A woman went to doctors the office. She was seen by one of the new doctors, but after about 4 minutes in the examination room, she burst out, screaming as she ran down the hall. An older doctor stopped and asked her what the problem was, and she explained. He had her sit down and relax in another room.
The older doctor marched back to the first and demanded, "What's the matter with you? Mrs. Johnson is 65 years old, she has four grown children and seven grandchildren, and you told her she was pregnant?"
The new doctor smiled smugly as he continued to write on his clipboard.
"Cured her hiccups though, didn't it?"
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Class encompasses the way you speak, conduct yourself, and your appearance. Many doctors don’t realize how these factors are important components of their bedside manner.
The more your patient population relates with you–while you maintain professional stature–the more you will be liked. Appearance and language change from one locale to another and constantly evolve with societal mores and styles. The longer you practice, the more likely you need to change, in order to keep current with how society defines a professional.
The following story relates to a practitioner who has no class and no compassion when speaking with patients.
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A renowned oncologic head and neck surgeon saw a patient with stage four tonsillar cancer. When he presented his protocol of treatment, he was physically intimidating (a very tall man with an in-your-face posture), demeaning, cold, and inconsiderate of the patient’s feelings. He told the patient there was no one who could do the surgery as good as he could and that if the patient didn’t go along with his treatment, “You will die a horrible painful death.” The patient, also being a rather large, intimidating man, got into his face and told him there is no way he would want to use him as a doctor. Interestingly, I had the opportunity to treat a nurse on the oncologist’s service and I asked her if she could tell me anything about this doctor. She made a face of disgust and asked me why I made such an inquiry. When I relayed the story of the terrified patient, she stated that this doctor speaks that way to all of his patients. She confirmed that he was probably the best surgeon in the area for this procedure and that is why she suspected the hospital kept him on staff. She further stated that he not only had no bedside manner, but that he was the antithesis of the concept. She was so riled by the thought of this man that she asked me if I would write a letter to the hospital administrator relaying the story I told to her.
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It is best to do a demographic review of your patient population. Demographics describe populations according to age, income, product preferences, and just about any measurable attribute, including health-care needs.
By utilizing demographic information, you can know what kind of conversation patients will enjoy, what marketing to consider, what type of magazines to include in your waiting room, and even what channel to keep on the television in the waiting room at different times of the day.
The Elderly (55 +)
Past generations get stuck in time. You have to remember this when dealing with the elderly. Elderly patients tend to be more conservative, they are respectful, and many deride the latest styles of the young. This is the population you need to think about before you become a trailblazer of pop-culture as defined by your fashion and language. Your senior patients won’t respond well to hip-hop music playing in the waiting room or dress unbefitting their perception of a professional.
The way you address and speak with the elderly is clearly different from the way you deal with younger people. Seniors may be offended if you call them by first name or if you introduce yourself by your first name. This is the generation that puts doctors on pedestals and demands professionalism, as defined years ago. These are the patients who expect that you have answers to their questions and that you will not rush them during an examination.
The Youth (Fifteen to Twenty-five)
If you treat many young patients, you will relate better and be perceived as having better bedside manner if you throw in a few slang phrases. However, you must be careful. Just because you may treat many young people, your elderly patients seldom embrace the slang and values of the younger set and may be offended.
If you see a young patient and wish to connect in an informal manner, you can alter your greeting to, “Hey, what’s up?” While this may not be your usual greeting, it could, in this instance, form an immediate bond of trust.
No one will fault you for not using slang. Ironically, many youthful patients may actually question your expertise if you speak and act like them. Remember, you can never offend someone by being polite and well spoken.
Try not to take offense by the way patients speak to you. It’s usually not personal. The aggressive talk of a person brought up in a bravado culture is part of their personality and not likely to change at a visit with the doctor. Some patients are frightened or stressed and may react in a coarse or belligerent manner. Of course there are some patients who are hostile and their behavior doesn’t have to be tolerated.
Upper Crust
Many successful, professional, or upwardly mobile patients like to claim personal friendships with their health-care providers. Some will insist on calling you by your first name and want to become friends with you. You have to make the decision how to react to what, at times, may be intrusive.
This type of patient may drop first names of other professionals giving the impression they are personal friends; and while they may be, they may be using the names to get more attention and reduced fees.
Generally speaking, if a patient calls me by my first name or asks if I mind, I have no problem going along with them. If you tell them you prefer that they call you by your title, you might be perceived as stuffy.
Some doctors like to introduce themselves by first name believing it enhances bedside manner by being more personal. I prefer to maintain a professional stature that is warm and friendly rather than trying to be my patients’ best friend. It is best not to encourage personal relationships with patients or you may find yourself having an examination or treatment turn into a social call. Furthermore, there is something more authoritative about following the directions of the doctor rather than a buddy.
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A busy neurologist: “Every time I see neighbors or friends in the office, they never seem to understand how behind I get when they decide to ask about my family and my life, and they then proceed to tell me about their family and life. I can’t be rude, but I surely couldn’t practice if I became friends with all my patients. It’s one thing to be friendly and ask about family in a controlled manner, but too much familiarity is not a good thing.”
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GROOMING
Grooming is important to the way patients perceive their doctors. If a patient sees a poorly groomed practitioner, it doesn’t take much to extend the lack of grooming to a possible lack of professionalism and competence and especially cleanliness. We all know that long dirty hair, bad breath, and soiled fingernails don’t necessarily mean you aren’t a capable doctor–but most people would rather go to a doctor who understands and respects the necessity of proper grooming.
Most people want a well-groomed, well-mannered doctor. Personal hygiene is imperative.
Hygiene Don’ts:
Avoid eating onions, garlic, peppers or any foods that repeat on you for lunch or dinner the preceding evening. Consider chewing a mint-flavored gum throughout the day. Use the gum more as a lozenge to avoid visible chewing motion. If you have a noticeable, longstanding problem with bad breath there are intensive programs available to help you.
Hair should be worn in an acceptable, conservative style. You don’t have to have a crew cut or a bun, but extreme styles should be avoided. The times dictate style. A beard and longer hair for men are more acceptable at certain times in history. The best rule is to avoid being at the leading edge. If no one wears beards then you should refrain. If everyone is wearing a day’s growth of beard, it may be acceptable. Just don’t be the trailblazer.
If you have a bushel of chest or back hair growing out of your scrubs, trim it.
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Conversation of staff members about one of the doctors: “I can’t believe how gross he looks with that hair billowing out of his scrubs. He is completely oblivious!”
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Make sure you don’t have hair growing out of your ears or nose to any appreciable degree.
Your fingernails should always be clean and well trimmed.
If you have oily skin, do regular checks and wipe or cleanse your face as needed. Check for wax or flaking skin in your ears.
Brush your teeth after meals and look in a mirror to make sure you don’t have food stuck between your teeth when you speak with your patients.
If you have a bad acne condition, seek the appropriate care.
Try to remedy any postnasal drip sounds and assorted tics that may be undesirable. Constantly clearing your throat may be a turnoff to some patients.
Avoid strong colognes and perfumes.
If you perspire heavily, keep a change of shirts or blouses in your office and use them as needed.
Make sure you have someone on your staff you can trust to call your attention to things like body odor. If you have the proper rapport, they will know you trust their critique, and they will be able to tell you when something is amiss. You cannot afford to be complacent about how you present yourself to your patients. Grooming and work habits matter.
ATTIRE
It is imperative for you to maintain attire befitting a learned practitioner – even on your days off. If country clubs can require a collared shirt, you can wear one when you go to the hardware store to purchase plumbing parts for your home repairs. If you want to have the consummate reputation and the ultimate bedside manner, you have to dress the part. You never know who you might bump into.
Can you picture a patient seeing you at the hardware store looking like a bum and turning to their best friend and raving about you? While your patient may see past your attire, their friend will respond, “He’s a doctor?”
Rules for Dressing Appropriately
Pants should be clean and pressed. Business trousers or khakis are acceptable, but if you are looking for a more polished look, consider seamed trousers. A smock or clean, white pressed doctor’s jacket goes best with pants. Scrubs are a casual and more comfortable choice, but they too must be clean and presentable.
Leather shoes are traditional and they must be polished and devoid of any signs of excessive wear. If you prefer athletic shoes to go with scrubs, make sure they are clean – save a pair for the office and don’t use them for jogging.
For women who prefer skirts and blouses, or dresses, short hemlines and obvious cleavage should be avoided.
When I attended dental school, the style was long hair, bell-bottom pants, and open shirts with bead necklaces. While we thought we were cool and nonconformist, the older population of patients thought we were arrogant, inconsiderate, and unprofessional.
I worked for a doctor during those hippie days while many of my friends opened their offices wearing jeans, open shirts with beads around their necks, and long wild hair styles. When my new employer told me I had to wear a dress shirt and tie (these were the days before scrubs and masks) I was mortified. How was I ever to express my individualism and flourish among the flower children? I went along with his request because I needed the job.
When I opened my own specialty practice that relied upon referrals from other doctors, I realized that I couldn’t offend anyone if I wore a shirt and tie. None of my patients could go back to their doctors and complain that I wore a shirt and tie.
Some of my referring doctors were hippies and wore the bell-bottoms and open shirts, but my best referrers were older established doctors who wore clinic gowns and conservative hairstyles. While I may not have been the coolest endodontist, I built up a great practice with referrals from my hippie friends as well as all of the established dentists who would never refer their patients to a hippie.
Making my staff wear presentable attire never led to rumors that my office was unprofessional. Your staff is a reflection of your personality. Poorly groomed or poorly dressed staff doesn’t belong in anyone’s office.
The same principle of trying to avoid offending anyone applies to the music you play in your office. Referring to the demographic of my patient population, I found that most of my patients were between forty and sixty years of age. As a group, they don’t generally appreciate heavy metal or hip-hop music. Surprisingly, some popular radio stations that tout playing a blend of tunes with the intention of appealing to everyone always seem to air some terribly inappropriate songs that are offensive to that age group. Make sure the music you play in your office won’t offend anyone.
VOICE
A truly unrecognized attribute of demeanor is the volume and tone of voice, which can range from soft and calming to loud and irritating.
You can adjust your voice to meet the needs of various patients. I’ve noticed many nervous patients love a soft calming voice when I’m offering explanations and during treatment. You can’t go wrong with soft and calming–but too soft and inaudible is not good, especially for the elderly.
Your loud and outgoing patients will connect with you if you, too, are animated and loud. You must know your patients, but generally try to stay away from loud and boisterous.
Being outgoing, cheerful, jocular, and personable is almost universally appreciated, so strive for those traits without being too over-the-top.