Why Nice Doctors Are Better Doctors

Going to the doctor is an exercise in brisk communication, trust and vulnerability -- talking about your health concerns isn't easy. Add to this crunchtime a new doctor who rushes in, fails to provide an introduction and talks down to you throughout the session. But doctors with bad manners aren't merely an added frustration while you're sick: There's evidence they could be hazardous to your health.

The role of bedside manner in medical treatment has been something of an afterthought in decades past, seen as secondary to a good medical education, proper experience and high-tech tools and resources. But this kind of caring could mean the difference between illness and health, according to experts, and with a growing focus on patient satisfaction, many doctors are taking note.

It's All About Empathy

In looking at bedside manner, modern practitioners are zeroing in on empathy. A paper in the International Journal of Caring Sciences describes empathy as "the 'capacity' to share and understand another's 'state of mind' or emotion" and a "powerful communication skill" that uses active listening and deepens understanding. This skill allows some doctors to fully grasp your apprehensions, concerns and the true weight of your questions when you're in the examining room or hospital.

Your doctor's empathy, or the ability to stand in your shoes, not only deepens the relationship between the two of you and makes you feel more satisfied with your visit, but also has measurable effects on your health.

Health Perks of a Good Doctor-Patient Relationship

When your doctor listens and takes your concerns into consideration, you'll likely feel more comfortable asking tough questions and sharing details you may have withheld from a more brash physician. You'll also be more apt to trust his or her recommendations and insight. It's these results of empathetic exchanges that could be driving positive health outcomes.

According to a 2014 analysis of 13 clinical studies, a positive doctor-patient relationship can have statistically significant effects on "hard health outcomes," including obesity, diabetes, hypertension, asthma, pulmonary infections and osteoarthritis pain. The research, published in the online journal PLOS One, looked at studies where doctors were randomly assigned either to provide their normal methods of care or to take additional training or steps to provide more empathetic and patient-focused care. And that additional care made a measurable difference.

The empathy problem is not just about older doctors forgetting what they learned about proper patient relations in medical school. Researchers at Johns Hopkins found doctors in training failed to introduce themselves, sit down with patients or explain their role in patients' health care treatment.

Fortunately, these are things both new and experienced physicians can get better at, and they may be getting more opportunities to do so.

Teaching Doctors to Show They Care

With patient satisfaction playing a more important role than ever before -- it's used to determine Medicare reimbursement rates and in several hospital rating tools online -- hospitals and doctors have added incentive to make their patients happier.

Dr. Helen Riess, associate professor of psychiatry at Harvard Medical School and lead researcher on the 2014 analysis of doctor empathy and health outcomes, says physicians don't have the support they need to sustain the good patient communication skills they learn in medical school once they begin practicing medicine. That's why she heads up Empathetics, a training program based on her research at Massachusetts General Hospital.

"We truly believe that empathy training can go beyond patients just feeling better about their relationship with their doctor," she says. "Through that improved relationship, there's a much greater commitment as a partnership to actually improve [the patient's] health."

Empathetics' curriculum was tested in a clinical trial and made available for physicians in an e-learning environment. Currently, such programs are few and far between. Riess says Empathetics is the only one of its kind. But they are likely to become more prevalent as patients become increasingly aware of their power in demanding better communication skills from physicians.

What's a Patient to Do?

For patients faced with a doctor who has a poor bedside manner, choosing another physician doesn't have to be the first option. It might not even be the easiest, with narrowed insurance networks and waiting lists as the alternative. One potential solution is to be the better communicator, and ask your doctor to meet you halfway.

"What we recommend is that patients find appropriate ways to ask for what they need," Riess says. She suggests patients "lead with their vulnerabilities."

Instead of thinking, "I didn't understand a word she just said, and I'm not going back," Riess says a patient should speak out: "I'm sorry, but can you put that into more everyday language for me?" Or, "You may not realize this, but I'm pretty anxious about this, and I need a few more minutes of your time to understand."

Your doctor may have gone to medical school and may even have years of experience, but that doesn't mean he or she knows everything, and it certainly doesn't mean you should feel intimidated about speaking up. In the case of good communication, you may have to lead the way -- not only in the interest of a better conversation but also for better health.