How Exemplary Teaching Physicians Interact with Hospitalized Patients
Sanjay Saint, MD, MPH, George Dock Professor of Internal Medicine, 2800 Plymouth Road, Building 16, Room 430W, Ann Arbor, Michigan 48109-2800; Telephone: 734-615-8341; Fax: 734-936-8944; E-mail: email@example.com
BACKGROUND: Effectively interacting with patients defines the consummate clinician.
OBJECTIVE: As part of a broader study, we examined how 12 carefully selected attending physicians interacted with patients during inpatient teaching rounds.
DESIGN: A multisite study using an exploratory, qualitative approach.
PARTICIPANTS: Exemplary teaching physicians were identified using modified snowball sampling. Of 59 potential participants, 16 were contacted, and 12 agreed to participate. Current and former learners of the participants were also interviewed. Participants were from hospitals located throughout the United States.
INTERVENTION: Two researchers—a physician and a medical anthropologist—conducted 1-day site visits, during which they observed teaching rounds and patient-physician interactions and interviewed learners and attendings.
MEASUREMENTS: Field notes were taken during teaching rounds. Interviews were recorded and transcribed, and code reports were generated.
RESULTS: The attendings generally exhibited the following 3 thematic behaviors when interacting with patients: (1) care for the patient’s well-being by being a patient advocate and forming a bond with the patient; (2) consideration of the “big picture” of the patient’s medical and social situation by anticipating what the patient may need upon discharge and inquiring about the patient’s social situation; and (3) respect for the patient through behaviors such as shaking hands with the patient and speaking with the patient at eye level by sitting or kneeling.
CONCLUSIONS: The key findings of our study (care for the patient’s well-being, consideration of the “big picture,” and respect for the patient) can be adopted and honed by physicians to improve their own interactions with hospitalized patients.