A good bedside manner

Richard P. Holm, MD

South Dakota State Medical Association, Sioux Falls, United States

The following essay was presented as part of the South Dakota Public Broadcasting Television show On Call on July 22, 2010.

In 1988 Arnold P. Gold MD, a physician educator at Columbia University, noted a disturbing trend for medical students and residents. Students were over-emphasizing advancing technology while forgetting about the value of a caring bedside manner. Indeed, a patient survey noted that 12% of patients believed their doctor didn’t know their name, 20% felt the doctor was rude or condescending, and 47% sensed their doctor was rushed.

Dr. Gold wondered why this was happening and if there was a way to train young students in medicine to be more compassionate. How does one teach walking in another’s moccasins?

Thus the Gold “Humanism in Medicine” Foundation was begun in order to emphasize the virtue of caring and the value of simple kindness at the bedside, not just because it is the right thing to do, but also because it is a very powerful tool in helping patients and families heal as they struggle with any kind of illness.

Humanism by definition started with the ancient Greeks. And ancient Chinese, Indian, and Islamic people independently described value concepts of compassion and justice. In the late 1400s and early 1500s, the Italian Renaissance brought back Greek teachings, classical humanities, and an ethical philosophy of social science. Hoping to bring all disciplines together, they also studied the Jewish Kabbalah as well as the earliest Gospel writings of Christian forefathers.

History has it, however, that eventually the humanism movement clashed with certain religious leaders who declared that “love of humanity” could not come from human reason alone but only from the divine. Humanism leaders, in contrast, came to reject any component of faith not supported by scientific proof. Unfortunately, the polarized groups lost sight of the message about caring for one another.

I like best the German Art Historian Erwin Panofsky’s definition of humanism as an attitude of respect for human dignity between individuals. He said that humans are intrinsically free and rational but are limited by fallibility and frailty. We therefore have the responsibility for each other to tolerate failings while protecting freedoms.

God, grant me the wisdom to walk in the other guy’s moccasins, the responsibility to accept frailty while protecting freedom, and the kindness of a good bedside manner.

 


RICHARD P. HOLM, MD is a General Internist practicing full time in rural South Dakota. He is director of his local hospice, past chair of the Ethics Committee for the SD State Medical Association, governor of the SD ACP, and medical editor for the weekly medical show on SD Public Broadcasting called On Call (oncall.sdstate.org). This essay was written both as an editorial for the TV show and as part of a presentation given to the Awards Banquet for the Sanford USD School of Medicine Chapter of the Gold Humanism Honor Society.