Healthcare staff must properly introduce themselves to patients
BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f5833 (Published 02 October 2013) Cite this as: BMJ 2013;347:f5833
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Kate Granger's mission is really important. Introducing oneself is common courtesy and should be routine, automatic practice at the start of any consultation, be it with a patient, a family member or a colleague. Unfortunately the problem is common in all these areas.
When junior doctors ask for tests or results it is very common to get no more than a given name. Often the introduction does not include a family name, job title or grade. Name badges are often hidden or misplaced.
Not only is it courteous to introduce oneself, it helps build rapport and is a safety issue: a senior registrar will understand the significance of a result much more than a house officer or a non-medical practitioner sent to get results. Knowing the role of the person ensures that information is conveyed in a way that will be clear and takes into account the person's training and experience.
Competing interests: No competing interests
Dear Madam,
Kate Granger’s campaign encouraging healthcare professionals to introduce themselves to patients is a positive step towards ensuring that good patient experience is an integral part of patient care. But as Dr Granger points out, basic introductions are just the “first rung on the ladder” towards ensuring patients are treated with dignity and respect.
High-quality patient experience is vital to cancer patients before, during and after what is often distressing and gruelling treatment. Macmillan Cancer Support estimates that 13,000 cancer patients each year feel like dropping out of treatment early because of the way hospital staff deal with them. This is unacceptable.
To help hospitals improve patient experience across the board, Macmillan has developed the Macmillan Values Based Standard®. This is a practical approach consisting of eight patient experience domains that matter most to patients and staff, expressed in the form of eight behaviours that staff can demonstrate towards patients to deliver high-quality relational care.
As with Dr Granger’s #hellomynameis campaign, the first behaviour of the Macmillan Values Based Standard® focuses on the importance of naming – encouraging staff to introduce themselves and in turn ask patients how they want to be addressed. This is important in every new interaction between a patient and a member of staff. As well as ensuring a more personal experience, it also provides an opportunity to gather other essential information about that person’s individual needs that may impact on their care, such as language and support requirements, disability issues, and religious and dietary needs.
The Macmillan Values Based Standard® was developed through an 18-month engagement process with over 300 healthcare staff and people living with and affected by cancer across the UK. Macmillan is calling for all NHS hospital trusts to adopt the Macmillan Values Based Standard® in order to improve their cancer patient experience.
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I'm a big fan of Kate Grangers campaign #hellomynameis and agree that it is a problem within the hospital setting.
I have often been in the situation as a medical student, and now as a junior doctor, where my presence at the bedside or in the consultation has not been explained by a senior colleague leading the patient encounter. I find myself adjusting my name tag to at least ensure that is visible to the patient, but this is less than ideal. When my grandmother was unwell in hospital, one of the biggest problems for non-medical members of my family was differentiating between nursing staff at different grades, physiotherapists, and occupational therapists; and getting short shrift when they interrupted the wrong person in their quest to get answers about her care.
Photo boards, a clear explanation of what uniform each occupation wears, and a clear contact point for the matron should be available on each and every ward to prevent this.
Competing interests: No competing interests
Granger provides an anecdotal experience that is effective in illustrating the importance of making clear introductions when interacting with patients. The hashtag ‘#hellomynameis’ provides a useful reminder in this respect.
I am writing from the perspective of a medical student nearing my final examinations. Throughout medical school, we are exposed to many different styles of communication employed by doctors from a vast array of specialties and grades. This is an important part of our training as we are given a unique insight into different communication styles. There have been many useful tools that I have added to my repertoire through careful observation of my seniors. Likewise, there have been several not-so-good encounters I have watched and reflected on. In general, medical students form their approach to patients through pensive analyses of the communication styles employed by our peers, colleagues and mentors.
There is a very strong emphasis on communication in medical education. For example, in Manchester Medical School, we were taught the ‘Calgary-Cambridge framework’ for medical interviews in a series of small group tutorials prior to meeting patients in the first year (1). One of the fundamental tenets of this is establishing initial rapport. This begins with a proper introduction. Although medical schools may differ, building and maintaining rapport with patients is a core skill that is expected from us throughout our courses (2).
To further Granger’s point, paragraph 47 in the General Medical Council’s ‘Duties of a Doctor’ states that ‘you must treat patients as individuals and respect their dignity and privacy’ (3). This is essential in building a partnership with patients. In order to truly treat patients as individuals it is our duty to introduce ourselves clearly. This is a sign of good medical practice.
Bibliography:
1. Kurtz, S et al. (2003). Marrying Content and Process in Clinical Method Teaching: Enhancing the Calgary-Cambridge Guides. Academic Medicine. 78 (8), 802-809.
2. General Medical Council (2009) Tomorrow’s Doctors London, GMC.
3. General Medical Council (2013) Good Medical Practice London, GMC.
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Kate Granger has raised the issue of clinical staff rudely failing to introduce themselves. As a result of recent experiences, I would add to this the failure of staff to acknowledge accompanying persons.
I have recently taken two of my children to hospital appointments. An orthodontist did not introduce herself to my daughter nor myself, and left me standing, uncertain as to whether I was permitted to sit. Similarly, a trainee surgeon did not introduce himself to my son nor myself, neither did he tell us his level of training. In both consultations, the clinicians completely ignored me, did not ask who I was, nor whether the patient was happy for me to be present.
Medical schools seem to be failing to teach communication skills. In future, I will ensure I instruct my own trainees in the basic courtesies of consultation.
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This is an important issue and Kate Granger's response is a constructive one likely to make a long term difference by changing working habits.
Yet it left me wondering why doctors are so poor at identifying themselves. Is there something in our culture which makes us ashamed to be identified personally? Is this a parallel to our tendency to hide behind the label of 'doctor'?
Some doctors seem ashamed of the labels they actually do wear, placing them in positions which prevent their patients from reading them. Unlike the doctor in the cartoon, whose labels are at least in a readable position, many doctors seem to favour labels hovering over their groin. If they sit down beside the bed, they can't be seen. If I meet the doctor in the corridor I have to crouch to see their names. Doctors identities are important: they are not a figleaf.
Competing interests: Ted is almost six feet tall
I found this article interesting and useful too. I think greeting patients and introducing oneself by name has far reaching positive effects in creating rapport yet it takes less than a minute to do so. Greeting and introduction sets the stage for open, unhindered history taking and subsequent patient management.
I think health personnel should take a cue from the airline industry, where it is routine to "welcome aboard" and introduce the flight captain and air hostess.
Godfrey.
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Re: Healthcare staff must properly introduce themselves to patients
It wasn’t till I left a practice where I knew almost all the patients and they almost all knew me that I realised the importance of introducing myself to patients.
Thereafter, as a locum or salaried GP, I always said hello, explained who I was, and asked who their normal doctor was. Nice to be able to relay back to the practice comments like “I see anyone – you’re all good here”. I always shook hands. It was not the cultural norm for many of the patients, but it is polite in Britain, and no patient, whatever their background, ever declined my hand. I always fetched the patient from the waiting room. The patient would walk towards me looking tense and anxious. When I introduced myself some looked surprised, but then their faces relaxed and they smiled. During the brief walk down the corridor I learned a lot about them, and we entered ‘my’ territory together.
It’s not just polite to introduce yourself to your patients, it gets the consultation off to a much better start.
Competing interests: No competing interests