Can Better Bedside Manner Be Taught?

The January 29th New York Times articles by Tara Parker-Pope and Dr. Pauline Chen asks a simple question: Can compassion be taught to physicians?

Dictionary.com defines compassion as "a feeling of deep sympathy and sorrow for another who is stricken by misfortune, accompanied by a strong desire to alleviate the suffering."

From the article and comments that follow on the NYTimes blog, it seems the real question is "Can compassionate behavior be taught to physicians?"

Many physicians went into medicine for all the right reasons: to use their intellect to help others. But sometime during the grueling training or after years of being dragged down by the daily pressures of clinical practice, some physicians stop empathizing with their patients. They seem to care more about getting through their day and seeing lots of patients than optimizing their interaction with each patient.

As I wrote on the NYTimes blog, compassionate care can be taught. Medical schools and post-graduate training programs can demand proficiency in compassionate bedside manner the same way they demand mastery of the Krebs Cycle and the diagnosis of aortic stenosis. If graduation and certification depend on it, students will learn it.

What about when these doctors are in practice? Patients "grade" physicians with their money. If the doctor fails the compassion test, the patients go elsewhere for care.

Some patients don't have much choice about which doctors they use. Their insurance plan (or their lack of insurance) limit their options. In an upcoming post, I'll talk about options for Healthy Survivors dealing with doctors who don't seem to know the meaning of the word "compassion." 

Comments

[Ronni Gordon]

Dear Wendy,

Thanks for bringing up this important topic. As many patients know, a remark or gesture from a physician can greatly influence your outlook and mood, which in turn can affect your health. I've had them at both extremes, from compassionate to clueless. I had a particularly compassionate doctor recently who seemed to have a genuinely warm personality. I asked him if he ever taught a course in bedside manner, and he smiled and said no. Like this doctor, many with good bedside manners probably come to it naturally. But certainly the rest could benefit from a course in the basics that many of them seem to lack.

[Wendy S. Harpham, MD]

Dear Ronni,

Take comfort: Even though your compassionate doctor doesn't teach a formal course in bedside manner, he is teaching every physician who sees him with patients.

What concerns me is the culture of many post-graduate training programs, where newly minted MDs are "broken down."

Then, in practice, a variety of forces can harden the hearts of once-compassionate people. I'm not interested in laying blame, but in having the medical profession make it the norm for healthcare professionals to display compassionate behavior like that doctor you describe.

I believe we'll get there. With hope, Wendy