Northwood News ♦ April 2014

Breaking Down ‘Bedside Manner’ in Seven Steps

By Melissa Clarke

When I was helping my 79-year-old Mom choose a doctor when she relocated to this area, we had a bad experience with the first physician she saw.  For almost the entire visit, he did not talk to her directly, only to me as another doctor.  This all despite my efforts to redirect the conversation.  As we drove home, fresh from the visit, she said to me, “He’s out!  There’s no way I’m going to him again.”  So we set out to find doctor who would talk to her about her priorities, be respectful, and dialogue directly with her.  My Mom was determined to “interview” any new doctor to get a feel for their professional style — the elusive “bedside manner.”

There are any number of reasons that we may find ourselves in the position of having to find a doctor.  It may be relocation, like my Mom, a change of job and, therefore, insurance plans, or getting a new diagnosis and needing a specialist.  Whatever the reason, have you thought about how to evaluate “bedside manner?” Is it just a “feeling” you get about a doctor or are there specific questions you can ask to get at what you value professionally?  Your intuition is certainly important.  However, I am a big advocate of interviewing a doctor to be your healthcare partner and having a clear list of criteria of what professional qualities are important to you.  On the first visit, as you talk with your prospective doctor, consider using the following list of seven qualities to assess how comfortable you are with them treating you and knowing your most intimate health details.

1. Listening skills.  Do they let you finish speaking, or do they cut you off?  Ask them to state your most important concerns back to you.
2. Attention Span.  Do you feel hurried during the encounter?  Does the provider give you their full attention, or are there numerous interruptions?  If there are interruptions, how do they deal with them?  Are they apologetic and respectful of your time?
3. Capacity for compassion.  This may be harder to gauge directly.  Indirect clues include the following:  Does the doctor treat you, other individuals in their practice, and their own staff respectfully?  How does the doctor respond to hardships you describe?  It would not be out of bounds to even ask the doctor what was their most challenging case and how did they deal with it.
4. Openness to other healing traditions.  If this is important to you, be up front if you want to or have tried other approaches like acupuncture or chiropractic.  Your doctor should know about this.  See how they respond.  Are they dismissive, or do they seem open minded, collaborative, or give you specific reasons for including or not including these in your treatment plan in a respectful way?
5. Clarity in explanations and answering questions.  Are you able to understand what the doctor is saying?  Do they speak in layman’s terms using language you can understand?  Do they answer your questions directly?  Can they provide a clear explanation of what they think is going on?  Most importantly, did you leave the office able to explain to someone else what is going on?
6. Promotion of shared decision making.  In medicine, for any major decision, there are at least two options:  do something or do nothing.  Doctors should be able to clearly explain the options and promote you and your priorities in the decision-making process.  Frequently, under the do-something option, there are several paths that can be taken.  The doctor’s job is to outline these clearly and help you make the decision that best fits your values.  Sometimes, though, because doctors may be hurried, have their own value system, or have a preferred way of doing things, they may not effectively carry this out.  One way of assessing your doctor on this is to ask how he involves individuals and their families in decision making.
7. Knowledge of their limitations.  If the doctor did not know something, how did they deal with this?  Did they get defensive or evasive, or did they honestly admit it and seek to get back to you with an answer, or refer to a specialist or someone who could help?

You can always ask others about your prospective doctor’s qualities.  Some physicians are now posting video clips of themselves on the HealthGrades website and, for a fee, you can get a feel for their personal style.  Nothing replaces meeting the doctor in person, though.  Pediatricians, especially, may be open to an interview appointment to discuss your concerns.  To do an interview, you may have to pay a copayment or other fee for the visit, but it can be a valuable way to gather information when making your decision.

The most important thing is to find a doctor before you need him or her.  That way you do not have to be rushed into a decision.  You can have the luxury of doing a thorough interview to see who will be the lucky professional to help you preserve your most valuable asset — your health!

[Dr. Melissa Clarke — an emergency medicine physician, speaker, author, and patient advocate — is former Assistant Dean of Howard University Medical School and currently Medical Director at Senior Helpers.  She lives on Glenwild Road.]    ■