The doctor -patient relationship is complex one. A lot of factors come into play. These are to do with doctor's own personality, family background, workload, work environment etc. Also matter the patient's background, education, etc Mostly it is to do with workload and to some extent the patient's repeated silly questions which needs common sense and not medical knowledge to answer. When confronted with such situations just nod your head rather then give a rude reply. In my opinion rudeness should be avoided at all cost.

1. Rude behaviour of
patients or doctors
Man Mohan Harjai

2. Introduction
• The doctor -patient relationship is complex one
• A lot of factors come into play
• These are to do with doctor's own personality, family
background, workload, work environment etc
• Also matter the patient's background, education, etc• Also matter the patient's background, education, etc
• Mostly it is to do with workload and to some extent
the patient's repeated silly questions which needs
common sense and not medical knowledge to answer
• When confronted with such situations just nod your
head rather then give a rude reply
• In my opinion rudeness should be avoided at all costs

3. Introduction
• Only when one of our dear and near once
share the experience of rude behaviour by our
professional colleague, we wake up and fume
• Personal experience as a patient (without• Personal experience as a patient (without
exposing our identity) will help us to change
our behaviour
• Courtesy and tender loving care (inherent in
us) need to be refreshed

4. Introduction
• Being in profession for 33 years and last 5
years as an administrator, I can vouch for the
fact that negative feedback of the patients are
directly proportional to the overall behavior ofdirectly proportional to the overall behavior of
the medical team, where physician is the
leader
• All of us must learn to be polite, courteous,
clear and should listen patiently and carefully

5. Introduction
• The patient profile has changed over the
years, so we must align ourselves to this fact
• An irritated patient goes to social networking
site and splash venom, which now we cannotsite and splash venom, which now we cannot
afford because of the competition
• The key is to still remain equipoise and stop
finding faults with patients as changing
patients is not in our hands, while we can
definitely work for changing ourselves

6. Patients perspective
• Patient find them rude for two reasons
– Telling a patient about complications of any
procedure or disease, they don't want to accept
any complication even told before admission, theyany complication even told before admission, they
want to listen all good things
– Medical services are expected to be free of cost,
patient don't want to pay so doctors when ask for
it, they look rude to people

7. Patients perspective
• A patient is already going through sufferings, is uncertain of the
outcomes, insecure and at times helpless
• Patient comes with high hopes and feels as if the doctor will be able
to reply all the queries
• Patient is not aware about a doctor's limitations• Patient is not aware about a doctor's limitations
• Yes, we are also human beings but I hope you all will agree that
most of us have entered this profession by choice and delivering
good service is the essence of our profession
• Encountering an irritated or irate patient/attendant is a part of
medical profession
• The major difference with other professions is that our customer is
already in pains and we are dealing with life and death
• Hence, we should be more sensitive and empathetic.

8. Doctors fact
• The rude behaviour of the doctors with their patients
depends on various factors
– Sometimes, although we are not rude but our tone
pretends as we are due to personal traits like patience,
kindness, tone
– If our working condition and surrounding is healthy /– If our working condition and surrounding is healthy /
happy we will reflect that only
– In govt. hospitals with loads of patient in a small room with
barely ventilation and full of offensive smell one can loss
his patience
– Enjoy your speciality, even under stress and over crowding
– Most of the times the patients and his accompaniers are
solely responsible for doctors rudeness
– Money matters is a least priority but sometimes the cause
of rudeness

9. Doctors fact
• Doctor gets impatient when the patient asks again and again on the
same issue which is explained and also brings the relatives and tells
the doctor to explain again
• This is a regular and very common reason for shouting or raising voice
• This happens only in Govt. set up as the doctor has to see so many
others who are waiting for his services to be over in fixed number of
hourshours
• If one doctor spends half an hour with a patient explaining the cause
for disease, certainty of diagnosis, investigations and possible therapy
success of cure and complications etc one can expect to see only 8
patients from 9 am to 1pm, but a Govt. doctor would see 40-50
patients with in this time, so is it correct to blame the doctor
• It is the system, but when patient and relatives get dissatisfied they are
not scolding /beating the system they are beating doctors

10. Doctors responsibility
• The onus is always on the doctors to behave and be
professional no matter what the situation, patients will
be patients after all
• Being riddled with anxiety, doubts, fear, suspicion and
many other negative feelings about their illnesses andmany other negative feelings about their illnesses and
the healthcare system, they approach the doctor with
immense expectations and skepticism
• The doctor has a complicated maze to negotiate while
dealing with patients and their problems
• This increasingly fragile relationship can run into rough
weather at any time

11. Doctors responsibility
• More often than not the doctor is blamed for the
failure
• If we maintain a professional attitude, we have no
reason to worryreason to worry
• A firm but polite approach is needed when dealing
with rude or unnecessarily inquisitive patients
• The amount of fees doctors are charging or the
number of patients doctors are seeing in a day
cannot justify being rude or otherwise

12. Doctors responsibility
• Quality Care delivered to patients depends upon
the doctors words, deeds & bed side manners
• Word of mouth spreads far & wide regarding the
well being of the individual how he/she workswell being of the individual how he/she works
• The doctors are their own marketing managers
• Seeing all the possibility of being humble, polite
& diplomatic pays its due in the long run

13. Doctors behaviour
• Rudeness totally depends on oneself which is constantly
modulated by various factors few are mentioned in
previous slide
• But for constant good behaviour with your patient
• you should be healthy from inside
• your mind should be cheerful• your mind should be cheerful
• practice to maintain yourself cool
• Always take some break for few minutes and try to read a
joke, facebook, mails etc
• Nurture good hobby
• Try to plan the day in morning itself and try to stick with
that plan
• I always try that I should not be hungry while I deal with
patients so accordingly have enough breakfast and lunch

14. Scenario in India
• The doctors may not necessarily be rude but they may
appear to be so due to hurried disposal of patients in
OPDs and wards teeming with patients and relatives
• They develop a sublime art of not paying attention to
things they consider less relevant when their overriding
concern is to do justice to as many patients to the bestconcern is to do justice to as many patients to the best
of their abilities
• Sometimes there is just no place in the OPD to have a
private conversation or counseling or to deal with an
aggrieved patient or relative
• Not surprisingly everything revolves around the
Doctor's convenience rather than the patient's, in
Indian scenario

15. Scenario in western countries
• In western countries everything revolves around
patients and their convenience where a rude doctor
will be noticed immediately by everyone, and if not the
patients, the nurses will escalate the matter to the next
level
• After moving to corporate hospitals some doctors with• After moving to corporate hospitals some doctors with
newly found time, space and ancillary staff or may be
for fear of adverse reaction from patients /
management start displaying their subdued courteous
side
• Optimum infrastructure and ancillary staff can make
things easy but it will never be a substitute for greater
time that a doctor can spend with a patient

16. Doctor-patient relationship
• Set a good example for your colleagues and
subordinates so that they also understand and
follow the nuance of it
• Love your profession,
• Love your job• Love your job
• Love your patients
• Ultimately develop a good culture
• A short capsule course of management should be
a part of MBBS curriculum
• A general awareness should be created to respect
medical profession

17. Effective doctor-patient
communication
• Few soothing satisfying words, this is what our
patient expects
• Effective doctor-patient communication is a
central clinical function in building a trustcentral clinical function in building a trust
which doctors enjoy with the tag #doctor the
messiah
• Much patient dissatisfaction and many
complaints are due to breakdown in the
doctor-patient relationship

18. Effective doctor-patient
communication
• The communication learning to communicate effectively
means making the most of every opportunity to interact
with others: to be positive and encouraging to your
team, to show empathy and concern to your patients,
and to be able to deal with demands and difficultand to be able to deal with demands and difficult
emotions
• Finally, interviews with patients who have filed
malpractice suits against their physicians often site poor
communication and lack of empathy as a factor in
pursuing legal action

19. 5A for patients Questions
• Availability
• Appearance
• Attitude
• Ability• Ability
• Answer
When all 5A are present your all patients get
satisfaction and then doctor take a long deep cool
breath, you feel good relaxation, your rudeness
ultimately disappears

20. Suggestions for medical practitioners
• We have to be empathetic
• We have to spend more time with patients
• We have to reduce our work , if we are over burdened
• With internet having more penetration in our society,
patients will ask several questions. No question is rude or
idiotic as all of us agreeidiotic as all of us agree
• If we feel, we cannot handle a particular patient, we have
to stop treating such a patient( except an emergency)
• We have to change our attitude towards patients and adapt
to modern society
• Being busy, or overworked, or patient paying not enough,
none of these is a justification to be rude and not spend
time to communicate properly with family and patient
• If we do this, medico-legal cases in our country will come
down by 80%

21. Summary
• Good communication with patients regardless
of a busy schedule & good documentation of
all in-hospital interventions are the way out of
litigationlitigation
• Communication skill development is a basic
requirement in clinical practice
• Overall, the one thing patients want the most
from their doctors is empathy

22. Conclusion
• No doctor wants to be rude to the patient as
we are not there without the patient
• The need for doctors to be polite, empathetic
and concerned with their patients cannot beand concerned with their patients cannot be
overemphasized