Smile, You're on Video


If you could watch a recording of your latest patient visit, would you be proud of your interpersonal skills?

Fam Pract Manag. 2016 Nov-Dec;23(6):40.

Author disclosure: no relevant financial affiliations disclosed.

You may recall the old television series “Candid Camera,” where unsuspecting persons were caught on video in humorous scenarios and told to “Smile, you're on Candid Camera.” I wonder how many of our patient encounters would make us smile (or cringe) if we were able to watch them.

I have done video monitoring of residents in a family medicine residency program for well over a decade. (We always get permission, of course, and everyone is aware of the camera.) Although it can be intimidating, I am convinced that video monitoring is one of the most powerful ways to help physicians improve their interpersonal skills.

If your patient interactions were recorded today, what would an observer notice? Here are a few of the things we pay attention to with residents:

Physical proximity. We sometimes see residents get inside the patient's personal space, causing the patient to lean backward. It reminds me of a classic “Seinfeld” episode where the character Elaine has a boyfriend who invades everyone's space and is dubbed the “close talker.” On the other hand, we have witnessed residents standing clear across the room from the patient in a manner that may communicate, “I want to keep my distance from you.” The appropriate distance can vary according to culture, so pay attention to nonverbal cues. A good rule of thumb is to allow at least a couple feet between you and the patient.

Empathy. Our residents often think they are exhibiting genuine concern for patients, but when they watch the video, they are surprised at how cold, distracted, or indifferent they seem. Compassion fatigue and burnout only make matters worse. To truly express empathy, make a point of addressing the patient's situation, perspective, or feelings, such as “That must be frustrating” or “How are you feeling about that?”

Catch phrases. At times, we can all fall into the trap of overusing certain words or phrases (“To be honest with you…,” “You know…,” etc.). Years

About the Author

J. LeBron McBride is director of behavioral medicine at Floyd Medical Center's Family Practice Residency in Rome, Ga. He is a credentialed pastoral counselor and licensed family therapist.

Author disclosure: no relevant financial affiliations disclosed.


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