I agree with tutumom2001, except that my real question was how others felt about the relative priorities of people skills and truly top-notch medical expertise, if as a patient you could not have a physician with both. I recognize that there are some doctors who do have both, and probably others who have neither, but often there is a trade-off and one has to strike a personal balance.
The only thing worse than expecting obedience is outright defying the patient. On my pediatrics rotation, we were told “don’t ask the question if you aren’t ready for the answer.” It was probably more eloquently said, but the context was essentially the scenario described in the OP. If I need to get a throat swab from a little kid (i’m thinking pre 1st grade in the scenario described - most older kids get it), I’ll ask the parent for permission although in this particular case I’d be very surprised that a parent would say no so I probably would assume consent unless proven otherwise. I will say please to the child when asking them to open their mouth but I’m definitely not presenting them with the option of saying no by asking for permission to do it because I don’t want to have to do it after they’ve told me no - that’s just wrong on multiple levels.
And with regards to pathologists (and radiologists) they may not need “bedside manner” but they certainly need people skills - they interact with other physicians daily.
People skills (which to me includes communication skills) is necessary for competence. Have you ever gone to the doctor and sat down and had them just say “go” and not have a back and forth of questions? Have you ever been hospitalized and had more than one doctor involved in your care? How is the doctor supposed to accurately diagnose you if they don’t ask the right questions (and more importantly, get the right answers)? How is the night person or the new team supposed to take care of you if the doctor can’t adequately communicate the situation to a colleague?
Along these lines, I just had a physician today tell me a story about why he always asks if patients are having “chest discomfort” rather than “chest pain.” The classic heart attack “chest pain” is often not really “painful” - it’s a pressure/squeezing sensation and many patients will say no if you ask them if they are having chest pain but will say yes if you ask either the more pointed question about pressure or the broader question of “chest discomfort.” The particular story was a patient having a heart attack and the first doctor to interview him in the emergency room wasn’t sure what was causing the patient’s symptoms and what tests to order given that the guy wasn’t having any “chest pain.”
^I suppose it depends on how you define people skills. A doctor can not preface his directions with please, be arrogant and abrasive, or even outright rude and still ask all the medically relevant questions.
Very useful post, iwannabe_Brown. But I think roethlisburger is right that it depends on how you define “people skills.” I would see communicating effectively with a patient about medical care to be a basic part of medical competence. I don’t think it is necessary to be a happy extravert in order to do that.
When I think of “people skills,” I tend to think of social success or success as a salesman. To me those seem different. But maybe the consensus is that the definition of people skills should come closer to the examples in #61.
Sales skills may be helpful if a physician is trying to sell the patient on getting a vaccine instead of listening to anti-vaccine conspiracy theorists, or trying to convince the patient that getting an antibiotic for his/her viral infection is worse than useless.
So “people skills” now mean the stereotype of an insincere salesman? The snake oil vendor? The guy in the used car lot? Pushing it to that extreme doesn’t make sense to me. Doctors can be nice and highly skilled, at the same time. And some of us like when they are. I assume no nefarious intent, when they’re pleasant. If anything, I wonder why someone would be suspicious.
Everyone wants a “nice” doctor. That is pretty reasonable. If we had a freer market in healthcare, doctors who were not nice would have a poor business even if they were objectively pretty skilled. But we don’t have a free market. Patients can’t freely choose their doctors, doctors absolutely have no choice in their patients, and hospitals have a hard time firing doctors. It would seem everyone is stuck with each other.
Doctors, like everyone else, strategize about how they can have a good day at work. For some, that is reducing liability to the max. For others, it is saying yes to every patient demand to avoid complaints. For some others, it is following dull quality algorithms to the letter so they can reassure themselves that they were adequate that day.
We have manufactured shortages of doctors. Admission rates to American medical schools are in the single digits so that even some of our brightest students fail to gain admission to medical school. Meanwhile, we import hordes of doctors from other countries whose cultures are vastly different and whose education systems are vastly different. Some of them are good, others awful.
There are a few doctors who most would consider normal and reasonable. But virtually every patient would consider himself normal and reasonable. Doctors are under many absurd pressures to do unreasonable things in the name of sham quality measures, ersatz patient satisfaction measures, unrealistic productivity measures. Meanwhile insurance companies drive patient volumes independent of all of those variables, hospitals buy up practices, and patients abandon personal responsibility to the nanny state.
So expecting to show up with a sore throat and receiving a loving interchange with an avuncular and charismatic doctor seems optimistic.
Enter the smiling nurse practitioner.
People skills seem to generally refer to the qualities discussed in #61 (for example, look at the corresponding Wikipedia page). If anything, the stereotypical snake oil salesman probably doesn’t display the greatest people skills.
Quant, that is not how most folks in the hiring/talent/HR business define people skills.
There is a large and growing body of literature about “people skills” and the extroverted, sales type personality that you describe is a pretty small piece of it.
And “social success” is often not even included. There is ABUNDANT evidence that serial killers for example- often present with enormous social success. Part of the pathology is their ability to be everyone’s best friend. The popular view of a sociopath is someone sitting alone in a cabin in the woods plotting the downfall of civilization- that does not jive with the statistics on sociopaths who have been convicted of violent crimes, many of whom have led lives as “the life of the party”.
There are many successful professionals with terrific people skills who are quite introverted.
One forgets that being a successful doctor includes a measure of patient loyalty. Except in some cases (let’s say, the uber specialist who will only report to and interact with the primary doctor, or some who will only do a one time service and follow-up,) doctors need to be able to satisfy their patients sufficiently, so they trust, comprehend, follow directions, and return, over time.
That’s not chitchat (or as we say, being “your new best friend.”) It’s a refection of mutual respect and understanding what makes the interaction successful, beyond the science.
Hi blossom–could you please give me some links to the literature on people skills that you mention? I think a Google search is likely to turn up a wide variety of results, mostly not useful.
I don’t think success as a salesman implies insincerity, and certainly not “snake oil.”
I am bound to be accused of parsing words, but it is not clear to me why good ways of interacting with others are thought to be predicated on skills, rather than personal qualities. I realize that both can be developed.
But could someone give an example of a “skill” that is just that, and not linked to personal qualities, such as empathy, thoughtfulness, kindness, and patience?
I looked at the Wikipedia page on “people skills” and found behavior reflecting empathy, respect, friendliness, and sincerity. Sorry to be annoying (I imagine this is to some), but why are those “skills?” It seems to me that the only “skill” would be to pretend to display those qualities, rather than actually having/feeling them. I suppose it would be possible to be empathetic and respectful, while not having anyone else see that, but it’s a little hard to see how (except for a case of extreme introversion or high functioning autism).
A skill is the ability to do something well, some expertise. Personal qualities can contribute.
Certainly, a skilled tennis player isn’t at that level based on PQs such as empathy. Otoh, being a skilled tennis teacher might use those. A skilled carpenter can build your cabinets well. Getting exactly what you asked for may be a matter of the qualities such as the ability to listen, translate, and understand.
One of the things med students are trained in is that ability to listen, not to use the science to jump ahead of what the patient is saying. And, to know what subsequent questions to ask. Then how to apply the science training. IWBB’s heart attack example is good.
Other than the sociopath (and I’d say we need to revisit just how a sociopath or psychopath is seen by the med and psych communities,) it doesn’t matter if one has to ramp up to be pleasant or it comes naturally. Bottom line: be pleasant, however you get there. One can learn the skills to come across as interested. You can learn to say hello and shake hands, the skills in interacting. Then, afaic, go home and brood.
Of course, the cost of medical school (resulting in new MDs with $300,000 in debt) and the limited number of residency slots (despite government subsidy of such) are factors that create the shortage and are unlikely to be changed by going completely free market. We import foreign-educated MDs because many of them do not have the debt levels that US-educated MDs have, so they can afford to go into lower paid specialties (e.g. the primary care ones), particularly in poorer regions.
An interesting article, based on a recent study…
Quant- West Point or the Air Force academy can screen for leadership potential… but that doesn’t mean that a cadet is exempt from four years worth of actual leadership training- followed by years of MORE training once he or she is an actual officer in the armed services.
Companies teach employees active listening skills, how to fire someone, giving and taking feedback (and most of the time it’s negative feedback), influencing skills, how to get someone to do what you need them to do even if they don’t report directly to you, etc.
Some employees have wiring which makes them easier to teach (that’s the innate stuff that you consider “social skills”). But even people not wired that way can learn these skills.
Haven’t you ever had a boss who was able to correct a mistake you made at work without making you feel lousy? That’s a skill which can be taught. And no- that person isn’t “faking it”- they have learned an actual skill (delivering feedback) which is critical for many types of roles. Have you ever worked on a team where one member had the uncanny ability to take a 25 minute argument and bring it to a rapid conclusion with everyone feeling pretty much on board with the decision? That can be taught. No- they aren’t “faking” empathy, they have learned a negotiating skill which allows adversaries to feel a “win” which gives them permission to cave on another element of the argument.
Are people born knowing how to waltz? No. Is it easier to teach someone who is naturally coordinated to waltz vs. someone who is physically awkward? For sure. Is it possible for someone who is physically awkward to learn to waltz? of course.
Re the throat swab, and similar situations - I’m a pediatric nurse practitioner with over 30 years in emergency medicine. I also have 2 daughters who were “difficult” at pediatrician visits when they were young (one had to have dental work under general anesthesia at age 3). I don’t mean to pat myself on the back, but the kids/parents and I almost always part friends, even after a 10-minute visit involving unpleasant procedures. It’s no favor to the kid to imply a choice if they don’t really have one. Cooperating at a medical exam is not equal to blindly obeying strangers. The medical staff can absolutely be kind, respectful, and firm and “let’s get this over with” at the same time. Restraint can usually be done by the parent with the kid in his/her lap. A sticker afterwards really does restore happiness to the small kids. The rare kid who is both large and agitated/combative can seldom be verbally persuaded (this only prolongs the agony); needs to be held by extra people and treated without any shaming afterward.
How are you defining “people skills”? This isn’t about being gregarious vs. an introvert, or having the personality of a top salesman. Do you consider yourself manipulated if you are treated with compassion vs. dismissiveness? Are you offended when a HCP tells you in advance what she is about to do rather than just acting on your person? You are suspicious of someone who treats you with respect, who has an understanding how you might be affected as he gives you the news that your beloved will never wake from his coma, or she has just told you that you have inoperable cancer, or operable cancer that will utterly change your life for the worse?
As a nurse, I’ve had the opportunity to observe the “people skills” of not only doctors, but of nurses and other health care professionals who care for patients. When they are severely lacking, it can be devastating for the patient or family members. With a few notable exceptions, being a doctor by definition puts you in the “people business.” Why anyone would go into a “people business” if he doesn’t like to deal with people is beyond me, but these kinds of HCP are out there in disturbing numbers. I’ve worked alongside some brilliant surgeons (and other doctors) who are actually very good at interacting with their patients, patients who are often quite terrified. These surgeons also understand the benefit of treating staff decently. Their surgical skills don’t deteriorate just because they happen to treat others well. I’ve also worked with surgeons who treat everyone around them like crap, including and especially their patients.They are not better at “cutting” just because they are jerks. Sure, if you MUST choose, you take surgical skill over compassion, kindness, and decency. But the point is that patients shouldn’t have to choose.
Having the ability to effectively deal with your patients(and coworkers) at the same time you utilize the vast amount of knowledge imparted in med school and beyond are not by definition mutually exclusive, though people often seem to think they are. Thus the “I’d rather have a doctor who knows his stuff than one with people skills” comments we often see. Well, I’d rather have both. I don’t want to have to prioritize one over the other. Some of these “people skills” can be screened for and also addressed in med school and residency.
@QuantMech, re. your original question, for me it depends on the specialty.
When my daughter needed surgery the referring doctor gave us two options, the surgeon with very good surgical skills and good people skills, or the surgeon with amazing surgical skills but horrendous people skills. We chose the second. The referring MD was right-the guy was creepy and unable to communicate, and neither D nor I liked him, but the fact that he had the personality of a turnip didn’t matter anywhere near as much as the fact that he was the one more likely to get her out of surgery without complications.
On the other hand, for many years I put up with a PCP with terrible people skills. She was condescending and dismissive and I always left the office frustrated, but since she knew her medicine and I was healthy and hardly ever saw her I kept putting off the task of finding a new PCP. After a radiologist misread my mammogram and sent me home with what turned out to be cancer I knew in my gut something was wrong but I delayed making an appointment with my PCP because I thought she’d think I was a hypochondriac. By the time I finally went to see her the cancer was advanced enough that I needed a year of nightmare treatments resulting in side effects lasting to this day. In this case lousy bedside manner led to a demonstrably worse health outcome.
One of the best things my kids’ pediatrician does is encourage her patients’ parents to trust their own instincts. Thus when D’s stomach ache seemed out of the ordinary I advocated for her and the pediatrician trusted me and gave me an immediate appointment. An hour later she was having an emergency appendectomy. Good people skills on the part of the doctor may have saved D from a burst appendix.
Lately I’ve been dealing with a horde of doctors treating my elderly father. Dad almost died in the hospital when multiple doctors wouldn’t listen to him and hear what he was experiencing.
So while obviously we want both people skills and technical skills from our doctors, from my personal experience I’d lean toward:
Pediatrics, Internal Medicine/PCP, Geriatrics- People skills first.
Radiology, Research, Surgery- Technical skills first.