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Many years ago, as I worked as a Senior House Officer in Maxillofacial Surgery, I was looking after a woman in her early 30’s who had just been told that her head and neck cancer was untreatable, but for some low-level palliative treatment, and that an early death was in inevitable.

I had some business in the side room in which she was residing, some sort of SHO business of taking blood or some procedural thing, I can’t quite remember. She started to speak to me, she started to cry, she started to tell me how it was unfair and that I would never understand what it felt like to not see my children grow up.

There are several such incidents I can remember clearly and vividly from my time in head and neck surgery, incidents that shaped me and changed me and contribute to the person and mostly the clinician that I am today.

I remember also going around the ward as a student and sitting at the bedsides of patients and being forced or encouraged, or both, to speak to them and learn about them and find out about them.

I remember watching extraordinary clinicians who I worked for do this and I remember watching terrible clinicians do it too.

I wonder sometimes now where bedside manner (as it was always known in those days) has gone and why it’s not talked about so much anymore and not considered important.

We might talk about the scientific basis for communication or we might discuss measuring individual’s emotional intelligence using a quantitative matrix but, somewhere along the line, we lost bedside manner as a subject, as a skill, as a tool, as something we were supposed to learn.

It’s perhaps part of the dehumanisation of medicine (and I will always consider dentistry as part of medicine).

It’s about how we train our juniors, it’s about the example we set to them, the way we react to difficult situations for the people for whom we are privileged to look after.

The risk is that bedside manner, in some parts of medicine and particularly in dentistry, has been substituted with what some people call ‘ethical sales’

This of course is extremely wrong and this is the point entirely.

In the same way that I strongly believe that a surgeon should be a physician first, I also believe that a healthcare business man should be a healthcare professional first.

We will complain as we exit dental training that no one taught us anything about business but we certainly shouldn’t substitute the knowledge of business for the knowledge of how to look after the patient by the bedside.

Blog Post Number: 1942