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BEDSIDEMANNER.INFO
BECAUSE PATIENTS JUDGE YOUR SKILLS BY YOUR BEDSIDE MANNER
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(2019/08/19)
 

The Patient With A Companion

When you enter the treatment room and find a spouse or other adult friend accompanying the patient who is seated on the examination table or treatment chair, say:

DOCTOR

“Good morning. How’s everyone doing today?”

You will get an answer from one or both of the parties. As long as they don’t burst into explaining why they are there (some patients and their guests impulsively want to tell you their story before you ask), you look at the visitor and say:

DOCTOR

“I suppose you’re the patient and you talked Jim, here, into sitting in that chair, so you could find out what we’re going to do to you.”

Unless the couple doesn’t speak English or has no sense of humor, you get a laugh and begin your relationship on a friendly lighthearted note.

Don’t use the same greetings with all of your patients every time you see them. Sometimes you can just say, “That’s great,” when they say they are fine, or “We’re here to get you better,” if they tell you they are terrible. You can even make small talk: “It sure is a lovely day. What are we doing in a place like this with the sun shining so brightly?”

There are an unlimited number of responses you can use to provide comedic variation. The object is to show that you have a sense of humor and some personality, even if you don’t. It’s not so hard to practice greetings and see which ones work. After trial and error, you should come off as friendly and witty to most of your patients. Practice these greetings and you are on your way to having great bedside manner.

TREATMENT HUMOR

Practitioners who perform procedures that are either boring or frightening to most patients should find treatment humor extremely helpful. This material doesn’t work for simple exams or treating patients under general anesthesia.

When explaining your procedure to a patient, you can get a good laugh or at least set the tone away from seriousness with this offering:

DOCTOR

“During this procedure there will be absolutely no pain (pause) for me and my staff.”

 You emphasize absolutely. This line provides a great use of the unexpected to engender comedic relief.

Never pass up an opportunity to make your patients laugh. When your stomach starts talking in the middle of treatment, it can be rather embarrassing if you don’t embrace the moment:

DOCTOR

“I guess you realize that’s my stomach talking to you. Please ignore him when he tells you I’m a jerk. I miss one meal and he carries on like I never feed him.”

This little banter turns an embarrassing situation into a lighthearted opportunity to make your patient laugh.

Compliment Humor During Treatment

During the course of treatment, you should compliment the patient often. Terms to use should vary: “You are doing great (so well, fabulous, awesome, fantastic).” At one point immediately after you have given one of these compliments, you say very seriously,

DOCTOR

“I know it’s not polite to compliment myself this way.”

The patient will usually laugh and you respond:

DOCTOR

“Oh…. I guess you thought I was talking about you all this time.”

They will laugh.

Other variations on the compliment humor:

DOCTOR

“You’re the best patient I’ve seen today.”

Pause:

 “Of course, no one else showed up yet.”

Variation:

DOCTOR

“I don’t think I have ever seen a patient as good as you.”

Pause:

 “Of course, considering I’m not the doctor, I guess that’s expected.”

They laugh. If they jump up from the table, you better go back to the “just kidding” line, but don’t worry, most patients get it. You continue:

DOCTOR

“Actually, I’m the maintenance guy and I’ve seen the doctor doing this hundreds of times while I’m taking out the trash. You have nothing to worry about.”

Variation on the above:

DOCTOR

“I don’t think I have ever seen a patient as good as you… at least not since I got my medical license revoked.”

Wait for the reaction (a laugh or a look of surprise), and then continue:

DOCTOR

“Don’t worry; I should be getting it back any day now. At least that’s what my parole officer told me last week. I can’t believe they make such a big deal over a few minor felony charges.”

A variation using a bragging premise also works well. In the middle of a procedure, you can say:

DOCTOR

“I’d probably be the best dermatologist in the world… if they didn’t take away my license. You know, the people at the licensing board in this state seem to take felony charges just a little bit too seriously. I mean what are three or four felonies anyway? It’s not like I robbed a bank…. this year.”

These lines usually get such a great response that, on occasion, you may have to halt treatment to let the patient regain their composure.

It takes practice and a little timing to realize a properly placed pause enhances the comedic effect. You may not get a great response every time, but there is nothing more satisfying than making a patient laugh during an intimidating procedure. They will love you and be forever grateful.

Another variation on complimenting patients involves the surprise of insincerity:

DOCTOR

“You are the best patient I’ve seen today.”

You look at your assistant and continue:

DOCTOR

“Mary, did the last patient leave yet?”

She will acknowledge that the last patient left.

DOCTOR

“I really have to be careful. I just told my last patient they were the best patient I saw today. Don’t you worry. I won’t tell the next patient that….

until I’m sure you’ve left.

You can try this for a fast line during your treatment:

DOCTOR

“You are the best patient in the chair at the moment.”

Pause:

 “Okay, you don’t think that’s much of a compliment, but I could have said you were the worst patient in the chair and that would be true, too. Hey, I’m on your side.”

There are a hundred ways to compliment your patients with humor, and while they aren’t always belly busters, they convey your personable nature.

DOCTOR

“You are doing so well that I think you are going to win the

patient of the day award.”

Pause while they chuckle.

DOCTOR

“I want you to stay by your phone tonight. We make the announcement around four in the morning, and I am almost positive you are going to be the winner.”

With a patient you’ve seen before and whom you have previously complimented you may continue the theme:

DOCTOR

“You are doing so well, I’m going to put another star on your chart.”

Pause:

 “You have so many stars already; I have nowhere to write

what we are doing today.”

The Toy Box For Adults

When the patient is doing well and you want another joke regarding praise, you can use the toy box lines:

DOCTOR

“You are doing so well that I’m going to let you pick something from our invisible toy box.”

They should laugh with your pause.

DOCTOR

“That’s right, I’m going to have Mary take you up front and you can pick out anything you want; a new car, a world cruise, just about anything you can imagine. I must, however, caution you; Mary will be watching to make sure you don’t try to take more than one prize. We keep a strict inventory and we’d hate to embarrass you by making you put back any extras you try to sneak out of the office.”

The lines offered in this text usually work well with little or no modification depending upon your type of practice. Start slowly and use material that requires one or two easy-to-remember lines. Once you have the confidence that you can get good results, try the longer lines.

LONGER ROUTINES

During the course of treatment, mind reading routines work well:

DOCTOR

“I know what you’re thinking.”

Pause:

 “Your life had little or no meaning until root canal therapy with me.”

Substitute your procedure above: corn removal, physical therapy, splinter removal, suturing in the ER, you name it – except perhaps during a GYN exam. The patient will laugh, chuckle, grin, or moan. You can stop there if you really need to concentrate on your operation, but if you do the same thing a hundred times everyday, you can proceed:

DOCTOR

“Pretty good, huh? You didn’t know I could read minds. As a matter of fact, the doctors who studied me at the institute had doubts, too. They told me it wasn’t mind reading. They said I was hearing voices.”

Pause:

 “Can you imagine that? So they insisted that I try this medication. Now you’re not going to believe this, but after a few days on the medicine, I couldn’t read minds. What a bummer. I was so lonely, that I stopped taking the medicine, and wow,

I can read minds again.”

Pause for the finale.

DOCTOR

“I know what you’re thinking.”

Pause:

 “And I am not full of…”

Pause:

 “I couldn’t make out that last word.”

 

A variation on the mind reading goes like this:

DOCTOR

“I know what you’re thinking.”

Pause:

 “You never had this much fun in your life.”

You either get the groan, a “not really,” or they may even agree, albeit with sarcasm. Look at your assistant and continue:

DOCTOR

“Jill, will you call the company and tell them I want to return the mind reading course immediately?”

Pause:

 “No, wait! I think I got it this time.”

You look back in the patient’s eyes and state:

DOCTOR

“You wish I’d shut up and get done.”

Pause:

 “I knew it. In mind reading, those two phrases sound very much alike. Jill you can forget returning the course. I’m just now getting the knack of this mind reading stuff.”

If you work on that routine, you will have many happy, loyal patients who will never forget the experience.

Here’s a great routine to offer while working on a patient who comes to you in pain or who may expect to have postoperative pain after you complete the procedure.

DOCTOR

“You’re going to feel like a new woman.”

You wait a moment for it to sink in.

DOCTOR

 

“Of course I don’t want you to get too excited, because this woman is homeless and sleeps on a park bench.”

They laugh and you continue:

DOCTOR

“I guess now you realize you should have been happy with the woman you were, instead of wanting to feel like a new woman.”

Don’t rush it; pause and continue:

DOCTOR

 

“Of course, there’s a bright side to everything. This woman you’re going to feel like: she has all her worldly goods in a shoebox.”

Pause for the laugh.

DOCTOR

“She never has to worry about closet space.”

A few minutes later, a variation works well as it utilizes unexpected irony:

DOCTOR

“You’re going to feel like a new woman.”

You pause letting them think you forgot you just used that line.

DOCTOR

“You think I forgot that I already told you that, but I didn’t.”

Pause:

 “I just changed my mind. This new woman you’re going to feel like…

she recently left home to join the circus.”

As trite as these routines sound, they work almost every time. Once you have mastered this little foray into standup, you will win over just about every patient you see, except for those who are going to report you to the state medical board. Some people just can’t take a joke!

Team Comedy

Having a great assistant with a sense of humor helps enormously. If you tell a joke and no one laughs, it takes its toll on your ego and could discourage you from continuing your quest for the perfect bedside manner. Having an assistant who will laugh over and over at the same joke makes your routines appear funny. When your assistant laughs, it lets the patient know you are joking, it tells them they can laugh, and it sets the stage for contagious laughter. Of course you may have to bribe your assistant with a big raise or bonus.

The assistant should be used as the straight guy and avoid upstaging the doctor. I once had an assistant who liked my jokes so much she decided to use them before I came into the room. I finally figured it out. After using a surefire winning line, the patient said, “That’s funny, but your assistant said the same thing right before you came in.” You may have noticed, I said I once had an assistant who used my jokes before I came into the room.

Your assistant can be used as the brunt of some of your jokes–but it must be in good fun and never to demean, as that would be inappropriate, and it may ruin your reputation and bedside manner. From the legal perspective, using an employee as the target of repeated jokes can result in a harassment or discrimination suit. You must make sure your assistants aren’t offended by your jokes. They usually welcome the humor, as it injects a little appreciated fun into the workplace, but be sure to ask.

Tell the patient how good your assistant is while ending the compliment with a punch line:

DOCTOR

“Jennifer is the best assistant I ever had.”

Pause:

 “And to think, she couldn’t speak English just last week.”

The patient and Jennifer will laugh. You pause.

DOCTOR

“I’ve always liked working with migrant farm workers. I met Jennifer during a grape boycott.”

Variation:

DOCTOR

“Jennifer is the best assistant I ever had. You can find some really good help at the home for the criminally insane.”

They laugh; you pause and finish with the finale.

DOCTOR

“I met her there when we were roommates.”

If your assistant drops an instrument, it offers an opportunity for a line:

DOCTOR

“Mary used to be a knife thrower at the circus. I guess you can figure out why she’s working here with me now. It’s not that she was fired; they just couldn’t find anyone to stand there with an apple on their head.”

Here’s another great series of jokes involving the assistant. While doing a procedure with your assistant say:

DOCTOR

“Sometimes people take things too literally. Why, just the other day, Mary asked if I needed a certain instrument. I said, ‘No, you can hold up.’ Now you’re not going to believe this, but when I said ‘hold up,’ she pulled out a gun and took my money and the patient’s insurance co-payment.”

Stories like this are so unexpected, especially coming from a doctor, that they take the patient by surprise. They love the stories and they will love you too.

You follow up with:

DOCTOR

“That was nothing. I was working on a patient the other day and they felt a little discomfort. Being just about done, I said, ‘Bare with me.’ All of a sudden, I turn around and Mary is standing there naked. I was so embarrassed.”

Needle Humor

Needle jokes are helpful if you administer injections and want to ease the process. They are a real boost for bedside manner. Needle jokes show a patient you care about them by trying to lighten the experience. By having needle jokes, you combine the elements of humor and compassion in one package.

You should do everything you can to make sure you give a great injection. There is nothing more powerful than giving a painless needle to make a patient love you forever. Usually, some form of distraction including elements of tissue manipulation and talking gets the job done. While topical anesthetics have limited effectiveness, using them helps allay fears and may provide a placebo effect.

When giving a mandibular block injection, or any of the many infiltrations used in dentistry, manipulate the mucosa vigorously with a finger or thumb and pull the mucosa onto the needle in such a manner that the patient very often won’t know when the actual injection takes place. A massage technique can distract a patient from most needles and make the experience more pleasant. Assuming you give a great needle, or at least that you are injecting one of the many patients who take injections stoically, there are a number of humorous lines that can enhance your bedside manner.

During or after injecting the star patient:

DOCTOR

“You’re doing so well. If I didn’t know better, I’d think you were Superman (Superwoman, Superboy, or Supergirl).”

Quite often the patient will chuckle, but don’t always expect it. Some stoic patients are concentrating so hard that they may not respond. That doesn’t mean they don’t appreciate your humor. Continue:

DOCTOR

“You know there’s a way to test this theory. I have Kryptonite in the back office and I can use that if necessary.”

This often gets the stoic to chuckle.

Variation:

DOCTOR

“I can’t believe how good you are at this. Why, just the other day I was treating Superman, and he didn’t do as well as you.”

Pause:

 “Of course, I put Kryptonite in his Novocain (flu shot, steroid injection).”

Or try this version while injecting:

DOCTOR

“You are doing so well. I can’t believe it. Why, just last week, I treated Superman, and you’re not going to believe this, but he cried. That’s right, you’re doing better than Superman.”

While young boys love that one, most adults laugh at every one of these Superman lines.

While injecting a stoic patient, you can try:

DOCTOR

“I can’t believe how good you are at this. You are a rock! I bet your friends call you Rocky.”

Pause:

 “But it’s probably because you can’t walk a straight line.”

Most patients are not fond of needles–even the stoics. You can use these lines with the patients who make noise and aren’t that great since conversation helps get their minds off the experience.

Another good line while injecting uses the addict theme:

DOCTOR

“You are doing so well. If I didn’t know better, I’d think you’re a B12 addict. Be honest, you just came here to get more B12.”

These lines work with allergy shots, flu shots, Novocain, steroid injections into joints, and just about any type of needle you may have to give.

When you get good at using humor with your patients, you will have some of them laughing quite a bit during the course of treatment. You can play upon this by saying things that really get them rolling:

DOCTOR

“I want you to know that your secret is safe with me.”

Pause:

 “I’m not going to tell the authorities you were laughing like this during root canal therapy (substitute your procedure here). But I can’t be responsible for anything you tell your friends and loved ones. You tell them how you were laughing and they may just have you committed.”

Goodbye Humor

After a visit you want to leave the patient with a last memento of your comical style. Depending upon when they need to see you again, you can use various lines. If you need to see the patient in a few days or weeks:

DOCTOR

“I’ll need to see you in two weeks for another treatment. Now, make sure you don’t go around telling all your friends and family how much you like coming here, or they’ll have you committed (locked up, sent away).”

Or you can try:

DOCTOR

“I know you’ll be counting the days in anticipation of another fun experience. Just don’t tell your friends how great this is, or I’ll get so busy I won’t be able to see you when you need my services.”

If you don’t need to see the patient again:

DOCTOR

“Well, I guess it’s time to say goodbye. I’m glad we were able to help you and if you’re lucky, you’ll never have to see me again. But we’ll be ready for you if you decide you miss us.”

Now isn’t that better than saying “Have a nice day”?


Comments
• Shane Curtis (2019/09/03 21:52)
I find that comedy comes easily with some patients, but can be very difficult with others. I think the key is finding reliable one-liners like those listed above that can break down barriers with the stoics. Once the barriers are down, comedy and light-hearted jokes become much easier. However, there are some patients that will resist humor every step of the way. I think these patients are best handled with straight talk and efficient treatment.
• Jen Schlesinger (2019/09/03 21:40)
This is such great advice! I would love to incorporate more comedy in my routine but it will definitely take some practice. Actually, our assistant Lori is one of the funniest people I have ever met. Her witty humor seems to put the patients and the clinic at ease. Humor helps us all with relaxation during anxious moments.
• Jane Shin (2019/09/03 21:34)
These are all great examples for using comedy during a patient\'s appointment, especially in endodontics where we see many who come in scared and in pain. Getting the assistants and staff involved would make for a fun work environment, which can also ease an anxious patient. As a new endodontic resident, still trying to get comfortable with the technical aspects of clinical endodontics, I will keep these examples in mind to help the patient (and myself) get through the visit more comfortably.
• Andrew Vo (2019/08/27 16:32)
I agree that comedy is a useful technique to quickly build report with patients. The comfort of the patient during and after treatment greatly influences the provider/staff and ultimately the care being provided. The day is near that a repeat patient will overhear my recycled jokes. This is one of the many reasons I chose endodontics -- to hedge myself against such embarrassment. #onestepping #justkidding

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