The role of a friendly physician in Covid-19 crisis

One of the main non-medical or social expectations of the patients, visiting a physician, is that the physician would behave with them in a friendly manner.

The first step of a friendly gesture of a physician is to greet the patients appropriately. During my doctoral research on responsiveness of physicians, I found that, physicians readily acknowledged the importance of greetings, but at the same time they perceived this to be out of the local custom.

As a result, the common practice is that, as I have observed, usually it was the patient who initiated greeting; many doctors responded politely, but some did not care.

Apart from the first impression created through the greetings, there are other aspects of friendliness of a physician, as discovered through exploratory qualitative research, later substantiated by structured observation survey. These include: identifying self by the physician, engaging in social talk, showing friendliness, giving reassurance, not using jargon or professional language, not showing hierarchical difference, exercising non-verbal communications, and being humorous.

Holding a gentle closing conversation is also important to build a friendly image of a physician. It is understandable that, due to the patient load and other logistical challenges, it is not possible for physicians to practice all of these during their practice.

So, based on a data reducing statistical analysis, known as factor analysis method, we identified the following factors to be the most important ones: 1) Asking patient's name, 2) Engaging in social talks, 3) Asking about patient's family, 4) Showing some forms of explicit friendliness, 5) Giving courage and reassurance, and 6) Demonstrating sense of humor.

We will see how these can be exercised in real-life settings.

Patients expect that the doctor would ask patient's name and treat them as an individual, i.e. call them by that name, not merely as an unnamed 'case'. It is very common for a physician to ask the name of a patient, but that is often done just to write it on the prescription note, and doctors mechanically write it down without even looking at the patient.

Since they are already doing it, gazing towards the patient at that time, and calling them by that name during the consultation would make a gulf of difference. Similarly, for returning patients, greeting them by their name would be a highly responsive gesture.

Patients also expect that the physician would not only listen to their complaints, but also engage in some social talks. Some examples of such talks may be, asking about the patient's profession, education, children, family members, etc. Even a casual conversation on the weather could seem as a friendly gesture.

Among these, showing interest about the family is the most important, for example, asking about how many children the patient has, whether they are all doing fine or not, etc.

There are some ways of showing explicit friendliness through some behaviors. Examples may include: remembering the face of the patient and calling by name of the patient in a friendly manner; asking or making comment about an event of the patient's family; praising the patient (about clothing or anything else); asking for an opinion of the patient about anything i.e. weather, politics etc.

Finally, under the 'friendliness' domain of the responsiveness of physicians, patients expect that the physician would have some sense of humor and would provide treatment by becoming easy with patients, using that sense of humor. I remember many such light moments during my doctoral fieldwork.

Duringan ultrasonogram, the female sonologist was telling her female patient, "I see that you have eaten very well at noon". A pediatrician was telling an adolescent patient, who was requesting for a vitamin syrup, "Leave those baby foods, you are a grownup young lady now, ready for getting married already."

Friendliness of physicians can be the first step towards mending the widening gap between them and their patients in recent times. However, it is important to realise that both the parties, i.e. both physicians and patients have a crucial role in this endeavor.

As the physicians take the first step by extending their friendly hands, the other party should respond with trust, love, respect, and appreciation.

This is the final part of the two-part series "Doctor patient relation". The first part of the story can be read here:  https://tbsnews.net/thoughts/how-can-our-doctors-be-more-responsive-time-covid-19-pandemic-86977

The author, a public health expert, is executive director of Public Health Foundation, Bangladesh and Associate Faculty at Johns Hopkins Bloomberg School of Public Health.