Posts tagged with "Doctors"

Cold comfort: Incoming medical students should be tested for empathy, study says

August 5, 2019

We’ve all been there—especially the women among our readers: Sitting in a doctor’s office and explaining our symptoms to a medical professional who is completely dismissive, disinterested, and in disbelief.

Worse yet is the practitioner who blames the patient for the condition—and lets her (or him) know about it through insolent or disdainful body language and comments.

Heather Cianciolo says she can tell within minutes if she’s going to like a doctor. “Ten minutes into a doctor’s appointment and I know if it’s going to be a waste of my time,” she said. “It’s a warning sign if someone doesn’t come in and ask me about me—{but rather] just starts talking at me.

“And it happens a lot,” she told The Chicago Tribune for a recent story.

The 46-year-old Oak Park, Illinois, woman—who has long suffered from migraine headaches— said she had to “go through” several specialists who didn’t listen to her before finding one she loves who is now her primary care physician.

“She listens and then she will explain her thinking. She expresses an interest in what’s happening,” Cianciolo said. “If you’re not going to take the time to answer my questions, why would I entrust my health care to you?”

Experts say the ability for doctors to build a rapport with their patients helps build trust and, in turn, improves patient outcomes.

In fact, Mohammadreza Hojat—a research professor of psychiatry and human behavior at Sidney Kimmel Medical College of Thomas Jefferson University in Philadelphia who recently designed a questionnaire for  more than 16,000 students of osteopathic medicine—suggests that a norm-level of empathy could (and should) be required for all incoming medical students nationwide, according to the report by the Tribune.

Once a norm-level is established, Dr. Hojat suggests, medical schools should use the data to assess for empathy, alongside academic measures like college transcripts and MCAT scores, when considering medical school applicants.

 “There are two components of medicine. One component is the science of medicine and one component is the art of medicine,” Dr. Hojat told the Tribune. “When it comes to art of medicine, it is about interpersonal relationships and empathy, and we have no method in place” to measure that in medical students’ applicants.

Although empathy can be taught, Hojat said, students who already come to medical school with a strong sense of empathy will make better doctors. And he noted that, although the study focused on students of osteopathic medicine, the tool should be used by traditional medical schools.

Dr. John Prescott, chief academic officer at the Association of American Medical Colleges, said in a statement that “humanism and empathy are critical qualities required of tomorrow’s physicians.” But the statement also claimed that medical schools already look at a “holistic review of applicants … which looks beyond grades and test scores.”

And Jean Decety, a University of Chicago neuroscientist who studies empathy, told the news outlet that, although he hadn’t read the study, his work has shown that empathy only is important for “certain types of physicians.”

In fact, he said, some students will go into specialties that don’t require strong interpersonal skills—for example, radiologists who mostly read images, or surgeons who require excellent technical skills but not necessarily a lot of empathy.

“That’s what you want from your surgeon,” he said.

The study was published July 25 in The Journal of the American Osteopathic Association.

Research contact: @chicagotribune

Patients care what their doctors wear

June 26, 2018

A survey of 4,062 patients at ten major medical centers nationwide by Michigan Medicine at the University of Michigan  has found that doctors should consider their white coats as much more than a fashion statement. In fact, one-third of respondents to the study, published on June 6 in Science Daily, said that what a doctor wears influences their satisfaction with their care.

Based on the findings, the researched have called for more hospitals, health systems, and practice groups to look at their dress standards for physicians, or create them, if they don’t already have one.

“Professional dress on Wall Street, law and nearly every other industry is relatively clear—and it typically mirrors what applicants would wear to their job interview,” says Christopher Petrilli, M.D., lead author of the study and an assistant professor of hospital medicine at the University of Michigan Medical School, who worked in the finance industry before entering medicine. “In medicine, the dress code is quite heterogeneous, but, as physicians, we should make sure that our attire reflects a certain level of professionalism that is also mindful of patients’ preferences.”

The study asked patients to look at pictures of male and female physicians in seven different forms of attire, and to think of them in both inpatient and outpatient clinical settings. For each photo, they rated the providers on how knowledgeable, trustworthy, caring, and approachable the physician appeared, and how comfortable the attire made the patient feel.

The options were:

  • Casual: Short-sleeved collared shirt and jeans with tennis shoes, with or without white coat;
  • Scrubs: Blue short-sleeved scrub top and pants, with or without white coat;
  • Formal: Light blue long-sleeved dress shirt and navy blue suit pants, with or without white coat; with black leather shoes with one-inch heels for women, and with black leather shoes for men, and a dark blue tie for men; or
  • Business suit: Navy blue jacket and pants with the same dress shirt, tie and shoes as in the “formal” option, no white coat.

Formal attire with a white coat got the highest score on the composite of five measures, and was especially popular with people over age 65. It was followed by scrubs with a white coat, and formal attire without a white coat. Indeed, when asked directly what they thought their own doctors should wear, 44% of patients said they preferred the formal attire with white coat, and 26% said scrubs with a white coat. When asked what they would prefer surgeons and emergency physicians wear, scrubs alone got 34%  of the vote; followed by scrubs with a white coat with 23%.

The results were largely the same for physicians of either gender except for male surgeons. Patients tended to prefer that they go with formal wear, without a white coat.

The setting of care mattered, too. Sixty-two percent agreed or strongly agreed that when seeing patients in the hospital, doctors should wear a white coat, and 55% said the same for doctors seeing patients in an office setting. The percentage preferring a white coat fell to 44% for emergency physicians.

Though the surveys were conducted during business hours on weekdays, the researchers asked patients what they thought doctors should wear when seeing patients on weekends. In this case, 44% said the short-sleeved outfit with jeans was appropriate, although 56% were neutral or disapproved of such a look even on weekends.

Interestingly, patients in the Northeast (38%) and Midwest (40%) were less insistent on white coats and formal attire;, compared with those in the West (50%) and in the South (51%). Northeasterners were more than twice as likely as southerners to prefer scrubs alone for surgeons.

“This is by far the largest study to date in this area. We used the expertise gained from our previous systematic review along with a panel of psychometricians, research scientists, choice architects, survey experts, and bioethicists to develop our study instrument. Given the size, methodological rigor and representativeness of these data, local, nuanced policies addressing physician attire should be considered to improve the patient experience,” says Petrilli, who treats patients in the hospitals of Michigan Medicine, U-M’s academic medical center, and holds a position at the VA Ann Arbor Healthcare System. He is a member of the U-M Institute for Healthcare Policy and Innovation.

The researchers note that while studies have shown that while physicians’ white coats, neckties and sleeves have been shown to harbor infectious organisms—leading some countries to require physicians’ arms to be “bare below the elbow”—no studies have shown actual transmission of infection to patients through contact with physician attire.

However, other research has suggested that physicians may be more attentive to tasks when wearing their white coats, perhaps increasing patient safety.

“Patients appear to care about attire and may expect to see their doctor in certain ways. Which may explain why even white lab coats received a high rating for ‘approachability’ — patients may see a white coat similar to a physician’s ‘uniform’ and may similarly also expect formal attire in most settings,” notes Petrilli. “Patients don’t always have the opportunity to choose their doctor. In this era of appropriately increased focus on patient centeredness and satisfaction, physician attire may be an important, easily modifiable component of the patient care experience.”

Research contact: MichMedmedia@med.umich.edu