbelief that courtesy needs to be taught, I remembered how easy it is to focus on the disease or illness and forget the person. Besides, hospitals can be chaotic, dehumanizing and impersonal so anything that helps us as providers observe these simple steps really can set the stage for a positive exchange for both the provider and the patient.
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It is refreshing to see an improving doctor-to-patient/customer relationship. My own experience in the past couple of years bears out this trend. For almost 20 years I refused to see a doctor and was helped tremendously by a caring and professional (and extremely competent!) nurse practitioner. My current doctor of two years has many of the same critically important relationship skills.
Not to sound like an old guy, but I still remember clearly and fondly my family doctor from the 1950s-60s, Dr. Adrian Delerzon. He was always friendly and calm no matter what was happening, and his concern and ethic has imprinted his memory on my mind as clearly as if I had just seen him last week. This was of course in the days when the doctor (in his solo practice with a part-time nurse) would see patients in his office in the afternoon, after spending the morning making house calls and hospital visits. Often he’d stop again at sickbeds on his way home at night. I was a teen when he retired, and I’ve never met a doctor like him since.
There was a time, I suppose, when competence was just assumed, and a professional was evaluated using perhaps more vague but still critically important indicators. The idea that the town doctor would live in town and be a central support of the community is I suppose a somewhat antiquated concept, but nobody had to teach Dr Delerzon or his replacement, Dr Kellogg, anything at all about human relations — they were treating their neighbors, after all.
Thanks for a great column! I look forward to reading here often.
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