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Patient-Centered Care and Good Bedside Manner

Janaki Deepak, MD, MBBS, FACP
Assistant Professor, University of Maryland College of Medicine

鈥淭he good physician treats the disease; the great physician treats the patient who has the disease.鈥濃Sir William Osler

Patient-centered care focuses on an individual鈥檚 specific health, emotional, mental, spiritual, social, and financial needs and desired outcomes. In this model, a patient partners with the provider to help direct their care.

Bedside manner is described as the manner that a physician assumes toward patients. Key components of good bedside manner according to a study by Zulman and colleagues (1) include:

Active listening skills. The single most important aspect of good bedside manner is taking the time to listen to your patient without interruption.

Nonverbal active listening: Listen completely and intently. Show genuine interest (a great technique for displaying this is to lean in toward them with an open posture as they speak to you). Notice and validate your patient鈥檚 emotions.

Verbal communication. As you listen to your patient, you will form a sense of what their level of understanding is and tailor your language accordingly. Laypeople's terms and simple language go a long way in putting your patient at ease.

Attention to detail. Pay attention to the details regarding your patient's comfort. In a hospital setting, take a moment to straighten their bed or ask if they need more ice. Touching a patient's head or leg can be construed as condescending, but gently touching their hand or arm is a tiny gesture that can be very impactful and leave a long-lasting impression.

Connect with your patient鈥檚 story (cultivate empathy). Put yourself in your patient鈥檚 shoes. How would you like to be treated? Remember that patients are in a very vulnerable position.

Practical skills that will help you fine-tune your bedside manner include:

  1. Introduce yourself to patients, and explain your role.
  2. Greet them with a smile; a greeting (鈥済ood morning鈥); and open-ended questions, such as 鈥淗ow are you?鈥
  3. Take the time to really listen (rather than typing into the health record or writing on a chart).
  4. Use body language that communicates that you care by sitting down, unfolding your arms, and making eye contact.
  5. Let the patient tell their story without interruption.
  6. Treat each patient as an equal partner in their care.
  7. Agree on what matters most, and develop shared priorities.
  8. Set expectations, and explain timelines.
  9. Be candid but diplomatic and, above all, nonjudgmental.
  10. Avoid use of stigmatizing words, such as smoker, drinker, demented, and mentally challenged. Use such alternative terms as history of tobacco use, substance use disorder, alcohol use disorder, vascular dementia, and person with intellectual disability.
  11. Ask if they have any questions. 鈥淲ere all your questions answered?" "Is there anything else I can do 鈥 ?"
  12. End each encounter with a compassionate statement, and direct them about the next steps.

Reference

1. Zulman DM, Haverfield MC, Shaw JG, et al. Practices to foster physician presence and connection with patients in the clinical encounter. JAMA. 2020;323:70-81. [PMID: 31910284] doi:10.1001/jama.2019.19003