By Karla Gale
NEW YORK (Reuters Health) – Most patients want to shake hands with their physicians when meeting them for the first time, according to survey results reported in the Archives of Internal Medicine for June 11. The majority also wish that doctors would address them by name, and that physicians introduce themselves by name.
"In general, doctors are told to greet patients appropriately. This is the first study to give evidence-based recommendations on what that means," lead author Dr. Gregory Makoul told Reuters Health.
The research team, based at Northwestern University Feinberg School of Medicine in Chicago, conducted a random digit-dial, computer-assisted telephone survey of 415 adults in the 48 contiguous United States.
"In the survey, we said that doctors need to know what it means to greet a patient appropriately," Dr. Makoul explained. "Then we asked, ‘what does this means? How would you want your doctor to greet you?’"
About three out of every four subjects wanted doctors to shake hands. Half wanted to be addressed by their first name, and one quarter by first and last name. Almost six out of ten preferred that physicians introduce themselves by both first and last name.
To compare the survey responses with what transpires in practice, Dr. Makoul’s group reviewed videotapes of patients’ initial visits to primary care physicians. Included were 15 physicians in Chicago and 4 in Burlington, Vermont; a total of 123 subjects participated.
The videotapes revealed that 9 physicians shook hands with every patient and the other 10 shook hands two-thirds of the time. In about half of the encounters, the physician did not mention the patient’s name at all. When introducing themselves, a third of physicians used their last name only, and almost two thirds used both their first and last name.
The research team recommends that physicians shake hands with patients, but to remain sensitive to nonverbal cues indicating that the patient is not comfortable doing so.
"When the doctor goes up to shake a patient’s hand, if the patient doesn’t look up or make motion with their hand at all, the doctor might not want to stick their hand out there and just wait," Dr. Makoul explained. He also noted that some patients can’t lift their arms because of their medical conditions, and in these cases, the physician may consider touching them on the shoulder as a means of developing a rapport.
When asked how physicians’ personality traits may affect the way they interact with patients, Dr. Makoul said, "Doctors should have their own style. We’re not trying to change their personality or write a script for them. We simply hope that we provide evidence that will help them to decide what they want to incorporate into their style."
"Clearly, greetings are only a small slice of the overall visit," he added, "but they do set the tone for the rest of that encounter, and for the ongoing doctor-patient relationship."
"The point is that this is one of those mundane things that can really matter," Dr. Makoul concluded.
Arch Intern Med 2007;167:1172-1176.