Patients Want a Decent Shake From a Doctor

CHICAGO, June 11 -- A hardy handshake is a good way to begin a doctor-patient encounter, according to a nationwide survey.

That finding was one of several that emerged from a telephone survey of 415 patients conducted by Gregory Makoul, Ph.D., of the center for communication and medicine at Northwestern, and colleagues. The survey results were published in the June 11 issue of Archives of Internal Medicine.

The cross-sectional, random digit-dial, computer-assisted survey was conducted from Dec, 2, 2004 through Feb. 5, 2005 among adults living in the 48 contiguous United States. There were 1,489 residential numbers that were called, with responses from 415 adults.

Respondents were asked open-ended questions about their preferences for a number of physician behaviors including shaking hands, use of patient first names, and use of physician's first and last name.

Among the findings:

• 78.1% of respondents said they wanted to shake hands with their doctor.
• Just over half (50.4%) said they preferred their physician to greet them by using their first names.
• Likewise, 56.4% said they liked their doctors to introduce themselves using their first and last name, i.e. "Hello, I'm John Smith" rather than "Hello, I'm Dr. Smith." This form of introduction was especially important to African-American patients, with 78.3% preferring first and last name introductions versus 58% for white patients (P=0.05).

The researchers also analyzed videotape of 123 new-patient visits taped at academic primary care clinics in Chicago and in Burlington, Vt.

The videotape revealed that 82.9% of physicians shook hands with patients. In half the video encounters physicians never mentioned the patient by name but the patients introduced themselves. However in 39% of the videotaped encounters the patient's name was never mentioned by either the physician or the patient.

Only one of the videotaped interviews revealed a physician who asked how the patient wanted to be addressed, but that exchanged occurred only because of confusion over several names listed in the patient's chart.

Slightly more than 40% of patients offered additional advice on how physicians should greet patients. The most common responses from the 177 patients who answered this question broke down this way:

• 23.2% said the doctor should smile.
• 19.2% said the doctor should "be friendly, personable, polite, and respectful.
• 16.4% wanted the doctor to be attentive and calm and to "make the patient feel like a priority."
• And 13.0% wanted their doctor to look them right in the eyes.

The authors concluded that because both patient and physician identification can be established with greetings "they might well be considered a fundamental component of patient safety."