EBSALUTA’S MAR [15-10]:Passing on Good Bedside Manners to our Junior Doctors

Medical Anecdotal Report
Indexing Title: EBSALUTA’S MAR [15-10]
MAR Title: Passing on Good Bedside Manners to our Junior Doctors
Date of Medical Observation: November 2015
Tag: Mentoring our Junior Doctors on the importance of a good physician-patient/ guardian relationship
Category: Professional/ Ethical, Reinforcement

Narration:
I was doing my morning rounds on one of my patients, when his nephew expressed his dismay regarding the way they were treated by one of the medical clerks. He said he was scolded for not measuring the urine output of the patient. He felt that they were mostly belittled for their financial status. But even though it is difficult, he said that their family are already doing their best for their uncle. He felt concerned that when these trainees become full-pledged doctors they might treat their future patients with the same level of condescending attitude. I was nowhere in the time of the incident and so could not judge if the words were really offensive to the patient and his guardian. And so the only thing I knew then to pacify his hurt feelings is to apologize in behalf of the medical team. I then finished my charting for the patient and had a short meeting with our junior doctors on the values of good bedside manners.

Insight:
Category: (Physical, Professional/ Ethical, Psychosocial) (Discovery, Stimulus, Reinforcement)

Most of the time in our training as physicians we encounter a lot of kinds of people. Some are kind and profusely shows their appreciation of our work through verbal thank you or GPC (good patient care). However, there are also times that we encounter patients and their guardians, who expect to be prioritized always. There are really those patients, who feel that since they have a “backer” or a connection to someone in the public office, that we as lowly government-employed residents-in-training are on their every beck and call. I am not saying however, that my patient and his guardian above are such since as their main physician in the hospital, throughout my interaction with them, I could assure that they are very humble and cooperative people. And more so I feel disappointed that the incident happened since I was not expecting it at all.

I am always pro for empowerment of our junior doctors. I believe they should be taught well on the theoreticals and skills needed in surgery. They are not merely manpower for extracting blood examinations nor just typists for clinical papers. But they are also are partners in treating our patients. The practice of medicine, more so in our field of surgery is based on mentoring. That is why they should also be guided on proper bedside decorum.
As such I told our junior doctors to always practice patience with our patients and their guardians. The patients are not the only ones suffering with their illness but also their guardians, who were now probably missing from their normal jobs/ routine just to stay and take care of the patient’s needs. In case of a miscommunication or an already heated situation they should always call one of us residents to clarify and pacify the situation. Most of the time the patients could recognize the resident’s authority and so would lessen his/her argumentative stance. It is also better to build good patient rapport with our patients since it would lead for them to be more cooperative and promote a less stressful working environment. And in the end, this is our training ground for building the value of professionalism. Professionalism means not only knowing the technical ins and outs of our jobs but also letting the patient know that they are well taken care of. I challenged them to break the bad connotation that doctors trained in public hospitals are tactless and heartless. We should instead build a better reputation – that we are doctors who despite of limitations remain to be doctors, who are competent and with utmost compassion to our patients.

ROJoson’s Notes (16sept5):

The success of a clinical practice of medicine starts with establishing rapport with patients and their relatives. There are so many and countless strategies and ways of establishing rapport.  There are standard strategies but the details or specific ways will vary from one situation to another and from type of patients and guardians to another (inclusive of the sociocultural factors).  The bottomline target of rapport is to have the patients and their relatives like their physicians.

In a setting of training department or hospital, where there are medical students, the consultants and residents should teach them how to establish rapport with the patients and guardians. More so, they should constantly remind them of its importance and continual practice.

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