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Rapid Responses: Rapid Responses published:
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![[Read Rapid Response]](/icons/misc/sectionDOWN.gif)
Are we too business focussed?
- Dil Sen (21 June 2008)
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What's in a name?
- Anke Medrington (Ms) (25 June 2008)
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Re: What's in a name?
- Dr. Herbert H. Nehrlich (26 June 2008)
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mutual respect can be enhanced by restoring the balance of power
- oscar,m jolobe (10 July 2008)
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Dil Sen, Consultant Occupational Physician & Hon Lecturer Grove Ho., Manchester, M16 0RB
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What a pleasure it was to read Tessa Richards's fascinating article on Manners in Medicine - it re-kindled many of the reasons why I wanted to do this job all those years ago. Also shows the usefullness of 360 degree feedback, especially from our patients. Where once we had vocation we now have business imperatives, and the business mantra that comes from both our non-medical and medical masters is so strong that it often blots out the vocation, the belief in the power of caring and even the manners. At least that's one theory? D Sen Competing interests: None declared |
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Anke Medrington (Ms), Interpreter & Translator 11 Rosedale Rd, Stockport SK4 2QU
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I am writing as a patient who is quite taken aback that whenever I’ve seen a doctor recently they have called me by my first name whilst introducing themselves by their title and surname. I was therefore very interested when my partner, who is a GP, showed me your recent article: 'Manners in medicine'. You wrote: "Seeking or undergoing medical care is stressful business. If frontline staff can muster good manners…it helps… " I realise that I am quoting you slightly out of context, but I find it distinctly unhelpful in my interaction with another adult to be addressed like a child by their teacher when the experience of illness is already making me feel unsettled, vulnerable and anxious. Whenever I have summoned up the courage and energy to raise this matter of unequal address during a consultation, it has been met with surprise and the mention of wanting to make me feel at ease…. I'd also like to say that I am German and that my partner is English, but worked in Germany for many years. We both agree that it would be unthinkable for a doctor there to introduce himself as Dr Schmidt to a new patient whilst summoning them from the waiting room by calling out "Helmut" or "Angela"! I've also asked some non-medical British friends about this custom, who've all replied along the lines of: "Actually, now that you mention it, it does seem a bit odd, it's just I've never thought about it before…." As a lay person I’m curious as to whether there have been any recent guidelines to encourage this practice in Britain, why it seems to be the norm and why so few people question, let alone challenge it when at the same time there is so much talked and written about patient's dignity, the doctor-patient partnership, respect, empowerment, etc.? I'd be very interested in your thoughts. Competing interests: None declared |
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Dr. Herbert H. Nehrlich, Private Practice Bribie Island, Australia
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What Anke Medrington describes can indeed be unsettling to some of us. I too, hail from the Fatherland and it took a while to become accustomed to having complete strangers call me by my first name the moment they ascertained what it was. After nearly forty years in the English speaking world (including America and Australia), I no longer mind this familiarity . However, it is an entirely different kettle of fish when it comes to the interaction between physician and patient (note the order I chose). There is method to the madness, believe me. When 29 year old Doc Arrog Confid addresses 89 year old Mrs. Lucy Oldmoney as "Lucy" he places himself on an invisible but very real pedestal from which he can look down. This forces Lucy to look up if she wants to hear what Doctor A.C. chooses to tell her.Thus, she becomes fully and acutely aware of the difference in altitude and she senses that this entails certain traditional rules. While the doctor (and the "system")is (are) most likely going to succeed in having "Lucy" surrender some of her dignity because of the illness and the situation caused by it, he initiates this by starting off on the right foot. It's all about body language put to use. Now, when the doctor wants to signal Lucy that he wants her out of there he simply points one or both feet toward the exit.To increase the strength of the signal he takes his glasses off and places them on the table (no he won't polish them, that would signal the start of a new consultation). Yes, I do find it demeaning to choose this setting with any patient.I had a professor who was fond of pointing out that the doctor who sits not across from the patient, separated by a huge desk, but next to the patient will not have to fear malpractice suits. In closing, may I say it is a good thing we don't speak Latin anymore in front of George, Lucy and Dick. Competing interests: None declared |
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oscar,m jolobe, retired geriatrician manchester medical societ, c/o john rylands university library, oxford road manchester M13 9PP
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The other unfortunate usage which is rapidly becoming the norm among doctors and nurses is to refer to patients, sometimes even within earshot, as this "chap" or that "chap". It seems that the only way to resore mutual repect between doctors and patients is introduce the hint of potential litigation so as to restore the balance of power between them. In that context,however frail or confused the patient might be might be, there is nothing to beat the mere hint that she has a barrister daughter, daughters being typically more proactive than sons, who just want a "quiet" life. As I used to say to my juniors "However confused this patient may be, treat her with the same respect that you would if her daughter were a barrister(who is unlikely to be confused), and that will be your best defence against the risk of litigation" Competing interests: None declared |
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