I’M A GP. THIS IS WHY A GOOD BEDSIDE MANNER IS SO CRUCIAL
“Hello, my name is Oscar and I’m one of the doctors”, is a phrase I have had on auto-play for over 15 years. Almost as nauseating as an overenthusiastic customer service provider at a fast-food joint. I just never got the stars or smiley face on my particular ID badge. I hope I have an excellent bedside manner, but was I born to care or did I learn to?
Communication skills certainly formed a considerable part of the medical school curriculum. Actors were drafted in – on what seemed like a weekly basis – to help simulate different challenging patient scenarios. I wiped a drop of spittle from my cheek whilst talking to a very angry gentleman. He was screaming, not talking. Another gave handy hints on appropriate topics for discussion whilst I conducted a smear test. That particular hero actually allowed unqualified doctors the fully simulated experience. Real-time feedback on both our rapport and practical skills with a swab and speculum. Her mirror ensured we had found her cervix correctly, but it was our ability to empathise, support and explain that she reflected on most.
Whilst training in the ranks on a ward round, I’ve returned to a patient’s bedside on several occasions to do some damage limitation when a boss appears to have left their manners at home. They really are an excellent surgeon though, I assure you. When lying vulnerable in a healthcare setting, even the slightest slip of a P or Q can send us spinning. The obstetrician entered just as my wife was about birth our second child. He glanced at Rae’s by now enormous tummy and enquired whether the last baby was “rather a big one”. Were we to worry? Might it get stuck? We panicked. “The thought had crossed my mind,” he proclaimed, before announcing he was heading home. He gave the midwife a reassuring pat on the shoulder and suggested I stock up on Percy Pigs.
Nowadays chatbots dish out medical advice without the need for waiting lists or the 8am reception dash. When I worry that a doc-bot might put me out of a job, I reassure myself that they can’t empathise quite like a good old human. One study asked a team of healthcare pros to rate and compare the responses given to the same medical query by qualified doctors and an AI chatbot. The bot came out on top for clinical quality – presumably helped by its infinite data collection. More concerningly, the bot was nearly 10 times more empathetic than the human responders. Perhaps these clinicians had been in the bar rather than attending the comms tutorial with the spitting man. The study only looked at written responses, so for now, hopefully that reassuring voice, appropriate eye contact or a carefully chosen smile-a-day might keep the P45 away.
The challenge for us medical professionals is to sustain that bedside manner and deliver it to each and every patient we encounter. Whether approaching the end of a night shift or in spite of that message from school informing you that your own child now has a fever. It is not easy. Research commissioned for a medical indemnity provider showed that miscommunication and poor bedside manners were responsible for more claims against doctors than misdiagnosis. Getting it right is critical in every sense. Every time.
The old adage that 90 per cent of a medical diagnosis comes from the patient’s description of their problem still feels as though it holds true today. Allowing time and the open channel of communication required for that story to shine through can be difficult. Time is, after all, waiting lists. But when a patient is genuinely allowed to explain their concerns and expectations this dramatically facilitates the process for all. A stitch in time saves nine. Even when it’s not a stitch they require but a hug or an antibiotic.
The power in sharing a health problem should not be underestimated. We are gradually removing stigma and enabling those conversations to happen between family, friends and even colleagues. I’m not advocating a game of top-trumps using your prostate blood test results or becoming a health bore at a yoga class, but there is a power in sharing experiences. When I suggest to patients joining a support group of others facing similar health issues, the majority recoil. As humans we bond through our vulnerabilities. Most of us would rather this was a neighbourly chat about a missed bin collection rather than a
medical diagnosis. Those who are brave enough to share rarely regret it. Isolation should come with more health warnings than many drugs.
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I was born with the genetic condition of albinism. I would avoid all but essential discussion on the topic until I made a documentary for the BBC, exposing the brutality that many people living with albinism face around the world. The response took me by surprise. I received countless messages from people living with genetic disorders, disabilities or chronic illnesses – as well as their nearest and dearest – who had never previously felt able to talk openly about the challenges they had experienced. The very people who needed excellent bedside manners from those around them were struggling. I had over-shared, but hopefully it had helped somebody.
What of the professional listeners though? Contrary to the vitriol on many a chat forum, the latest NHS GP Patient Survey brings positive news: 85 per cent of respondents felt that they were treated with care and concern, and 92 per cent had confidence and trust in the healthcare professional they saw. This certainly fits with the experiences of most of the guests on my new podcast, Bedside Manners. When Miriam Margolyes looks you in the eye and reminds you of the necessity of kindness and active listening in caring for those who are ageing, you take that forward.
If you find yourself in the dissatisfied category what can be done? Consider the doctor-patient interaction like any other professional relationship. Sometimes people gel, sometimes not. It is often worth giving it a second go. Perhaps your first consultation caught your doctor on a bad day. You yourself might be able to help the relationship blossom. Time is sadly limited, so be direct with your concerns and give your doctor a clear focus for the time you have together. If things are unclear or you feel upset, let them know. Sometimes a previously bad experience – like an unwelcome diagnosis outside of your doctor’s control – can mean you no longer feel comfortable seeing a particular clinician.
As clinicians we welcome feedback but if you feel it is difficult to talk directly to your doctor about an issue, then you can always provide feedback or raise a complaint via either the practice manager at the GP practice or the hospital PALS (Patient Advice and Liaison Service) team.
When you can no longer continue, look to change. Many GP practices will have multiple doctors and it may be that you are better suited to an alternative team member. My jeans may not fit you, but they’re not necessarily bad jeans. You could also consider moving to another local practice – word of mouth recommendations or the NHS website are a helpful guide.
I dream of a world where we can each truly offer one another the bedside manners that we all deserve. Even with training, is it rather a big one? The thought had crossed my mind.
Bedside Manners with Dr Oscar Duke is available on major podcast platforms from May 20
2025-05-20T06:07:17Z
