A fresh perspective has emerged from a recent study suggesting that physicians interacting with hospitalized patients on the same eye level can foster enhanced trust, satisfaction, and potentially improved clinical outcomes. This indicates that when doctors sit or crouch beside a patient’s bed while discussing their diagnosis or treatment plan, it can be more impactful than standing.
This research was conducted by a joint team from the University of Michigan and VA Ann Arbor Healthcare System, and their findings have been published in the Journal of General Internal Medicine. The researchers embarked on this study as part of a broader assessment focussing on the effects of various non-verbal factors on patient care, perceptions, and outcomes.
The team encourages healthcare professionals and hospital administrators to promote more bedside sitting until the final results of their ongoing study are out. This can be as simple as ensuring folding chairs or stools are readily available in or near patient rooms. In line with this, the Lieutenant Colonel Charles S. Kettles VA Medical Center, part of the VA Ann Arbor, has already introduced folding chairs in many of its rooms.
Nathan Houchens, M.D., a faculty member of the U-M Medical School and VA hospitalist, along with U-M medical students, delved into this topic with a particular focus on physician posture. According to Houchens, the power dynamics and hierarchy in hospital-based care can be significantly altered if the attending or resident physician interacts with patients at eye level instead of standing above them.
Houchens noted that their systematic review revealed only 14 studies that met the criteria for evaluation, and just two of these were rigorous experiments. The studies spanned a wide variety of metrics, from the duration of patient interaction and patient impressions of empathy and compassion to hospitals’ overall patient evaluation scores.
While the data generally indicated a preference among patients for clinicians who sit or engage at eye level, this was not always the case. Houchens also mentioned that even when physicians were assigned to sit with their patients, they often failed to do so, especially in the absence of dedicated seating.
Houchens and his team hope their work will bring greater recognition to the importance of sitting at the patient’s level. They believe making seating available, encouraging physicians to sit, and senior physicians setting an example for younger practitioners could all contribute to this cause.
A new VA/U-M study, funded by the Agency for Healthcare Research and Quality, is currently underway. This study, known as the M-Wellness Laboratory study, includes physician posture as part of a series of interventions aimed at making hospital environments more conducive to healing and fostering stronger patient-provider relationships.
The research team will monitor any differences in hospital length of stay, readmissions, patient satisfaction scores, and other metrics between the units where these interventions are being introduced and those where they are not yet implemented. This study was made possible through funding from U-M and VA resources, while the ongoing study is supported by an AHRQ grant.
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