Bedside game (formerly, bedside manner)

Dr. Wes links to an article in the NYTimes about a person who volunteers to let medical students auscultate her heart. It is somewhat infuriating, in that it is filled with treacle such as "The students had just learned the technical term for a heart murmur that a physician can feel: a 'thrill.' As any patient knows, the touchstone of a good doctor is the ability to feel one’s heart." The author is a science journalist and should know better. It is a perfectly reasonable expectation for patients to want doctors that treat them compassionately. It is a completely other thing to claim that "good doctors" are the ones patients like.

However, the article does have some good reminders for all health care workers. Most important: maintain your bedside game. I say "bedside game" on purpose. In more civilized times, this was known as "bedside manner," and encompassed behaviors that recognized the patient was another person with potential fear, embarassment, and ignorance of examinations and procedures. In short, it was the medical instantiation of politeness and manners.

But in today's world, bedside manner is not enough. The author wants her medical students to be interested in her first name and approves of a doctor who seems "easy-going" and has arty cuff-links. She doesn't adjust her posture to improve the students' auscultation unless she feels they've paid sufficient attention to her. (Just reflect for a moment on what she is doing there and its importance for the 1000s of patients these doctors will examine!) The author is not scared, she is a self-involved egoist who makes judgements of people based on superficial characteristics like their affect and clothes. In this day and age, you need game just to win over people enough to get them to cooperate in their own examination.

I'm not saying it's a bad idea to accommodate patients, but as our social fabric decays, it's important to remember that we aren't bad people for not wanting to be chummy with strangers. Sometimes you may just need to employ bedside game to reach your Pareto optimal patient care.