What to do if your doctor isn’t polite

Here’s a question I’m almost afraid to ask: when you go to a doctor (not one you see all the time), does the doctor usually introduce himself (or herself) and explain what they are there to do?

And, do they sit down?

I really hope that you are answering yes … but I know that the answer is often no.

In a study recently published in the Journal of Hospital Medicine, researchers observed 29 interns during patient interviews. They found that only 40 percent introduced themselves, only 37 percent explained their role — and only 9 percent sat down. And when they asked the interns about the interviews, they found that lots of them didn’t even realize they had forgotten these basic things.

Now, these are brand-new doctors, so maybe we should cut them slack. But I don’t think that this is a problem specific to new doctors. Besides the fact that doctors learn from watching other doctors, I know from experience that even doctors who aren’t brand new sometimes forget to, well, be polite.

This is embarrassing, puzzling–and really interesting.

It’s really interesting because many of the doctors who forget to be polite are actually very polite and pleasant people — when they aren’t with patients. I see this sometimes both with doctors-in-training and with experienced doctors: they are lovely and friendly in the hallway or conference room, and become much more stiff, formal and disengaged when they enter the exam room.

What’s going on?

I remember being a brand new doctor. I remember feeling like I needed to come across as very smart and capable, even though I didn’t feel smart or capable. I felt like I needed to act very professionally and use big words — more than that, I felt like I needed to become a certain persona.

There’s this idea, I think, that in order to make patients respect us and listen to us, we doctors need to act not just formal and professional, but, well, like we are smarter and a bit more important than patients and families. We also think that in order to make the best decisions — and, also, to protect ourselves emotionally — we need to keep some distance.

This is ludicrous, of course.  Patients and families are way smarter about so many things than we are (most importantly, about their lives and situations and how they feel) — and nothing is more important than the patient and his family. As for emotional distance … it’s never that simple, and sometimes backfires. Over time, many of us figure that out — and adjust our behavior accordingly.

But before we do, as we are being that persona, we sometimes forget the basics of human interaction — like being polite.

I think about this a lot, as I’ve been teaching communication skills to the residents (doctors-in-training) at Boston Children’s — who are all, without exception, remarkably wonderful people. I’ve realized that a big part of what I want to teach them is: don’t stop being yourself — and think of each patient and family member as a new friend. Not only does it lead to better communication, it leads to better relationships — and better relationships lead to better care.

Do me a favor, okay? If a doctor doesn’t introduce himself, get him to do it by holding out your hand and introducing yourself. And ask him to sit down.

Claire McCarthy is a pediatrician at Boston Children’s Hospital. She blogs regularly at Thriving, the health and parenting blog of the hospital, the Huffington Post and Boston.com as MD Mama.

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  • NormRx

    I recently went to an urgent care center, the place was packed. After waiting about 2.5 hours I finally was called in to see the doctor. Since there were many patients waiting to see the doctor I thought I would hustle through my problem as quickly as possible, no small talk or bs. When he came in I asked him how he wanted to do this. Did he want to ask me the questions or should I give a brief summary of my problem. He said “first I would like to introduce myself.”

    • Dr. Drake Ramoray

      I remember being an intern in the ER seeing a simple arm lac (translation the patient had been waitin for hours) and when I sat down introduced myself and smiled he told me I was the first person to smile at him all day.

      He had some good stories to tell. My most pleasant patient encounter all night. Never underestimate the power of politeness and a smile.

      • NormRx

        Dr. Ramoray I don’t underestimate the power of politeness and a smile. I always try and be respectful to people I meet unless they give me a reason to behave otherwise. Since I called on physicians for 27 years I don’t think you will find a person that is more sympathetic to the plight of the average physician than myself. I don’t have to go into detail of all of the stresses you physicians are under. you being a physician know only to well. That being said, that is why I tried to make my office call as quick as possible so he could get to the next patient, there were probably at least 15 patients waiting to see this physician and they keep coming in the door. I almost think seeing his work load bothered me more than him, I suppose this was a normal day for him. Thanks for your comments, I always enjoy reading them. Norm

        • Dr. Drake Ramoray

          It was not my intent to suggest you weren’t aware of that. It probably should have been phrased “No one should underestimate….” Some nuances and inflections get lost online. Your post just made me think of my dad telling me when I was growing up to Never underestimate the power of politeness and a smile.

    • querywoman

      Ha! You made an incorrect assumption that this doctor wouldn’t have the time for niceties!
      It takes a certain type to work in an urgent care center. He may be quite good at keeping his personality intact.

      • NormRx

        Apparently I wasn’t too clear in my post. I never made any assumptions. All I was trying to point out is that I was trying to be very respectful of this doctors time. He had a full clinic and it turns out that his full schedule bothered me more than him. I like to have a personal relationship with my primary physician, but in an ER or urgent care setting I really don’t care.

  • DoubtfulGuest

    Great post, Dr. McCarthy. I actually don’t hold any of this against a doctor. Well, I need to know their names, but if some of them aren’t hand-shakers that’s okay with me. I know doctors can feel a lot of pressure when they walk into that exam room the first time. I suppose some of them get caught up in their initial assessment of the patient, looking for signs of illness. I also don’t mind socially awkward people at all. I’m glad to help someone feel at ease. What I’ve had problems with is doctors getting angry, seemingly for no reason. This doesn’t happen at all with my current docs, but when I was trying to get a diagnosis, I had a few doctors be so “rude”, if you want to call it that, that I had recurring bad dreams about it afterward. The words they used were standard polite words, but the tone…the tone. Like, a high-pitched, sing-songy, baby talk but obviously very angry. It’s hard to describe because it’s not something I’ve experienced outside doctor’s offices. I can see it is stress-related, but I have no idea what patients are supposed to do when this happens. Is there some doctor-tone decoder app available? Or just…doctor decoder in general? :)

    • rbthe4th2

      As someone who gets a lot of illnesses, and has asthma and can’t do the flu shot, I’m actually very happy when a doctor doesn’t want to shake hands. I don’t shake them in church until the summer months.

  • Patient Kit

    If a doctor is rude, impolite or not present, they are setting themselves up for an uphill battle to get me to respect, trust and listen to them. Or even come back. And I admit to having a hard time trusting a doctor who doesn’t make eye contact with me. Trying to command more respect for themselves by being disrespectful to the patient seems totally counterproductive to me. Of course, if I already have an ongoing good relationship with a doctor, I’m going to cut them some slack. We’re all only human and we all have bad days. But first impressions are important and hard to overcome if they’re bad. In general, I feel like there is no good reason to be rude to each other, in a medical setting or elsewhere. Basic politeness should come naturally.

    • DoubtfulGuest

      “Trying to command more respect for themselves by being disrespectful to the patient seems totally counterproductive to me.”

      This. It makes you guys look bad. We can see through it — if not right away, then after we leave your offices, fuming about the crappy visit we just had.

      I’m not sure I’ve ever had a doctor want to earn my trust or respect, though. It’s always very clear in my situation which of us needs the other. It’s just my doctors now are kind enough not to take advantage of that.

  • Lisa

    I’ve never had a doctor fail to introduce themselves. I could care less about shaking hands with the doctor and I don’t really care if they sit down upon entering a exam room. What is important is if I feel they are paying attention and listen to my explanation of why I am there (if I am there as a new patient) If it is a doctor I see on an on going basis, I appreciate if their opening statement acknowledges our past interactions in some way. Example, I saw my pcp for three pre-op physicals in a relatively short period of time. The second time he said something along the lines of we have to stop meeting this way. The third time he said this was becoming a bad habit. Contrast that with my first oncologist – at times I wondered if he remembered me. Certainly, I had several phone conversations with him where I knew he was having trouble remembering me.

    I would prefer not to meet a doctor for the first time in a gown. I appreciate it when a consult begins in the doctor’s office, not the exam room.

  • http://www.CommunicatingWithPatients.com/ Edward Leigh, MA

    Hello Dr. McCarthy: Outstanding article. It is critical that patients have an excellent first impression. This first impression sets the tone for the rest of the meeting. It is hard to recover from a poor start. I am happy to read that you teach communication skills. That is my area of expertise so it is always wonderful to find others who share my passion. Keep up the great work! Best wishes, Edward Leigh, MA, Center for Healthcare Communication

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