Medical interns may need to brush up on bedside manners

(HealthDay)—Doctors-in-training lack "common courtesy" when dealing with patients and this problem can lead to lower patient satisfaction and worse medical outcomes, a small new study suggests.

It included 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. The interns were followed for three weeks during January 2012.

They were observed during 732 patient encounters to determine if they used five key strategies known as etiquette-based communication. Strategies included introducing themselves, explaining their 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.

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. Interns asked open-ended questions 75 percent of the time. However, they introduced themselves only 40 percent of the time, explained their role only 37 percent of the time and sat down during just 9
percent of visits.

The researchers also found that the interns performed all five of the recommended behaviors during just 4 percent of all patient encounters, and were only a little more likely to introduce themselves to patients during their first encounter than a later one, according to the study published online recently in the Journal of Hospital Medicine.

Research shows that courteous bedside manners are associated with improved patient recovery and satisfaction. These findings show the need to improve interns' communication with patients, according to the researchers.

"Basic things make a difference in patient outcomes and they're not being done to the extent they should be," study leader Dr. Leonard Feldman, an assistant professor of medicine at the Johns Hopkins University School of Medicine and one of the associate program directors of the internal medicine residency program at the Johns Hopkins Hospital, said in a Hopkins news release.

"These are things that matter to patients and are relatively easy to do," he noted.

One of the reasons why interns may not follow basic social protocols when dealing with patients is because the senior doctors they learn from often fail to do so, according to the researchers.

"Many times when I sit down, patients say 'Oh my God, is something wrong?' because I actually bothered to take a seat," Feldman said. "People should expect their physicians to sit down with them, to introduce themselves. They shouldn't be taken aback when they actually do. It's part of being a doctor."

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