What social skills that every medical student must know, but are not taught in medical college?

We all know social skills are particularly important in the medical profession where emotions are extremely high, we must deal with patients and their relative’s emotions in highly volatile situations. Among students we notice a significant variance of social aptitude, so I personally feel there should be a curriculum for imparting social skills among the medical community.

But Medical colleges are known for the meticulous and rigid practices and any deviation from them will not be entertained by senior faculty. So vital skills like social aptitude are not taught, in fact many senior practitioners also lack these skills.

So, I compiled a list of practices that I follow based on my experience which got me good terms with my patients.

Give them a bright Smile

Everyone likes a pleasant doctor not a long-faced strict one, besides a smile is contagious. It will impart a friendly environment around you and make you more likable. But keep in mind that plastering a big smile always will make you look comical.

So, when should we smile? 

Just as we look at the patient’s face have a fraction of the second delay and then start smiling. This conveys that the smile is not for everyone this smile is exclusively for you.

How much should we smile?

Too little and the smile goes unnoticed and too big the smile looks weird. Strike a balance in between so that your teeth are just visible but not too much, I personally use my canine teeth a landmark for how wide my smile should be. Do practice looking at the mirror and find what is best for you. Because of the use of face masks our smile may not be visible, so try narrowing your eyes as if you looked at a bright light. The contraction of orbicularis muscle replicates the emotion of a genuine smile.

Remember personal details

Nothing makes your patient feel special than you remembering their personal details. What is a personal detail that you can remember of a patient?  please do not tell “diagnosis”. Many medicos communicate using a patient’s diagnoses to establish their identity eg- send INR for AF patient, and It makes them feel objectified.

You can start by using patient’s names, it is unique to them and makes them feel special. As your rapport builds you can enquire more details like remembering their village and enquire about their job, children, etc.

Pro tip – write small cues about their personal details at the end of the case sheet which you can quickly refer before going to rounds.

Be a good listener

I heard a quote that said, “Most people do not listen with the intent to understand; they hear with the intent to reply.” The best skill a doctor can have is listening. Most of the time we just hear what the patient says not trying to understand what they are really conveying. We tend to look at what they say in a uni-dimensional way only from a medical perspective and tend to miss out on the hidden context.

That is what differentiates “listening” from “hearing”. Listening is an active process in which we understand subtle untold things the speaker wants to convey. 

For example, if an old lady says she lives alone at her house and her kids rarely call her, which indirectly translates to I just want someone to talk to me. If still active listening is not your cup of tea just hear what they say maintaining eye contact. When you have spent enough time and want to end the conversation, break eye contact, and turn away from the speaker, most of them will understand the cue.

The healing touch

There has been a shift in medical practice from a clinical approach to an evidence-based approach. The shift has caused physical examination to take a backseat. We rationalize – Why spend 20 mins auscultating the heart when you are going to order an Echo anyway? This led to the creation of an imaginary barrier between patients and doctors, and in this COVID era the barrier grew larger.

However irrelevant the physical examination may be, many patients still expect it. They need a comforting touch during times of pain – a gentle tap on their shoulder or holding a hand during blood pressure examination would suffice. I personally witnessed – many of my mother’s (gyn & obs practitioner) patients constantly tell that her hand is magical; once you touch us, we feel better instantly.

Once this pandemic crisis passes readopting small practices of physical examination establishes a better connection with your patients.

Do not tell patients they are wrong

In our career we come across lots of patients with psychosomatic disorders and from our perspective there is nothing with them. But looking it from their perspective there is something terribly wrong and they are suffering because of it. The worst thing we can do is antagonizing their emotions and telling “everything is in your brain”, “you are just acting “, “go visit a psychiatrist”. Refrain from using such phrases, it will cause them to doctor shop and leave a bad taste with you. Put it to them in a more palatable way by using phrases like “sorry I could not find anything wrong with you, maybe I can refer you to my friend who is better equipped to handle such cases “.

The same applies to the use of homeopathy, Ayurveda, or any alternative forms of medication. Please do not antagonize their beliefs, convey to them “I personally don’t believe the use of alternate medication, but if you truly believe you can use them”.

 They will be having nothing but praises for your compassionate nature, and what is better than a good word of mouth publicity.

Step into their shoes

Last but the most important of all, even if you do not follow all the above-mentioned steps, this one step will take you far. Treat them how you want to be treated.

 This makes me remember an incident from my UG days when I saw my junior examining a patient without his consent and the patient is clearly in distress because of it. At one-point patient told enough, instead of complying with his wish the young medico said, “this is a government hospital you can’t deny me from examining you”. At that point I realized how socially handicapped and entitled we have become. Is this how I want to be treated? no, not in a million years. So Please step into their shoes and respect their privacy, their customs, religion, and beliefs.

All the above-said things are like quick fixes, in medical terminology are like symptomatic treatment instead of addressing the root cause. Nothing can replace true genuine compassion for patients. You may be busy, you may not even be having time to eat, but if the time permits, be in the present moment and try to truly connect to them. Do not expect anything in return besides what is more rewarding than true human compassion and bonding.

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