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These Two Things Set ‘Good’ Doctors Apart

As patients, weā€™ve probably all seen doctors we thought were better and worse at their jobs. I met my favorite doctor in graduate school. During my first appointment with her, she remarked with excitement, ā€œOh, youā€™re a PhD student ā€” youā€™ll get this!ā€ and then took the time to carefully provide a detailed explanation of a procedure she was recommending.Ā 

But what exactly is it that sets apart the ā€œgood doctorsā€ from the ones who leave a less-than-favorable impression? To find out, Stanford psychologists Kari Leibowitz and Alia Crum and I recently collected stories about patientsā€™ healthcare experiences. It turns out what seems to matter most is whether your doctor exhibits the right mix of medical know-how and investment in you as a person.

In a survey, the findings of which were recently published in Frontiers in Psychiatry, we asked 334 adults in the U.S., from a variety of racial/ethnic and socioeconomic backgrounds, to explain what a good and a bad doctor meant to them. First, we asked survey participants to describe the positive characteristics that their ideal doctor would possess: Imagine what a good doctor would be like. What good things would this doctor do? What good qualities would this doctor have? This helped us understand what participants were looking for in a dream doctor, whether or not they’d ever interacted with one who checked all the boxes.Ā 

Then survey participants reflected on their own, real-life healthcare experiences. First, they indicated whether they had ever seen a good doctor. If they said yes, we asked what was good about that doctor. In addition to learning about the platonic ideal of a doctor, we were able to get a sense of what appealed to participants about doctors theyā€™d actually seen and liked.

In our paper, we suggest that provider competence and warmth are the key ā€œingredientsā€ in patient-provider interactions.

Their responses revealed a few common themes. Many descriptions ā€” of both ideal doctors and good IRL doctors ā€” concerned whether doctors seemed to ā€œget it,ā€ i.e., whether they demonstrate medical proficiency, knowledge and skill. For example, patients depicted the ideal doctor as one who would be ā€œup to date with newer medical studies.ā€ One patient described a good doctor they’d seen as one who ā€œhad a good knowledge of his field.ā€ Others described doctors who were thorough, attentive and had a good work ethic, such as one who ā€œlooks at any and all alternativesā€ and ā€œwould follow up on small concerns.ā€

The other good-doctor descriptions reflected considerations of whether your doctor seems to ā€œget you,ā€ i.e., whether they demonstrate personal engagement, an interest in connecting and a commitment to patient care. Patients shared stories about good doctors who ā€œhad genuine concern about my well-beingā€ and ā€œlistened to what I was saying.ā€ Many of these stories emphasized the importance of being treated as an individual ā€” for example, doctors who ā€œtreated me as a person, not an illnessā€ and ā€œasked me questions about what was going on in my life,ā€ like my doctor who acknowledged that outside the exam room, I had a life as a PhD student.

These examples all fall into the categories that the psychological literature on social perception calls competence. That includes qualities like intelligence, ambition and skill (the ā€œgets itā€ aspect of medicine), and warmth, meaning qualities like friendliness, empathy and kindness (the ā€œgets meā€ aspect). In fact, research suggests that these are two key dimensions that we pick up on when we first encounter any new person.

In our paper, we suggest that provider competence and warmth are the key ā€œingredientsā€ in patient-provider interactions. The example I shared of my favorite doctor captures both dimensions. She made it clear that she got me as a patient: She remembered something I had told her about my personal life (that I was a PhD student) and seemed to change her behavior toward me accordingly. By giving me a thorough and clear explanation of a complex medical procedure, she also showed me that she got it. Because she demonstrated both of these qualities in tandem, I trusted this doctor more than others Iā€™ve seen where those qualities were less apparent. (A close runner-up for my favorite doctor was one who insisted on meeting me in person before I made an appointment for surgery, saying that he likes to get to see who his patients are before conducting an operation on them. Again, this highlights how important it can be to feel like your doctor sees you as an individual rather than just another body in the operating room.)

Of course, when it comes to displaying competence and warmth to patients, one size doesnā€™t fit all. Providers could communicate both qualities to patients in many ways, and what works for one doctor or patient might not work for others. My doctor taking extra time to explain a procedure was great for me. Some patients might not be interested in so much scientific detail, or might prefer a doctor to realize they have a child sitting in the waiting room and just get to the point.

As another example, touching a patient on the shoulder might feel genuine and help communicate warmth effectively for one provider, whereas for a different one, it might seem like an unnatural gesture and thus make the patient feel less, rather than more, comfortable. Ultimately, what appears to matter for healthcare is that patients perceive providers as both ā€œgetting itā€ and ā€œgetting meā€ ā€” regardless of how they get there.

A large literature suggests that when we expect to get better, we actually improve in response.

Our research also suggests that not only does exhibiting competence and warmth make patients view doctors favorably, it could also influence the effectiveness of medical care. My colleagues and I ran one study in which volunteer patients received treatment for mild, lab-induced allergic skin reactions. Patients had stronger (positive) responses to treatment, we found, when it was administered by providers who displayed high levels of both warmth and competence.Ā 

This finding is supported by a few other recent studies in which patients were more responsive to treatments when providers connected with them socially (see here, here and here). Not only did the positive experience I had with my doctor make the task of managing a health issue far more enjoyable than usual, but it might have increased my confidence that the treatment regimen she chose for me would work well. In turn, my enhanced expectations about treatment might have led me to exhibit more healing after medical care, since a large literature suggests that when we expect to get better, we actually improve in response. The placebo effect is the classic demonstration of this phenomenon.Ā 

Given these findings, patients might consider whether a healthcare provider seems to embody competence and warmth when choosing where and from whom to get medical care. Finding a doctor with both of these qualities could make trips to the doctorā€™s office less stressful and more satisfying. And the very same medical treatment might even have more of an impact when itā€™s administered by a doctor who seems to ā€œget itā€ and ā€œget you.ā€Ā 


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Show Comments (9)
  1. Frances

    Could you please share this article with the medical profession through their associations? The docs need to hear this info! šŸ™‚

  2. Joe Moran

    I cannot agree with these conclusions. Unless you are a doctor yourself, it is impossible to know how knowledgeable or competent your doctor is. A doctor may sound competent and knowledgeable, without being so. So while patients may very will like a doctor who ā€œseemsā€ knowledgeable and competent, this does not establish in any way that the doctor is, in fact, knowledgeable or competent.
    The appearance of competence and warmth does not equate to a doctor being good or bad. Moreover, the best doctors, or professionals in any field for that matter, are not simply competent. Would you really want a heart surgeon who was merely competent? The problem is, there is no way to find out how good a doctor actually is.

  3. Robert

    Reading this merely confirmed what I have observed (I am a medical professional). However, left out is one of the most significant reasons I and others I have interviewed have left providers – the incompetence and/or arrogance of their staff. As a highly trained therapist and former professor (although I do not list these) I greatly resent the failure to listen to my issues/complaints and glossing over/misinterpreting my statements/writings. Sadly I have left some competent colleagues because of their staff. In law, financing and medicine paperwork is 90% of the important tasks (including research and reporting) and if a lawyer, banker/advisor, doctor or staff cannot accurately perform this I leave after attempting to correct the issues. Good articles – good comments – thank you.

    1. Denise Thornton

      I just left a Dr. because he was so arrogant and full of himself. He almost always said my specialists werenā€™t correct which left me panic and anxious but he never offered any solutions. He said he was more knowledgeable than other Drā€™s and would find the cause which he never did. He loved to hear himself talk and I know more about his frustrations, life, bragging than I want to know. Then heā€™d complain about time after spending my time talking about himself. He had a short fuse and would snap at me. He also would only respond directly to my concerns if my husband was with me. He literally would made me cry, question my medical decisions, treat me like a crazy woman and left me feeling crazy. This has seriously caused me depression and anxiety. I just started with a new Dr. and hopefully heā€™s as good as I hear because I have yeRs if medical issues that have been ignored.

  4. Laura

    Yes!! Just made the decision to leave a doctor who told me she ā€˜toleratedā€™ my preference for integrative/functional medical options. She also couldnā€™t be bothered to return my phone call while I was hospitalized with a condition I was seeing her for!

    The comment above mine is very important. The medical community needs to be aware of patientā€™s need to connect. Too many are oblivious and view themselves as authority figures instead of partners in our care.

  5. jane carter

    It was sad to leave a trusted internist because of her insistence in promoting ‘for sale’ products she carried at her practice. These included but not limited to, a skincare line, vitamins, medication to grow eyelashes, a fat freezing treatment, weird tape that one supposedly gets wrinkle relief from. I politely mentioned my need to support 4 children, and my overall disinterest in any of these non-insurance covered items. to no avail, the good doctor pressed on and after 10 years, I left.

  6. Holly

    I like my doctor but her office staff seems disorganized and does not follow up in a timely manner, or not at all. I feel like a number when I have to call her office. I was referred to a specialist and his office needed a copy of a scan my doctor had me take. Her office told them it would take weeks. I don’t know why. I gave them the name of the facility and they got it from them in a timely manner.

  7. George

    Great article! Thank you.

  8. Till

    What surgeon operates on a patient he hasn’t seen before (in an elective operation)? That’s standard.

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