Why aren’t doctors always 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.

  • Alice Santarlasci

    Twenty years ago, when my daughter had just turned 18 she was examined by a new female doctor at Lahey Clinic Burlington. The doctor spoke to my daughter about trying to diagnose a major neurological problem. When my daughter came out to tell me she didn’t know what to do I asked if she wanted me to ask the doctor to explain in to me while she was there. My daughter said she did so I approached the doctor who quickly reminded me that my daughter was 18 years old, and I had no right to be included in a discussion.
    I quickly reminded her that my daughter asked me to be there. That she did not have enough life experience to make such a decision and wanted her mother there. The doctor pushed back and so did I. I asked her if I should go directly to the hospital administrator’s office to inquire about why a patient can’t have their parent with them at an appointment if the patient requested it. Funny thing happened, she pulled us into an office and told us both the outcome of the testing. Doctor’s have to realize that we are frightened, and often times need to share information with our family.