BY: VICTOIRA GRAHAM TREATMENT OF TERMINAL ILL PATIENTS

DOCTORS TODAY In more recent years Doctors compassion and good will seems to have been replaced by fast and rudely abrupt visits. Their lack of communication and bed side manner with their patients as seemed to have been lost over the more recent years. Leaving the families of terminal ill patients even more lost and confused

REASONS FOR LACK OF BED SIDE MANNER S The cost of care, and the ways doctors are paid has changed Insurance and government payers tell a doctor how much time they may spend with a patient. And if they spend too much time, then they will lose money. Many doctors have learned short cuts to ensure they spend as little time with a patient as necessary.

REASONS FOR LACK OF BED SIDE MANNERS Some doctors, in particular specialists, learn to distance themselves on purpose. Imagine going to work every day knowing someone you have treated, perhaps for a long time, will die despite your best efforts. Or watching patients get sicker because they don't follow treatment instructions. Distance creates a buffer that protects them from emotional stress. Of course, some doctors really don't care, never did and never will.

RESULTS OF LACK OF BED SIDE MANNER This has resulted in frustration among patients and doctors. It has also resulted in more medical errors. Confusion of patients diagnoses Loss of hope and the chance of a miracle They pass the duty of telling the families the bad news to the Nurses or the Physician Assistant Emotional distress on patient and their families. Making them feel like there is no opportunity to try anything else. Lack of knowledge of the prognoses and what to expect.

STUDY OF THE EFFECTS OF DOCTORS AND TERMINAL ILL PATIENTS 188 doctors, attending physicians, and interns who cared for 68 patients who died in the hospital in the UK. Many doctors 103 or 55% reported that the patient's death disturbed them very little. 58 or 31% doctors rated the death as having strong emotional impact. And 43 or 23% reported that the patient's death was very disturbing to them. On average, doctors reported experiencing two symptoms of grief after the death. 88 or 47% “feeling upset when thinking about the patient” And 45 or 24% feeling “numb”

EFFECTIVENESS OF COMPASSIONATE HEALTHCARE Conducted by Marttila Strategies and Braun Research from September 23-October 10 Among patients, 84% agreed that compassionate healthcare makes a difference in how well patients recover from illness, while 81% of doctors also agreed with this statement More surprisingly, 81% of patients and 71% of doctors said they believe that good communication and emotional support - the essential elements of compassionate healthcare - can even make a difference in whether a patient lives or dies. DoctorsPatients Compassi on Helps Recover 81%84% Makes a difference in life or death 71%81%

HOW TO GET BETTER MANNER FOR YOUR DOCTOR When you have an appointment, be prepared. Bring a list of questions, and keep them concise. Limit them to the top three or four. Break the ice. Don't chat aimlessly about something that's not important. Once the ice has cracked or broken, remember to continue being respectful of your doctor's time. If you feel as if you've experienced that shake his hand. and thank him for being the kind of doctor whose bedside manner you appreciate.

WHY THEY DON’T HAVE MANNER In College, medical students are focusing their learning on how to fix and repair a patients. They are not focusing on the psychological process of their patients that are diagnosed with a terminal illness. Most students are taught not to get close with their patients and avoid being with them so that if they die then they will not be effected by their death Thus changing peoples once glorified views of doctors

SOURCES Bedside Manner: A conversation about compassion, communication, and other issues in Health Care. Julie Rosen. Wednesday, November 17, The Schwarz Center. November 17, BMJ Helping Doctors Make Better Decisions. July 24, BMJ November 17, Adams, Damon. “The last goodbye: Comforting your dying patient.” The American Medical Association. September 10, Chen MD, Pauline W. “The Hidden Curriculum of Medical School.” The New York Times. January 29, How to Improve a Doctor’s Bedside Manner: Improve Your Communication with Your Doctor. Trisha Torrey. February 01, About.com. November 17, htm