Monday, September 05, 2016

Communicating with the patient - why doctors need to go beyond the bedside

We all know the importance of the doctor patient relationship , and this is why so much stress is laid on the doctor's bedside manner .  Good doctors can communicate care and compassion to the patient , and patients are comforted , because they know that not only is the doctor competent, he also cares about him , and will do his best to help him to get better.   Good bedside manner is an intangible skill which is often something mysterious, and is hard to emulate.

While this still remains extremely important , I think we need to move beyond the bedside, because a lot of the care we provide is now done digitally. This could be through Whatsapp or by email , and we need to cultivate equally good manners for these channels of communication with our patients as well. Doctors need to learn good digital manners as well !

This can be easy to do, because it's just a question of applying etiquette to digital communication.  Thus, email queries should be replied to promptly , so that patients aren't left hanging in the dark ; telephone calls should be returned by end of day; and Whatsapp messages answered. Even if you can't do all this yourself, you need to identify staff members and assign them these responsibilities, which you need to monitor.

In some senses , this can be harder as well, because when the patient is sitting in front of you, you can look into his eyes, which means it's much easier for you to demonstrate that you are concerned and compassionate.  However, digital communication tends to be a little more impersonal, especially when this is a new patient whom you've never seen before.  The reason I like email is that everything is documented, and this reduces the scope for miscommunication and error; and encourages openness and transparency.

Many of my patients complain that my email replies are too short, and they believe I am curt , but the truth is that I am a one-finger typist, and it's much easier for me to provide quick and dirty replies, especially when this is a patient whom I have never seen before, and  who has reached out to me through the internet. I tell my patients that the quality of my answer will depend upon the quality of their questions !

Similarly, at the end of a phone conversation, patients may feel that the doctor is uncaring , and didn't answer all their questions properly, but this could just be because the phone line was bad, and he couldn't hear you clearly; or didn't have enough medical details to provide intelligent answers. Also, many patients expect the doctor to provide a free consultation, and doctors are naturally reluctant to do so, because their time is precious ! I don't like phone calls personally because the signal to noise ratio is poor and there is no documentation.

However, both face to face and digital communication are complementary channels , and doctors will need to master skills in both these settings if they want to continue being able to take good care of their patients in this day and age.

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