Medical etiquette

Why delivering good gratifying medical care is so complex is because it involves not just knowledge, skills and ethics but another vital component that is often overlooked, called medical etiquette.

Medical etiquette is simply good proper behaviour that is expected of physicians and nurses when dealing with patients. Simple, etiquette is usually not given much importance during medical training in this country and is hence often found woefully lacking in our professionals. Consequently, do not be surprised to meet a top-notched specialist with a string of degrees below his name, who may forget the etiquette of offering you a seat when you enter his chamber, and continue talking on the phone.

A resident doctor, who comes to train with us to become a superspecialist, is often grossly deficient in etiquette. In the busy and crowded OPD, I see him often examining a female patient in the presence of 10 unrelated spectators. In the ward, I see him doing an ascitic tap (drawing fluid from the abdomen) without putting screens around to ensure privacy. Another common gaffe is barging into the private cabin of a patient without an announcing knock or a “please may I come in?”.

While etiquette may not decide life and death, what it does decide is whether the patient feels comfortable, cared for and treated with dignity while in hospital. And as most of my genre gets to know by the time they reach my vintage, attempting to treat patients without ensuring their satisfaction is like driving a sedan without suspension.

In all fairness, it is the British, whom we all love to hate, who brought in the concept of propriety and courtesy in general life as well as in profession. Etiquette, a French word, while meaning much the same, conveys a hint of style, in addition.

Officers of our defence forces exemplify this British legacy best in the country. They adhere to time, are dressed appropriately for an occasion, are well mannered, show the right measure of the right kind of courtesies towards seniors, ladies, colleagues (and enemies too!). This etiqutte does not come naturally. For most, it has been the result of years of grooming in their academies, training and at postings.

This British legacy was once strong in Indian medical schools too. It was, in fact, so strong that an Indian doctor would also rub and warm his hands before examing a patient in the swealtering Indian heat, just as was expected of a British doctor to do in freezing England. .But the general courtesies that thay taught us, often referred to as “bed-side manners” has all but evaporated in the summer heat!

American medical institutions are increasingly recognizing the need for formally incorportaing medical etiquette in the training of their doctors. Indian doctors need it too, perhaps even more desperately. And officers of the defence services can chip in a good bit to hone our etiquette. 

As published in HT City( Hindustan Times) dated 29 April, 2012.