I always enjoy posts from Psychology Today. This one is ‘What can you learn from a handshake?’ Medical students I've taught will know the importance I put on shaking your patient’s hand when you first meet them. I’m a believer in the power of touch for creating strong relationships between people, as well as a therapeutic tool in medicine on a number of levels.
Touch has been shown to be linked to interesting outcomes in non-medical situations. In psychological experiments, a light touch on the arm when asking people in the street to complete a questionnaire led to compliance rising from 40–70% (1). A second touch during the interaction led to even higher compliance. When an experimenter asked for help picking up an object they dropped, a light touch on the arm led to assistance going from 63% to 90% (2). People were more likely to be honest about money found in a public street when questioning was accompanied by a light touch on the arm (3) and waiting staff in restaurants will receive better tips if they touch diners when returning their change (4).
It was the touch of percussion documented by Leopold Auenbrugger (5) in the late 1700's, that moved medicine beyond the barber surgeons offering empirical treatments of blood letting, cupping, purging or gruesome surgery. Shortly afterwards, the stethescope was discovered by René Laennec in Paris and suddenly the barber surgeon gave way to a physician, making use of his skills of diagnostic touch.
As doctors, I think we are guilty of gradually eroding the amount of touch we offer our patients, especially as diagnostic technology seems to offer more accurate alternatives. If we are not careful, the attention to our ‘e-patient’ on the typed hand-over sheet, ward flow software, in lab results and MRI scans is going to replace the important diagnostic and therapeutic tool we all learned in medical school. Clinical exam is a ritual of exceeding importance, where you will discover pathology often more quickly than through CT or ultrasound. Avoiding a thorough examination also compromises the patient-physician relationship, which we know underpins our treatment.
The handshake provides this first connection with our patient, marking the beginning of that relationship; a contract of trust, accompanied by eye contact and a genuine greeting. The quality of the handshake tells each party something about the other. During the course of the history, when the patient relates the details of her illness or a life experience, the doctor’s hand on her arm or shoulder during a moment of distress demonstrates to her, that her physician empathises and is there to support her.
Keep touching your patients, shake their hand when you meet them. And make it a firm one.