An Evidence-Based Perspective on Greetings in Medical Encounters

[Guest guest]

This study surprised me in some ways. I probably am not formal enough in some ways -- but the area I live in is vary informal in general.I don't wear a tie to work and patients are very casually dressed at work, play, restaurants, etc.

I shake hands with most of the new patients, but not all the established patients' hands.

I use a lot of first names, but it's pretty relaxed out here in Colorado, so they often call me by my first name, too.

I'm not sure what the "both first and last names used" means. Am I supposed to say -- how are you ? Well, , that is an interesting point, but..., etc?

I think if the question is -- you are seeing a new doctor or specialist -- how would you want to be addressed?I could see most people wanting to be addressed by shaking hands, 1st/Last name, etc.

But if I saw the same family doctor for 10 years -- I might feel like there was too much emotional distance between my personal family physician and I if they never got to the point of saying -- Hi, . Great to see you today. How are the kids doing in soccer? What can I do for you today.

Also, if it was some big city situation in a big clinic where I many never see the doctor at the grocery store, I would would probably expect more formality.

But if I live in a small town where I see the doctor at the kids soccer games -- I might expect that the doctor should address me by my first name and be less formal.

Also, the open ended question showed that patients want...

Fewer than half (42.6%) of the survey respondents answered the open-ended question regarding other expectations for greetings.The most common responses from this subsample of 177 respondents were as follows: smile (23.2%); be friendly, personable, polite, respectful (19.2%); be attentive and calm, make the patient feel like a priority (16.4%); and make eye contact (13.0%).

Still...I guess I'll make a bigger effort to shake hands...and remember to smile. :-)

Locke

The “Drug Doctor” — How Do Patients Like to be Greeted by Their Physician?

• Population based telephone survey (Arch Int Med 2007; 167:1172-1176) of 415 adults (mean age 48, 63% women,

93% high school graduates) closed-ended questions.

• 78% expected to have their physician shake their hands.

• ~50% of patients wanted to be addressed by their first name.

• 24% wanted both their first and last names used.

• 1 in 6 wanted to be addressed by their last name.

• 56% of the patients wanted their physicians to introduce themselves with both their first and last names.

• Only 7% wanted their doc to use only her first name.

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http://www.abms.org/News_and_Events/downloads/ABMS%20Evidence-base%20perspective%20on%20greetings%206-11-07.pdf

An Evidence-Based Perspective on Greetings in Medical Encounters Makoul, PhD; Zick, MA; nne Green, MD

Arch Intern Med. 2007;167:1172-1176.

Background Widely used models for teaching and assessing communication skills highlight the importance of greeting patients appropriately, but there is little evidence regarding what constitutes an appropriate greeting.

Methods To obtain data on patient expectations for greetings, we asked closed-ended questions about preferences for shaking hands, use of patient names, and use of physician names in a computer-assisted telephone survey of adults in the 48 contiguous United States. We also analyzed an existing sample of 123 videotaped new patient visits to characterize patterns of greeting behavior in everyday clinical practice.

Results

Most (78.1%) of the 415 survey respondents reported that they want the physician to shake their hand,

50.4% want their first name to be used when physicians greet them, and

56.4% want physicians to introduce themselves using their first and last names;

these expectations vary somewhat with patient sex, age, and race.

Videotapes revealed that physicians and patients shook hands in 82.9% of visits.

In 50.4% of the initial encounters, physicians did not mention the patient's name at all.

Physicians tended to use their first and last names when introducing themselves.

Conclusions Physicians should be encouraged to shake hands with patients but remain sensitive to nonverbal cues that might indicate whether patients are open to this behavior. Given the diversity of opinion regarding the use of names, coupled with national patient safety recommendations concerning patient identification, we suggest that physicians initially use patients' first and last names and introduce themselves using their own first and last names.

Author Affiliations: Center for Communication and Medicine (Dr Makoul and Ms Zick) and Division of General Internal Medicine (Drs Makoul and Green and Ms Zick), Northwestern University Feinberg School of Medicine, Chicago, Ill.