If you believe patient rating sites, the answer is yes.
Pauline Chen takes a look at one site, and found that “reviewers gave less-than-passing, and even failing, grades to those physicians who seemed rushed, brusque or distracted; and they uniformly gave ‘A’s’ and ‘B’s’ to doctors who were warm, concerned and focused.”
I’m going to assume that’s a finding common to the majority of physician rating sites.
It’s also a reason why mid-levels generally have satisfaction scores that meet, or exceed, those of physicians. Under no financial pressure to see 30+ patients a day, they are able to spend the necessary time with patients seeing only fifteen or so. Doctors however, don’t have that luxury. If physicians were able to practice seeing half the patients they currently do, I suspect their scores will rise accordingly.
But I digress. The point remains, good bedside manner does not necessarily equate to better patient outcomes. The surgeon who is a jerk may have the best technical skill in the operating room. That’s the doctor I want for surgery.
It’s a shame that most rating sites fail to acknowledge that.
Related posts:
- Can bedside manner be taught, or is it something you’re born with?
- Bedside manner
- How bad do online doctor rating sites suck?
- Can a doctor sue a patient for a negative online review?
- Should physicians display emotion at the bedside?
- Suing patients for poor online reviews
- Should patient satisfaction influence physician compensation?
{ 24 comments }
The problem is one of information. A patient rarely has the ability to know and interpret a doctor’s clinical skills or a surgeon’s technical ability. All a patient is usually able to evaluate is whether 1) the doctor appears to be listening 2) the doctor identifies and aligns treatment goals.
A counter analogy: the surgeon might have all the technical skills in the world, but if they remove the wrong body part because they weren’t listening to me, then I am not going to be pleased with the outcome.
It is apples and oranges.
The standards of a surgeon are completely different than a primary care doctor, which, for those of us in primary care, can be quite frustrating as we frequently have to make excuses for the abrupt manners of our surgical, and other, colleagues. In a small community you just do not have much choice.
The problem is managing patient expectations. Many patients want a primary care doctor that is accessable and attentive. However, these same patients frequently want to talk on the phone, rather than come in, and call after hours for flimsy reasons. They are the same ones that come in with a lengthy “laundry list” and expect you to go over all of it. They are the same ones who arrive 10 minutes late for an appointment, give my front desk a hard time about their copay (we have to collect it before a visit because so many patients will try to run out without paying it) but complain when the office is running behind. It is almost as if the more available you are, the less you are respected. Perhaps it is because patients are now health care “consumers”, and we are merely providers of a service.
I guess I sound jaded. The upside is that, for appreciative patients, and their families, I have all the time in the world.
A family practitioner
I agree entirely with the flaws of rating systems, etc., but I think that it is important to note that the properties of being a nice physician and a competent physician are not mutually exclusive. It is possible to have both technical expertise and a good bedside manner, and this should be the goal for every practitioner. This may seem like an obvious point, but it’s one that you didn’t make here and one that gets lost a lot of the time when this subject comes up. Too often, I hear people justifying rudeness, hostility, and bad manners with the caveat that he or she is “a brilliant fill-in-the-blank.” That’s not good enough for me. In a pinch, if I have to, I’ll take the competent physician over the nice-but-clueless physician. But I’ll go great lengths to find someone who is both, and I think that is the standard to which we should hold everyone.
Many services, from law to plumbing, are difficult for consumers to evaluate the quality of. We rely on heuristics and signals. A doctor with good bedside manner indicates a generosity with time and the desire to at least appear compassionate. These qualities are consistent with the quality fo taking the time to conduct all necessary analyses for acceptable medical treatment–at least for a general practitioner, internists, etc. As the first commenter noted, surgeons are different.
Following the theme of the first post, when the surgeon does not respect the human right of the patient to participate in the decision-making process that determines the parameters of the surgery, through disinterest or poor listening skills, then the OUTCOME may be something the patient did NOT desire. A tragic example is seen among the countless women who think they are undergoing a diagnostic procedure and wake up with their entire reproductive systems amputated as a precautionary measure. Another example includes the patients who are never fully informed by the busy or arrogant surgeons of the procedures actually planned, de facto performed, the “squelae” to be aware of on a long term basis, and other crucial details affecting long term health and “outcomes” after the surgeon has done her job.
Thank-you, to Mollilicious for the dedicated position to do your best for your patient despite tremendous and often invisible challenges .
Dr. Kevin, you and other mindful and compassionate medical personnel can never undo your knowledge, and so, when you or your loved ones must seek medical services, you will never fall victim to some of the “relationship” and information tragedies we lay people are subject to.
So, it is very hard for you, the good guys, to imagine the traumatic outcomes that are caused by inhumane attitudes, disregard for full disclosure, and disrespectful behavior relegated to the category of bedside manner. Perhaps even colleagues you respect and enjoy the company of cause patients consequences that traumatize them for the rest of their lives, despite being competent technical experts.
Thank-you immensely for exposing lay people and medical professionals alike to the information you discover and share. Thank-you for your comments and insights in presenting information. Thank-you, Dr. Kevin, for your courage to make your own personal positions known. I have learned so much from your facilitation of information.
But please remain open to the fact that not all outcomes that damage a patient for life are the result of forgivable human errors or miscommunications; indeed, the knowledge the surgeon or other expert holds can be as easily abused as it can be used toward healing.
“Patients don’t care how much you know until they know how much you care.”
Or something like that.
-Steve
So that begs the question.. how DOES a patient know they have a good doctor?
Nice to see the inmates are running the asylum.
Yes, and get used to it.
And about time, too….
Patients who care about bedside manner are not sick enough to need a doctor. They need a friend instead. Ordinary good manners is enough for the real patient.
While bedside manner might not matter to a doctor or especially you, Dr., it matters very much to a patient! Speaking as a patient, say you have the misfortune to get an arrogant, unapproachable doctor and you don’t feel comfortable asking him questions about your treatment – that could be a potential life or death situation. Or you get a doctor who doesn’t deign to explain a medical procedure to you – if you are lucky, his nurse takes pity on you and takes you aside to explain, but if you don’t have that option, you either walk away from the treatment or you take it and then end up being surprised at the length and discomfort of the healing process, etc.
Or it’s some person you don’t feel comfortable sharing your medical history with, or it’s someone who undertreats pain issues because you are a black or brown skinned person and a female to boot. Now that crosses over to tort and potential litigation, all because the doctor is a *rick! It’s a serious issue, the approachability of a doctor. Like most of Dr. Kevin’s “analyses” his commentary lacks depth, which doesn’t do anyone any good. You might try writing about this again, Doctor, and this time with a little more depth.
Agree that “ordinary good manners” are enough; completely disagree that patients who care about such things aren’t really sick. Any human interaction goes better with courtesy. I don’t care how skilled a person is…doesn’t give them permission to treat others poorly, especially others who are ill or injured.
A couple of years back following a course of treatment with a surgeon, I received several unsolicited and supposedly anonymous Scantron evaluation surveys from the clinic. Several questions did indeed ask to rate the doctor’s “bedside manner”. Apparently some internal corner of the medical profession feels this sort of rating has value.
And here are a few more reasons a good beside manner matters, based on several studies:
1) Strong doctor-patient relationships based on trust and commitment are positively associated with patient adherence to treatment.
2) Chronically ill women who reported a connected relationship with a health care provider and viewed their care as a partnership had more confidence and motivation to manage their illness and a greater sense of well-being.
3) Cancer screening rates improve when healthcare providers spend more time with patients and adequately explain the importance of surveillance.
4) Communication between cancer patients and their care providers may impact cancer outcomes by influencing empowerment and hope.
I am a Family Nurse Practitioner and see as many patients a day as the doctors in our practice do. Our company does surveys and most patients comment on how much time I take to listen to them which is interesting because I don’t take more time than the doctors. It’s a perception of care. As a patient, I don’t care what kind of bedside manner a provider has, but that they know what the hell they are doing. I’ve seen too many missed diagnoses out here from providers (NPs and MDs) who don’t listen to their patients. We need to collaborate with each other and stop the bickering or more patients will get hurt.
I think most patients would consider listening a component of a good bedside manner, not as two separate qualities. If you care that medical professionals listen to you, then you probably are aligned with those who value the “bedside manner”. That phrase hasn’t been very well-defined here. I personally wouldn’t go so far as to say I care about the docs sitting on the bed and having a chat — to heck with that. Just be reasonably gentle and sympathetic as you poke and prod, and listen closely during the time that you do have.
Supremacy Claus, lot’s of people who aren’t feeling particularly sick need to go to doctors. Are you saying that a diabetic on 3 oral hypoglycemics and 3 meds for BP, with a hemoglobin A1C of 10% and a BP of 185/95, who cares about bedside manner is not sick enough to see a doctor, but needs a friend instead???
Dr. Rack: The doctor that controls my brittle diabetes by experience and skill, keeps me out of ICU, skips my yearly diabetic coma, he can cuss, spit on the floor, and throw the bedpan against the wall, as far as I am concerned.
The slick, patronizing, salesman type who is not loyal to me, and does not go all out on my behalf, he can be your doctor.
If physicians were truly interested in reducing their malpractice exposure, it is their relationships with their patients they would worry about the most. They whine and bitch about anyone who dares question their work and asked to be paid for damages they cause, yet most see no benefit whatsoever in improving their skills with regard to how they treat the patient. If they spent 1/2 as much time worrying about their relationship with the patient as they do ordering what they claim are “defensive tests”, their exposure would decline significantly.
If Anonymous 9:23 PM is a disgruntled patient, try switching doctors to someone who will focus on your emotions.
If it is a lawyer, it is implying most medmal cases have an improper motive, namely disgruntlement, rather than damages from a deviation from standards of professional conduct. This view is supported by data. First, disgruntled patients are more likely to sue to retaliate, not to be made whole. Second, three fourths of medmal claims fail at every step of litigation. This combination of failure and malice represents a massive intentional tort by the plaintiff bar. These malicious, and negligent lawyers owe doctors about $trillion. It is the height of injustice that biased lawyers on the bench have granted them immunity for their malice and carelessness.
Are you really surprised supremacy claus? Judges protect their own (lawyers).
“If it is a lawyer, it is implying most medmal cases have an improper motive, “
Not at all. It’s just that people are more likely to forgive errors of those who treat them with respect and dignity. A physician conducted this study.
Whatever the motive of the client, though, that doesn’t mean the lawyer has that same motive, and it’s the lawyer who has to decide if the case has merit and proceed with spending his money. So your argument doesn’t hold much water.
Anon 3:44, you’re a fool if you think all lawyers are united in the same way on these issues. There are far, far more corporate and insurance defense lawyers, not to mention probate, criminal, contracts, etc. lawyers than there are those who represent plaintiffs in personal injury cases.
Anon 4:37: The lawyer is the agent of the retaliating plaintiff and has its motives, no matter how deeply, pretextually couched in supercilious virtue in the complaint. The pretextual appearance of virtue is itself another form of bad faith, but this time on the part of the lying lawyer. Those are intentional torts. Once the lawyer’s self-dealt immunity ends, the lawyer, the judges, the law schools, the states, the counties will have to pay $trillions to the doctor, down to the last water bucket of the last fire brigade sold at sheriff’s sale.
Anon 4:39
Read for comprehension. Talking judges here. How often have lawyers had action taken against them for bringing crap into court? THAT is sup clauses point.
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