13 Powerful Tips For Incredible Bedside Manner (With Examples)
If you want to be your patients' favorite provider of all time, you've got to have an amazing bedside manner.
1. Get on the same eye level.
A lot of things elevate us over our patients: the scrubs, the white coats, the flashy badges.
And perhaps for good reason: we’re extremely knowledgeable, capable, and, in the end, responsible for their well-being.
But it never feels good to be the one who feels small.
That’s why one of the simplest ways to level the playing field is to get on the same eye level as your patient.
If they’re in bed or sitting down, grab a seat next to them so you can talk to them face to face.
Just the other day, I was talking with an elderly patient of mine who’d been a nurse for thirty-something years and had lived alone with her two black labs until a few days prior.
Now she was crying in the hallway in her wheelchair as she realized her nephew had dropped her off here, gotten rid of her dogs, and that this was her new normal.
I knelt down and put my arm around her.
She looked at me and then to the left, where photos of the rehabilitation team hung. She pointed at them and said, “I guess you all can be my family now.”
Cue the waterworks. “We will be. We so will be,” I said.
Research backs this tip up.
Kelli Swayden, RN and Dr. Paul Arnold found in 2011 in their randomized controlled trial that 95% of patients really liked their doctor if he or she sat down with them as they talked, compared to only 61% of patients whose doctor stood and talked over them instead.
That’s a 56% increase in satisfaction just for sitting down!
Those researchers also found that patients thought their doctors had spent 37% more time with them when they sat down, although doctors spent the same amount of time with patients in both conditions, meaning there’s no time cost to this little trick.
2. Ask them what they'd like to be called.
I don’t know about you, but I really open up to my close friends: I tell them what I’m really thinking and how I’m really feeling.
I can also tell you none of them call me Mr. Groner.
Would you like to be called Mr. or Mrs. Your-Last-Name by everyone that came to see you in the hospital? I sure wouldn’t.
While I get it’s respectful to use a formal title, I think it’s even more respectful to ask, at the start, “What would you like me to call you?” or “What do you like to go by?”
And then just always use that.
Dr. Parsons, Dr. Hughes, and Dr. Friedman found in 2016 that only 1% of patients actually want healthcare providers to call them by their last names5. Only one out of a hundred!
I once had a patient who came to us for short term rehab after a fall at home, but she eventually transferred to long term care because her dementia had gotten too bad for her family to take care of her anymore.
Everyone called her Mrs. Knabb*, from the nurses, to the doctors, to the therapists.
And boy, she was a handful.
She’d constantly ask you what was going on even if you told her 10 times and she always rolled her wheelchair backwards down the hall and crashed into things, from wet floor signs, to linen carts, to other patients.
A lot of us seemed to get overwhelmed by her.
One day, the daughter of another patient came to visit and stopped me while I was talking in the hallway with Mrs. Knabb. “I know her through my older sister!” She said. “They used to be friends. Everyone calls her Lillian.”
It was her middle name.
At the sound of it, Mrs. Knabb looked straight up into her eyes and said, “Well hello! How are you? I’m stuck here for some care and I’m looking for my son,” the most clearly and lucidly I’d ever heard her speak. It was like night and day.
Ever since then, I’ve called her by her name, Lillian, and our conversations have been so much easier. Who knew it could be such a good way to get through to people?
*name changed for privacy
3. Forecast what's coming up and narrate what you're doing so your patients don't have to guess.
As I made my way through the confusing maze of parking garages, elevators, and check-in desks to try to make my 7:15 am GI appointment before a full day of classes, my stomach was tying itself harder and harder into knots.
I had zero food in me and the signs were about as easy to read as hieroglyphics.
My throat was throbbing. When I found the clinic, I sat for a few minutes in the waiting room full of magazines I never read.
Once called back by the nurse, I caught her up on my story and tried not to miss anything. Then vitals and some more questions.
The whole time, I was scouring the exam room for the drawer or cabinet that invariably held the shot they were going to give me (a hold-over from childhood, I think).
All I knew was I was in a new place, had gotten lost finding it, and I was about to have a ten-minute conversation with a doctor that would decide if I lived the next few months in pain or not.
That’s why forecasting and narrating can be so life-giving. It drains the strain from our patients minds.
Orienting patients to the progression of the session you’re envisioning at the start, and then, as you go on, narrating what you’re doing while you do it, takes away all the mental guesswork.
For example, after I ask them if I can come in and what they like to be called, I might say, “First, I’d like to hear about what got you here, then I want to do an assessment to see what’s what, and then we can make a plan together about where to go from there.”
Then, a little into the session, if I find myself growing silent and staring intently at my computer screen, leaving my patient out of my thought process, I might narrate, “I’m looking at the scan they had done of your head to see if the radiologist found anything I should know about.”
In fact, Dr. Wendy Levinson at the University of Toronto and her colleagues found in 1997 that doctors who had never been sued made 30% more of these kinds of orienting comments than doctors who had been sued, for a medium effect size of .537.
Let patients in on what you’re thinking and they’ll let you in too.
4. Ask open-ended questions so your patients will tell you more.
Think of the difference between a kindly therapist asking, “What would you want to talk about today?” and the cashier at McDonald’s asking, “Do you want fries with that?”
There’s a world of difference between how you can respond in those two moments.
In the first, you have all the control. The floor is literally yours.
In the second, the only correct answers are “Yes” or “No.”
How we ask a question vastly affects how it can be answered. If you really want to hear a patient’s story on their terms, ask them an open-ended one.
A safe rule of thumb is that if your question starts with “How…” or “What…,” it’s an open-ended question.
As you go further into the encounter, you may need to ask for more specific details that can’t be asked in an open-ended way, but at least in the beginning, give the patient the floor.
If you can get them talking, keep them talking, and show them you heard them while they were talking, they’ll actually listen to you when it’s your turn to talk. It’s a pretty cool circle.
Dr. John Heritage and Dr. Jeffrey Robinson found back in 2006 that open-ended questions get patients to share their chief complaints for 15 seconds longer than closed questions do (27.1 seconds vs. 12 seconds, respectively).
Those extended presentations are also more than four times more likely to include more symptoms than those in response to close ended questions.
Some of my favorite open-ended questions are:
“What brings you in today?”
“How can I be helpful to you today?”
“What do you understand about your current situation?”
“What do you think’s going on?”
“What else?” (as opposed to, “Anything else?”)
“How does that land on you?”
“What would you like to do?”
“How do you feel about that?”
“What do you think of that?”
“What questions do you have for me right now?” (as opposed to, “Any questions?”)
5. Tell them a bit about yourself.
We ask our patients to open up and share a lot about themselves.
But rarely do they get to learn more about us than the name on our name tags.
I remember the moment I learned one of my professors in grad school was an avid paddleboarder. It turned him from a stodgy professor into a fitness guru in just a few seconds.
I always liked him more after that.
Dr. Brent Morris and his colleagues at Vanderbilt University Medical Center found in 2014 that simply knowing a few facts about their doctors’ backgrounds made patients 42% more satisfied with their hospital stays over controls.
These were little things like where their doctor went to school and what their hobbies were.
Knowing those things led to a 42% increase in patient satisfaction!
So if the time is right, I’ll sometimes say to my patients, “Just to tell you a bit about me, I grew up in Texas, but moved to Nashville for college. My wife, Margot and I, live on the west side of town and are expecting our first baby. Ask me anything that’s on your mind. I’m an open book.”
Apparently that makes them 42% more satisfied with my care.
That’s an easy win to me.
6. Convey the look of being willing to listen.
The other day, a nurse was walking towards me down the hall and I could tell she was just fried.
She didn’t say a word, but she didn’t have to.
She was walking fast, her head down, eyebrows furrowed, and lips pursed tight. Those clues told me loud and clear that she wasn’t available right then.
If our bodies say the same thing to our patients, who could blame them for not engaging deeply, easily, and comfortably?
If you want people to be drawn to you like a magnet, here are some body language signals you can send out:
Put on your warmest and most curious face (go ahead, try it).
Your feet are what “feel it.” They normally point towards where you want to be going. To make people feel wanted, point your feet squarely towards them, saying, “I want to be here with you right now.”
This holds true for where your shoulders are facing too.
Be aware of what your arms and legs are doing. If your arms are crossed tight across your chest and your legs are too, there’s a good chance you’re, consciously or not, closing yourself off from something. Don’t make it the conversation with your patient.
Stay open towards them as much as you can.
7. Give visible signs to your patients they're getting through to you.
One day, a few weeks back, I had to ask my boss if I could have half a day off to make a doctor’s appointment. The only thing was, I didn’t want to use any of my PTO.
I knew it would be an inconvenience for her to find coverage, but I really wanted to try to make it work.
I rehearsed what I was going to say on my drive in and worked up the courage around lunch to walk up and ask her.
I began a little bashfully, then looked up at her face to see how things were going. It was expressionless, like glass.
I kept going, faltering a bit but smiling and looking up again to see where I stood. Still utterly inscrutable. It was a little unnerving, to tell you the truth.
While I got the day off, it was one of the most uncomfortable parts of my week. I don’t want my patients’ appointments with me to be the most uncomfortable part of their week.
That’s why I let my patients’ words physically move me, continuously updating my facial expression in real time to match the information I’m hearing from them.
For example, if I walk into a patient’s room and the first thing they say is:
“I’ve been lying here for ages!” I’d crinkle my eyebrows and shake my head in exasperation too, “...all I want to do is be able go to the bathroom on my own without needing help,” I’d nod in agreement, flash a quick smile, and exhale a sigh of happiness for how great that would be.
Then, I’d just keep doing that throughout the conversation. Whatever he said, I’d make sure I let him know it was getting through to me by letting it affect my facial expressions.
Dr. Wojciech Kulesza and his colleagues found in 2015 that people will like you significantly more if you reflect the feelings they’re expressing with your facial expressions, with a very large effect size of 1.45.
Interspersing the small, verbal exclamations that bubble up from those facial expressions, like “Woah!” (genuinely excited) “Oh no…” (crestfallen), “Really?!” (intrigued) are yet another way to tell your patients you’re tracking with them too.
8. Use a gentle touch (on the shoulder or forearm) to convey warmth and real presence.
One of the most difficult things I do for my job is nasal endoscopy to visualize the pharyngeal cavity during swallowing to see where things go wrong, and I can tell you from experience no one likes getting a tube stuck up their nose while they’re awake.
I’ve seen other clinicians bound up, say they’re going to do a “swallow study,” then push the endoscope through the nare and scope away.
Most of the time, patients jerk away and the study ends up being a nightmare.
That’s why, before I even get near them with the endoscope, I sit down, touch them warmly on the shoulder, and walk them through step-by-step what I’m about to do. A warm touch just seems to work in the really difficult moments.
Dr. Muzza Eaton and a few colleagues found in 1986 that a soft touch helps elderly patients eat 30% more food than without one.
Frank Willis and Helen Hamm at the University of Missouri found that a brief touch makes people 47% more likely to do something tedious for you.
Appropriate squeezes on the shoulder or arm timed in a genuine moment really and truly tell people you care.
Keep in mind that there’s a fine line here, though. Some cultures don’t allow men to touch women and some patients just won’t want you to.
Use your best judgment, but know this is a tool that can help get great healthcare done well.
9. Match the tone of your voice to emulate the emotion you just heard in your patients'.
We spent a lot of time in the fluoroscopy suite during one of my clinical rotations in school doing modified barium swallowing studies to see how well patients were swallowing.
The suite was pretty dark and home to a foreboding machine that looked like it could be a massive instrument of torture. At least, that’s how one of my patients saw it when my preceptor asked him to sit in it for his study.
He went over to it and slid his shoulders in.
“Uh...it’s kinda tight in here. I’m not sure I’ll be able to get through all this.”
“You’ll be fine,” my supervisor said reflexively (we were running late).
We got started and handed him his first cup of liquid barium to swallow. After the first taste, he recoiled from the cup, “This stuff is terrible!” He exclaimed.
“It’s not that bad,” my supervisor said. “We need to see you drink it. Take another sip, please.” He made it a few more but then shook his head. “I can’t do this. We have to stop, I’m sorry.”
The next day, I got to walk our patients through their studies.
When our first one came in and sat down, she asked with slight hesitation in her voice, “So...what’s going to happen in here?” With the same twinge of trepidation in my voice, I said, “This room is pretty cold and dark, isn’t it? I want you to know you’re sitting in a really powerful camera to help us get a great picture of how well you’re swallowing.”
I went on to describe what we were going to do and then, and only then, did I say, “Don’t worry, I’ll be right here next to you the whole time.”
If we respond to our patients with the same tone of voice they just used with us, they’ll know we got how they were feeling.
If they’re heartbroken, we need to sound crestfallen too. If they’re worried, we need to sound a little justifiably tense too.
It’s like playing a game of catch. They throw us an emotion and we have to catch it and throw it back.
When we do, they’ll be assured we understood them. And always, always be warmer than necessary.
Dr. Nalini Ambady and Wendy Levinson found in 2002 that surgeons were almost three times more likely to be sued if their tone of voice was too dominant or brusque and 46% more likely to be sued if it didn’t have enough concern weaved through it.
So make sure yours is extra warm, inviting, and open.
But be careful not to fall into that patronizing, sickly-sweet tone of voice we use with small children, unless you want your patient to feel like a five-year-old.
10. Avoid blind reassurance.
A few months ago, one of my elderly patients stopped me as I walked by and said, “Will you sit with me?”
I knelt down and asked her if everything was okay. “My left arm hurts me from time to time. I’ve already gotten a pain pill for it, but I just needed someone to sit with me while it hurts.”
My breath caught in my lungs at her request’s simplicity.
All the medicine in the world couldn’t beat someone just sitting with her and being okay with it all not being okay. So I pulled up a chair, missed my lunch meeting, and it was the best decision I made all week.
One of first reflexes we tend to have when someone voices discomfort, fear, or pain, is to reassure them that everything will be fine. “You have nothing to worry about,” or, “It’ll all be okay,” are common offenders.
However well-intentioned, they belittle the patient’s perspective as silly.
Making sure a patient doesn’t feel silly first can go a long way in diminishing their anxiety.
Another knee-jerk response is immediately jumping in to try to solve the problem for them.
Some call this the Righting Reflex.
You know that friend or coworker who gives you advice when you share you’ve had a bad day? There’s no doubt the advice is probably useful, but there’s something about someone trying to give you advice right out of the gate that implies you’re not good enough to figure it out.
Sometimes, people just need someone to sit with them in it for a minute.
Then, and sometimes only then, can the helping begin.
11. Putting negative feelings into words reduces their intensity.
One day, in my first few months out of school, I saw my most involved patient yet.
He’d suffered a massive right hemisphere stroke and the left side of his body was completely flaccid. Facial droop, dysphagia, dysarthria, and cognition problems galore.
He was also one of the meanest people I’ve ever met. It was like trying to convince a pit bull to sit and talk to you.
The first day was hard.
But after a few weeks of rehab, we formed a friendship, or, at least, an understanding. I pushed him in therapy, yes, but I made sure his priorities were my own. If he needed something, I’d always make sure he got it.
One night—probably four weeks into his new, difficult life—the whole dam broke and all his feelings rushed out. He shook his head at me and snarled, “I hate this f&#%ing place. I feel like I’m being treated like a damn dog. I’m sick of being stuck like this!”
He was seething.
I widened my eyes in surprise and pursed my eyebrows in real concern. Pause. I nodded.
“I’d be enraged too,” I said, crestfallen.
I’d seen the way some of the staff had snapped at him after he’d cussed them out or how long he had to wait to get help to relieve himself.
Instead of trying to dispel his anger, tamp it down, or sweep it under the rug, I invited it straight out into the open. I put a name to it. Enraged. And far from making him more angry, his face softened a little bit.
He started crying. I put my hand on his shoulder and sat with him while he wept.
A few minutes later, he looked up, wiped his eyes with his good arm and looked at me. “Thank you,” was all he said.
I nodded, silently saluting him. The rest of the treatment session was the best one we ever had.
We don’t often want to talk about things like anger, frustration, or grief because we think talking about them will make them worse. But far from it, talking about them actually makes them better.
Dr. Matthew Lieberman discovered this in 2007 when he and his colleagues at UCLA looked at people’s amygdalas when they were uncomfortable.
They found that having an internal, uncomfortable emotion like “afraid” or “angry” named out loud in words reduced activation in their amygdalas by a large effect size of .87. Verbalizing negative feelings out loud actually causes their power to diminish.
“That sounds so frustrating,” or, “I would be so exhausted too,” or, “You know what? You’re right, this is scary,” are all perfect examples.
Get comfortable with being uncomfortable.
Negative emotions don’t really have all that much power when you call them out into the light.
12. Say more by talking less.
Once, a patient of mine who’d had a bad stroke was getting ready to go home.
Despite some of the best and most creative treatment of my career, he was still dependent on his PEG tube for all his meals and had significant trouble swallowing even ice water or pudding.
I sat down with him and his wife and pulled out a sheet packed full of recommendations I’d made for when they got home.
It started out well, but then I got a little flustered. I had to get through a lot in a short time.
I flew through it, barely looking up to see if they were with me.
When I got to the end, I knew instantly from their eyes they probably hadn’t followed the last half of what I said.
That’s when I remembered something I’d read in grad school: patients only accurately remember 25% what we tell them.
Only a quarter. The rest? Poof.
That’s why I try to talk less most of the time. I just say something simple and true and then leave space for them to respond. To ask questions. To signal understanding. Then I go on.
It keeps me from rambling (which I’m prone to do) and boxing my patients out with word vomit.
Communication guru Alan Alda puts it this way, “If we talk to our patients without making sure they got it, did we really communicate anything, or were we just making noises?”
13. Smile and laugh, often.
One patient of mine loved jokes so much he kept three books of them by his bed.
Naturally, I asked him to tell me one during a quiet second. He paged through one of the books.
“What do skeletons say before they eat?” I thought for a moment, then shook my head. “Bone appetite!” he laughed, his eyes twinkling.
I cracked up.
“Well, sometime I hope to get to eat with you.” He looked up, “I hope you do too.”
It was a small thing, but it was a big thing.
Smiling lowers your heart rate by seven beats per minute. And doctors who have never been sued laugh 40% more with their patients than doctors who have been, for a medium effect size of .49.
If you genuinely enjoy the people you help, smile abundantly, and make light of the silly things, they’ll really enjoy you too.