Introductions and Greeting Attitudes Amongst Future Physicians in the United States
Purpose Understanding of the intricacies of the patient-physician relationship is essential to understanding outcomes in health communication. However, factors that influence the initial encounter--the backbone of one’s longitudinal or acute relationship -- are poorly understood in medicine.
Method In 2019, medical students at 30 United States (U.S.) medical schools were asked to complete a questionnaire assessing their preference regarding their attitudes toward how they plan to introduce himself or herself upon graduation. For all survey respondent data, respective frequencies of categorical variables for patient cohorts were compared with Fisher exact test including 2 groups or chi-square test for patient cohorts including more than 2 groups
Results Among all respondents (n=1056), the majority of U.S. medical students plan to introduce themselves as resident and attending physicians most formally via “Hello, my name is Dr. Appleseed” where ‘Appleseed’ is their last name (n=685, 65% resident, n=772, 73% attending), followed by: ‘First Last’ (15%), ‘First’ only (16%), and then ‘No preference’ (4%). Among stratified comparison sub-groups, there was only a significant difference wherein female students more preferentially introduced themselves using the prefix “Doctor” than male students when considering introductions as future-residents. Additionally, 40% of subjects report that their preferred greeting construct would change based on the following patient factors: age, race, gender, clinical condition, and clinical setting.
Conclusions Future U.S. physicians prefer to introduce themselves using the prefix ‘Doctor’ via “Hello, my name is Dr. Appleseed,” in which “Appleseed” refers to the treating physician’s last name. Female students show a stronger preference for introducing themselves using the prefix “Doctor” than male students, and nearly half of all students acknowledged that their greeting construct changes based on patient demographic factors and clinical setting.
Riedl D, Schussler G. The Influence of Doctor-Patient Communication on Health Outcomes: A Systematic Review. Z Psychosom Med Psychother. 2017;63(2):131-150. doi:10.13109/zptm.2017.63.2.131
Fujimori M, Shirai Y, Asai M, Kubota K, Katsumata N, Uchitomi Y. Effect of communication skills training program for oncologists based on patient preferences for communication when receiving bad news: a randomized controlled trial. J Clin Oncol. 2014;32(20):2166-2172. doi:10.1200/JCO.2013.51.2756
Aiarzaguena JM, Grandes G, Gaminde I, Salazar A, Sanchez A, Arino J. A randomized controlled clinical trial of a psychosocial and communication intervention carried out by GPs for patients with medically unexplained symptoms. Psychol Med. 2007;37(2):283-294. doi:10.1017/S0033291706009536
Little P, Everitt H, Williamson I, et al. Observational study of effect of patient centredness and positive approach on outcomes of general practice consultations. BMJ. 2001;323(7318):908-911. doi:10.1136/bmj.323.7318.908
Cooper LA, Roter DL, Carson KA, et al. A randomized trial to improve patient-centered care and hypertension control in underserved primary care patients. J Gen Intern Med. 2011;26(11):1297-1304. doi:10.1007/s11606-011-1794-6
Zandbelt LC, Smets EMA, Oort FJ, Godfried MH, de Haes HCJM. Medical specialists’ patient-centered communication and patient-reported outcomes. Med Care. 2007;45(4):330-339. doi:10.1097/01.mlr.0000250482.07970.5f
Auerbach SM, Clore JN, Kiesler DJ, et al. Relation of diabetic patients’ health-related control appraisals and physician-patient interpersonal impacts to patients’ metabolic control and satisfaction with treatment. J Behav Med. 2002;25(1):17-31. doi:10.1023/a:1013585617303
Wodskou PM, Host D, Godtfredsen NS, Frolich A. A qualitative study of integrated care from the perspectives of patients with chronic obstructive pulmonary disease and their relatives. BMC Health Serv Res. 2014;14:471. doi:10.1186/1472-6963-14-471
Zolnierek KBH, Dimatteo MR. Physician communication and patient adherence to treatment: a meta-analysis. Med Care. 2009;47(8):826-834. doi:10.1097/MLR.0b013e31819a5acc
Ong LM, de Haes JC, Hoos AM, Lammes FB. Doctor-patient communication: a review of the literature. Soc Sci Med. 1995;40(7):903-918. doi:10.1016/0277-9536(94)00155-m
Kaplan SH, Greenfield S, Ware JEJ. Assessing the effects of physician-patient interactions on the outcomes of chronic disease. Med Care. 1989;27(3 Suppl):S110-27.
Butz A, Kub J, Donithan M, et al. Influence of caregiver and provider communication on symptom days and medication use for inner-city children with asthma. J Asthma. 2010;47(4):478-485. doi:10.3109/02770901003692793
Cappuccio A, Bugliaro F, Caimmi SME, et al. Consensus communication strategies to improve doctor-patient relationship in paediatric severe asthma. Ital J Pediatr. 2019;45(1):31. doi:10.1186/s13052-019-0623-0
Levinson W, Roter DL, Mullooly JP, Dull VT, Frankel RM. Physician-patient communication. The relationship with malpractice claims among primary care physicians and surgeons. JAMA. 1997;277(7):553-559. doi:10.1001/jama.277.7.553
Cegala DJ, Gade C, Lenzmeier Broz S, McClure L. Physicians’ and patients’ perceptions of patients’ communication competence in a primary care medical interview. Health Commun. 2004;16(3):289-304. doi:10.1207/S15327027HC1603_2
Kuehl SP. Communication Tools for the Modern Doctor Bag. Physician Patient Communication Part 1: Beginning of a medical interview. J community Hosp Intern Med Perspect. 2011;1(3). doi:10.3402/jchimp.v1i3.8428
Ruben BD. Communication Theory and Health Communication Practice: The More Things Change, the More They Stay the Same. Health Commun. 2016;31(1):1-11. doi:10.1080/10410236.2014.923086
Medicine I of. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington (DC); 2001. doi:10.17226/10027
Gerteis M, Edgman-Levitan S, Walker JD, Stoke DM, Cleary PD, Delbanco TL. What patients really want. Health Manage Q. 1993;15(3):2-6.
Rathert C, Wyrwich MD, Boren SA. Patient-centered care and outcomes: a systematic review of the literature. Med Care Res Rev. 2013;70(4):351-379. doi:10.1177/1077558712465774
Bernieri FJ, Petty KN. The influence of handshakes on first impression accuracy. Soc Influ. 2011;6(2):78-87.
Uleman JS, Adil Saribay S, Gonzalez CM. Spontaneous inferences, implicit impressions, and implicit theories. Annu Rev Psychol. 2008;59:329-360. doi:10.1146/annurev.psych.59.103006.093707
Todorov A, Mandisodza AN, Goren A, Hall CC. Inferences of competence from faces predict election outcomes. Science. 2005;308(5728):1623-1626. doi:10.1126/science.1110589
Silverman J, Kurtz S, Draper J. Skills for Communicating with Patients. CRC Press; 2016.
Lipkin M, Frankel RM, Beckman HB, Charon R, Fein O. Performing the interview. In: The Medical Interview. Springer; 1995:65-82.
Coulehan JL, Block MR. The Medical Interview: Mastering Skills for Clinical Practice. FA Davis Company; 1992.
Comstock LM, Hooper EM, Goodwin JM, Goodwin JS. Physician behaviors that correlate with patient satisfaction. J Med Educ. 1982;57(2):105-112. doi:10.1097/00001888-198202000-00005
Makoul G. The interplay between education and research about patient-provider communication. Patient Educ Couns. 2003;50(1):79-84. doi:10.1016/s0738-3991(03)00085-5
Makoul G, Zick A, Green M. An evidence-based perspective on greetings in medical encounters. Arch Intern Med. 2007;167(11):1172-1176. doi:10.1001/archinte.167.11.1172
Davies-House A, Ball N, Balmer C. Meeting and greeting in the clinical setting - are we doing what patients want? Br Dent J. 2017;222(6):457-461. doi:10.1038/sj.bdj.2017.269
Walley KC, Lechtig A, Parker AM, Dowlatshahi AS, Harper CM, Rozental TD. Patient Preferences of Physician Introductions In Hand and Upper-Extremity Surgery. J Hand Surg Glob Online. 2019;1(4):198-204.
Wallace LS, Cassada DC, Ergen WF, Goldman MH. Setting the stage: Surgery patients’ expectations for greetings during routine office visits. J Surg Res. 2009;157(1):91-95. doi:10.1016/j.jss.2009.03.065
McLafferty RB, Williams RG, Lambert AD, Dunnington GL. Surgeon communication behaviors that lead patients to not recommend the surgeon to family members or friends: Analysis and impact. Surgery. 2006;140(4):614-616. doi:10.1016/j.surg.2006.06.021
Manzoor F, Redelmeier DA. Sexism in medical care: “Nurse, can you get me another blanket?” CMAJ. 2020;192(5):E119-E120. doi:10.1503/cmaj.191181
Wong Y-L. Review paper: gender competencies in the medical curriculum: addressing gender bias in medicine. Asia-Pacific J public Heal. 2009;21(4):359-376. doi:10.1177/1010539509337730
Files JA, Mayer AP, Ko MG, et al. Speaker Introductions at Internal Medicine Grand Rounds: Forms of Address Reveal Gender Bias. J Womens Health (Larchmt). 2017;26(5):413-419. doi:10.1089/jwh.2016.6044
Girod S, Fassiotto M, Grewal D, et al. Reducing Implicit Gender Leadership Bias in Academic Medicine With an Educational Intervention. Acad Med. 2016;91(8):1143-1150. doi:10.1097/ACM.0000000000001099
- There are currently no refbacks.