Evidence That Little Touches Do Mean So Much
Regular readers know that I have a great interest in bedside manner. I have written often about how one role models bedside manner, and thus how one helps learners improve their bedside manner. One habit I have (that of course I believe is a good one) is to use appropriate touch.
For several years, I have felt strongly that holding a patient's hand or feeling their pulse, while discussing their medical situation, provides reassurance and makes a clear statement of empathy. I generally shake hands with patients when entering their room. I often check pulses, or examine their neck for accessory muscle use. These touches convey something important to the patient.
A sympathetic touch from a doctor leaves people with the impression that the visit lasted twice as long, compared with estimates from people who were untouched.
What do other physicians think? What do patients think?
{ 5 comments… read them below or add one }
I agree that touch is important, and in the typical US culture is underused. One caution I would offer is that for some people touch is traumatic, and it’s important to be very sensitive to people’s nonverbal responses as touch is approaching and be prepared to back off, or to ask whether touch is welcome or not.
I agree completely. I can’t tell you how many points I lost on ICM quizzes because I refused to say that doctors should never sit on a patient’s bed. I think sitting down with a patient and touching them conveys empathy and shows them that they have your complete attention.
You sound like a caring doctor whose touch would come across as a nice gesture. And I agree that simple touch can make you feel so much better. As a woman, I’m not sure how comfortable I’d be with a male doctor holding my hand, but I’m sure you docs are smart enough to read each patient, as Sue suggests. I like the alternate touching ideas mentioned in this post–and the idea of sitting on the bed, which PK suggests.
I wonder if touch has been going by the wayside even more in hospitals, given the seeming upswing in concerns about MRSA, germs and hand washing in the last few years.
I still remember my obstetrician holding my hand for a few moments while I was in labor with my first child. That was 46 years ago.
To be ill or in pain is to be in a lonely place.
I don’t know about touch per se, but a good bedside manner (so I’ve heard) is the best malpractice insurance. There have been instances in my life where a malpractice lawsuit would have definitely been appropriate, but there was no way that I was going to do that to that particular doctor. Ever. Not even the one incident that required three surgeries to correct. On the other hand, it’s been two months and I’m still so ticked at the area surgeons that…. oh, let’s just say that if I have to speak with them for any reason that there had better be chemical or physical restraints involved, LOL! Trust them with my life, but they drive me crazy. One has been permanently fired because he would not LISTEN to me. Oh, and because he wouldn’t listen, that means at least two more surgeries (one to figure out/pinpoint/confirm what he screwed up, one to correct what he did).
In 1925, Frances Peabody said, “the secret in the care of the patient is in caring for the patient.” It is far too simplistic to think that is all that is necessary, but it does go a long way.