Patients more and more feel like a number in a computer. But clinicians shouldn’t be vilified. You work tirelessly to provide the best possible treatment to the greatest number of people. The challenge is time. Hospitals are increasingly busy, requiring you to be as efficient as possible. The good news is, building a trusting relationship with a patient doesn’t have to take an unattainable amount of time. Enhancing patient experience sometimes comes down to the little things – like a smile or touch through physical exam.
“It only takes 56 seconds to make a meaningful human connection with a patient,” according to a Health System Management article. Within that time, a clinician can discover a shared hobby, favorite food or musician. Finding a common thread can crack open the door to a trusting relationship.
Even beyond the verbal communication is what transpires within the physical examination. Abraham Verghese, MD, MACP, Stanford University Medical School professor and author, regards the physical exam as a ritual of great importance. In his TED Talk, he stresses the value of not only a routine physical exam but a thorough one. His experience has shown him that patients will be more forthcoming if they feel the examining medical professional is taking the time to truly get to know them, their body and their condition. In doing so, medical staff have “earned the right” to help determine a path forward. The familiar and comforting touch of a physical exam can send a powerful message that the clinician cares even if no words are exchanged.
A tool frequently used in a physical exam is a stethoscope, and it is often the first point of physical contact between patient and clinician. Stethoscopes play a clinical role during the physical exam, but Verghese believes their value transcends auscultation findings. He believes stethoscopes are among a clinician’s greatest assets to connect with the patient. Verghese explains that if clinicians “shortchange” the physical examination “by listening with your stethoscope over the nightgown, by not completing a full exam, you have bypassed on the opportunity to seal the patient-physician relationship.”
Verghese isn’t alone in his sentiments; other physicians agree with him. Even in today’s era of advanced diagnostic methods, the stethoscope’s value should not be diminished, believes M. Thomas Stillman, MD, FACP at Hennepin County Medical Center. He serves as Undergraduate Medical Education Director for University of Minnesota Medical School, Minneapolis, where he teaches the art of auscultation.
Stillman is a firm believer and proponent of the stethoscope’s relevance in medicine today. He recently sat down with us to discuss the topic, which was also the theme of a 2014 commencement address he delivered to University of Minnesota Medical School graduates. He gave the following advice in that speech:
“Technology without careful explanation and patient understanding can be isolating and we cannot let it create barriers between us and the personal connection we have with our patients. Maintaining the doctor-patient relationship requires adaptation to technology not submission to it. Sitting in the patient’s exam room, staring at the computer screen with little or no direct patient eye contact is like reading a book while talking to someone. Our patients need our undivided attention. Step back from your computers, sit beside your patient, talk patiently to them, and most important, they must feel we are listening and absorbing their story.”
Stillman carries this lesson of finding balance between utilizing the advanced technology in modern medicine and providing patients with a trusting relationship into the classroom. He urges his students to be “both an attentive and competent physician,” which he believes begins with the stethoscope.
Teaching auscultation is important to Stillman because of its ability to bond the patient and doctor together. He says that making it a ritual is very important as it’s something that should be maintained rather than replaced.
As he teaches Generation Z, the “technology natives,” Stillman knows how much they value patient interaction.
“The future medical professionals are interested in building connections with people beyond devices and electronics because it brings back why they want to go into medicine in the first place. They want to physically connect to the process in making an accurate diagnosis.”
While there are many ways to make a connection, the stethoscope serves both a practical purpose and an emotional one. It helps to find a path towards diagnosis, but Verghese and Stillman agree that the stethoscope also serves as an opening to a trusting, caring relationship.
As Stillman says, “The stethoscope connects the doctor to the heart of the patient.”