You’ve probably heard somebody talk about a doctor’s “bedside manner”. It can be fun to watch television shows such as House, M.D., where the doctor is not-so-nice to his patients, but there is a very real reason that doctors like this are often not successful in the real world, and why part of a doctor’s medical training includes learning how to communicate with their patients and treat them appropriately, especially after a major medical event such as childbirth or surgery.

While you can guess that the way a doctor interacts with their patient can affect their psychological well-being, you might not have considered the fact that the same interaction can influence the patient’s perception of pain. In fact, one study has shown that discussing pain with patients who have had a Caesarean childbirth adversely affects their perception of pain, and can actually make them feel worse.  This raises several important for both doctors and patients as they consider what it means to have a good “bedside manner”.

There are two ways to quantitate the perception of pain.  One is a numerical scale (http://pain.about.com/od/testingdiagnosis/ig/pain-scales/Numerical-Scale.htm) and the other is a visual analog pain scale, also known as the FACES or Wong-Baker scale (http://pain.about.com/od/testingdiagnosis/ig/pain-scales/Wong-Baker.htm),   These pain scales allow the physician or nurse to get a better idea of the extent of the patient’s discomfort.  Still, even with these pain scales, some doctors still will act like “House”.

Talking about pain  is also a complex issue because it forces both doctors and patients to consider how they will manage pain and discomfort after surgery or childbirth. On the one hand, it is important for the doctor to know that their patient is feeling all right, and that there are no potential complications that need to be addressed. Some patients, especially those who have never undergone major surgery before, may feel that certain types of pain are “natural” and will not speak about these issues with their doctor. However, if asking about pain leads to negative effects, it important for doctors to choose their wording carefully in order to acquire the information they need while still aiding in their patient’s comfort.

It is always important for patients to have a doctor whom they feel that they can trust—who they already know through interacting with them has a bedside manner that meets their needs. This is especially important for women who are preparing to give birth, as they will want to heal as quickly as possible so they can begin to care for their newborns.

– Yvonne S. Thornton, M. D., M. P. H.