Please, Have a Seat

Premier Pulse     May 2021

Belcastro_336x336By Marc Belcastro, DO, system chief medical officer, Premier Health

Do you ever sense that internal dread when you are hurried, and someone invites you to have a seat? Doesn’t it take more of our time when we sit down for an exchange of information? I would guess in some instances the answer is yes. Many physicians and APPs tell me sitting down for patient encounters would take too much time. It might, though studies do not support this claim. Even if the encounter is a bit longer, it often takes more time (often while under stress) to address communications breakdowns that can occur in the absence of front-end conversations. Patients commonly perceive a provider has spent more time at their bedside when a provider sits rather than stands. Sitting at a patient's bedside, in the inpatient setting, is recommended as a best practice but has not been widely adopted. What does the literature say? Plenty, and the following is a small sample.

The study below was a prospective, randomized, controlled study with 120 adult post-operative inpatients admitted for elective spine surgery. The abstract states, “The actual lengths of the interactions were compared to patients' estimations of the time of those interactions. Patients perceived the provider as present at their bedside longer when he sat, even though the actual time the physician spent at the bedside did not change significantly whether he sat or stood. Patients with whom the physician sat reported a more positive interaction and a better understanding of their condition. Simply sitting instead of standing at a patient's bedside can have a significant impact on patient satisfaction, patient compliance, and provider-patient rapport, all of which are known factors in decreased litigation, decreased lengths of stay, decreased costs, and improved clinical outcomes. Any health care provider may have a positive effect on doctor-patient interaction by sitting as opposed to standing during a hospital follow-up visit.”

What about hospitalists? The authors of the article below performed a cluster‐randomized trial of seated versus standing physician posture during inpatient rounds on a hospitalist service at an academic medical center. The abstract states, “Patients whose physician sat were significantly more likely to rate their physician highly on measures of listening carefully and explaining things in a way that was easy to understand. The average time spent in the patient's room was approximately 12 minutes and was not affected by physician posture. Patients' perception of the time their physician spent in their room was not affected by physician posture. Sitting at the bedside during rounds does not increase the amount of time spent with the patient but may improve patient‐physician communication.”

I always tried to sit when talking with parents in the NICU. The feedback from families to the staff were almost always around the fact that I sat verses what I said. Why not commit to sit?

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