Bedside manner is the way you communicate and interact with your patients as a doctor. It can make a huge difference in how they perceive your care, trust your advice, and cope with their conditions. But how can you develop a good bedside manner as a new doctor? Here are some tips from experienced mentors in the medical field.
The first step to developing a good bedside manner is to listen to your patients with attention and empathy. This means not only hearing what they say, but also observing their body language, tone, and emotions. Try to understand their concerns, fears, and expectations, and avoid interrupting, judging, or dismissing them. Show that you care by using eye contact, nodding, and paraphrasing what they say.
Active listening is a true skill that needs conscious effort to effectively practice. It also involves time which many physicians lack- both in primary and secondary care. Some scheduled appointments takes on average 7 minutes! An acknowledgement that active listening cannot be rushed and the doctor has a responsibility to address what the patient says during these tender interactions. It is the very essence of medicine. The patient will divulge- via words or subtle actions- what they true needs and symptoms are if you give the the time to talk.
The second step is to explain your diagnosis, treatment, and prognosis to your patients in a clear and respectful way. This means using simple and understandable language, avoiding jargon and acronyms, and checking for comprehension. It also means respecting your patients' autonomy, preferences, and values, and involving them in the decision-making process. Provide honest and realistic information, but also offer hope and support.
I would suggest taking a step back to ask what the patient has understood thus far and what their expectations are. It helps bridge a gap, allows for misunderstanding to be addressed and hopefully minimises the risk of breaking news unexpectedly to a patient who is completely unprepared. As we look after patients and work in teams from diverse backgrounds, it is crucial to consider the patient' s own belief systems and how that could affect their interaction with the medical profession. Humility and a true curiosity are the cornerstones to guide the conversations.
The third step is to express empathy and compassion for your patients' situation and feelings. This means acknowledging their pain, distress, and frustration, and validating their emotions. It also means showing kindness, warmth, and encouragement, and offering comfort and reassurance. You can use verbal and non-verbal cues, such as saying "I'm sorry" or "I'm here for you", or touching their hand or shoulder gently.
Empathy and compassion has to be authentic. A patient and their loved ones will be able to sense any disingenuous behaviour. As active listening takes time, showing empathy and compassion can be exhausting. The clinician needs to have the maturity and inner strength to manage these moments and interaction considering they might have multiple patients to review or families to meet. There is a pointer here towards one of the first potential signs of physician burnout: when they can' t afford to show empathy anymore.
The fourth step is to manage your own emotions and stress as a doctor. This means being aware of how you feel, and how it affects your behavior and communication. It also means finding healthy ways to cope with the challenges, pressures, and uncertainties of your work. You can seek support from your colleagues, mentors, or counselors, practice self-care, and set boundaries. Remember that you are human, and you can't help others if you don't help yourself.
Active listening, discussing risks diagnosis and treatment regimes with empathy and compassion while facing the burden of fiscal and time constraints can lead to burnout. The pillars of lifestyle medicine (good sleep, nutrition, exercise, strong relationships and avoiding potentially harmful substances) are often the first to be neglected by busy and overwhelmed doctors, In order to care for patients we have to be health (in mind and body) ourselves!
The fifth step is to seek feedback and learn from others who have more experience and expertise in bedside manner. This means asking for constructive criticism from your supervisors, peers, or mentors, and reflecting on your strengths and weaknesses. It also means observing and learning from other doctors who have a good bedside manner, and asking them for tips and advice. You can also read books, articles, or blogs on the topic, or attend workshops or courses.
We can learn so much from each other: both how to do it and how NOT to do it! The learning opportunities start from medical school. Often students feel like spare parts but they have a 'fly on the wall' perspective of the teams and can start to distil their own communication skills. If you are the more senior clinician, it helps to set the scene for more junior colleagues in training so the educational objectives including the communication skills! Increasingly we know that communication skills can be taught so read widely and consider your own style. Of course the most important feedback comes from the patients themselves...
The sixth and final step is to practice and improve your bedside manner constantly. This means applying what you learn from feedback, observation, and education to your interactions with patients, and evaluating your progress. It also means being open to new ideas, challenges, and opportunities to enhance your skills and knowledge. Remember that bedside manner is not a fixed trait, but a dynamic and evolving one, that you can always improve with time and effort.