Doctors & Manners

“During my postgraduate training in Britain, I once wrote a psychiatry reference for a man whose symptoms appeared disproportionately out of range for most neurological conditions” one of my Neurology professors was telling me.

“After the psychiatrist saw the patient she agreed that the patient had some issues with depression due to chronic stress, and started treatment. However when I went on the next day for rounds, the patient smiled at me and spoke with some distaste: ‘Doc, thank you for referring me to the psychiatrist, I feel better after talking with her, but don’t you think you should have first discussed with me before referring me to her?’ I realised my mistake and apologised to the patient. That day onwards I never took for granted any patient.”

This Profeesor had taught me one of the best secrets of good patient care. I am forever indebted to him for this invaluable technique he taught me. Yes, genuine respect and politeness for the patient is a technique most essential for every doctor to imbibe. It is NOT artificial sweet-talk or show-compassion that matters, it is an inner wish to solve their problems when possible, to counsel the best even if there’s no treatment or cure, and to treat them equal that makes the core of a true doctor.

It is indeed true that many doctors behave in a manner-less, high-handed way with patients, speaking only medicolegal language and maintaining a distance from the patient. The other side is an artificial sweet talker whom most patients can now identify.

One definite reason for aloofness of doctors is that many patients are indeed suspicious of the doctor’s intentions, ability and integrity. Many patients actually behave quite rudely with the doctors, asking questions beyond the sphere of relevance, directly questioning the experience and accuracy of doctor’s diagnosis and treatment, expecting to understand everything about the complicated medical condition in five minutes what can only be understood over years of actually dealing with patients.

Still, it is the good doctor’s responsibility to simplify and write down his opinion about the possible diagnoses and encourage patients to read from some standard sites. That prevents many misunderstandings.

Many medical institutions have included training curriculums for doctors to learn how to behave with the patient, but these are grossly insufficient. The internal effort to treat the patient like an equal must only be self-taught by every doctor who wants to become successful in long term. To even treat an angry, paranoid patient with dignity and respect is an art. That said, there indeed are aggressive and violent patients and relatives in India, whom no doctor can tolerate. The doctor should also learn how to avoid them without being impolite.

I am grateful that I had professors like Dr. Sorab Bhabha and Dr. George Rice who took me to another level in both Neurology and best patient care including bedside manners. I may not be able to solve every medical problem, but behaviour with patients will never be a problem for me, thanks to what they taught me.

Dr. Rajas Deshpande

Neurologist Pune / Mumbai / Goa

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