Article Text

other Versions

Download PDFPDF

How good are doctors at introducing themselves? #hellomynameis
  1. Peter Gillen1,
  2. Sue Faye Sharifuddin1,
  3. Muireann O’Sullivan1,
  4. Alison Gordon1,
  5. Eva M Doherty2
  1. 1Department of Surgery, Professorial Unit, Our Lady of Lourdes Hospital, Drogheda, Ireland
  2. 2National Surgical Training Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
  1. Correspondence to Professor Peter Gillen, Department of Surgery, Professorial Unit, Our Lady of Lourdes Hospital, Drogheda, Co Louth, Ireland ; pgillen{at}rcsi.ie

Abstract

Background This explorative study was triggered by the ‘#hellomynameis’ campaign initiated by Dr Kate Granger in the UK. Our objectives were twofold: first, to measure rates of introduction in an Irish hospital setting by both consultant and non-consultant hospital doctors. Second to establish whether such practices were associated with patient perceptions of the doctor/patient interaction.

Method A patient ‘exit’ survey was undertaken following doctor–patient consultations in both acute (surgical and medical assessment units) and elective settings (outpatient clinics). The survey was carried out over a 5-month period by three trained clinical observers.

Results A total of 353 patients were surveyed. There were 253 outpatients and 100 inpatients surveyed. There were 121 outpatients (47.8%) who attended a surgeon, 73 were medical (28.8%), while 59 (23.3%) were divided between obstetrics, gynaecology and ophthalmology. One hundred acute presentations were surveyed: 52% in the emergency department, 20% to the acute medical assessment unit, 21% attended the acute surgical assessment unit and 7% attended other specialties/departments.

Conclusion According to the returned forms, 79% of doctors (n=279) introduced themselves to patients. Eleven per cent (39) of doctors did not introduce themselves, and 8.5% of patients (30) were unsure whether the doctor had introduced themselves. Five patients left their response blank.

Consultants were significantly more likely (P=0.02) to introduce themselves or shake hands than non-consultant hospital doctors. Gender had no bearing (P=0.43) on introductions or handshakes regardless of grade of doctor.

Three hundred and seventeen patients (89.7%) felt that an introduction had made a positive difference to their healthcare visit. Thirty patients (8.5%) felt it did not make a difference and 8 patients (2.2%) were unsure or failed to answer.

This study has highlighted the importance of introductions to patients. Definite evidence of an introduction was documented in 79% of patients with 14.5% either not receiving or could not recall whether an introduction had been made on repeat visits. 6.5% stated that they did not receive an introduction.

  • #hellomynameis
  • patient/doctor communication
  • handshake
  • audit
  • quality in health care

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Introduction

‘Remembering to introduce oneself may help to put patients at ease, make patients feel more comfortable, improve patient satisfaction and reduce complaints.’1

‘A proper introduction is more than a common courtesy—it is fundamental to providing excellent and safe care.’1

The author of these words, Dr Kate Granger a doctor and a patient with terminal cancer initiated the ‘#hellomynameis’ campaign on Twitter in August 2013 when she was hospitalised with sepsis.2 She felt disheartened with the number of staff who failed to introduce themselves to her and that ‘as a patient you are in an incredibly vulnerable position. The healthcare team knows so much personal information about you, yet you know next to nothing about them’.1

Despite the fact that knowledge of the physician’s role on the attending team has been linked with patient satisfaction,3 4 only a minority of patients know the name of their attending consultant.5 The first few moments a doctor has with a patient sets the tone for a medical consultation and is the foundation on which the doctor–patient relationship thrives or collapses.6 7 There has been little research into the value of greetings in the medical setting, perhaps because it seems so obvious.7

Over a 5-month period (December 2016–April 2017), we asked the following research questions to direct this study:

  • What percentage of doctors in both acute and outpatient settings introduce themselves to patients?

  • Do more consultants introduce themselves than non-consultant hospital doctors (NCHDs)?

  • Do patients notice that doctors have introduced themselves?

  • Do patients think that introductions make a difference?

Methods and materials

A questionnaire (figure 1) was designed to assess quality of doctor–patient communication and the impact of this on patients’ perceived satisfaction with their doctor’s consultation. The questionnaire was administered by face-to-face interview, and responses were entered onto the questionnaire sheet.

Patient recruitment

Patients were approached during the research period and invited to participate in a brief interview administered by the three junior doctors (SFS, MO and AG). Patients were selected via convenience sampling from the outpatient department (OPD), the emergency department (ED), the acute surgical assessment unit (ASAU) and the acute medical assessment unit (AMAU). Patients were excluded from participation if they had known cognitive impairment (including dementia and delirium), were non-English speaking or were too acutely unwell to participate. Verbal informed consent was obtained from all participants. The study was unfunded. Ethical approval was not required.

Data collection and management

Data collected from the interviews were inputted by one of the primary researchers onto an Excel spreadsheet and subsequently analysed. Data were subdivided into OPD and non-OPD (including ED, ASAU and AMAU).

Results

A total of 353 patients were interviewed for the study: 253 in OPD and 100 in non-OPD. There were 180 female patients and 172 male patients with an average age of 44 years.

Statistical analysis

The demographic data is summarised in table 1. The Statistical Package for the Social Sciences (SPSS) V.22 was used to analyse the data using χ2 tests for independence. Effect sizes (Cramer’s V) were included to assess the magnitude of the effect size for a χ2 with more than two variables8 as follows:

Table 1

Demographic data

Small=0.06 Medium=0.17 Large=0.29

Consultants were significantly more likely to introduce themselves (χ2 (1, n=353)=20.19, P=0.02, Cramer’s V=0.14) and/or a shake hands (χ2 (1, n=353)=12.71, P=0.05, Cramer’s V=0.13) than non-consultant hospital doctors. Established guidelines indicate small to medium effect sizes for the association between the seniority of the doctor and the likelihood of an introduction and a handshake.8

There was no association found between the gender of the doctor and the likelihood of an introduction (χ2 (1, n=353) =4.82, P=0.57, Cramer’s V=0.08) and/or a handshake (χ2 (1, n=352)=3.83, P=0.43, Cramer’s V=0.43).

Of the 253 patients from OPD, 47.8% (n=121) attended a surgical clinic, 28.8% (n=73) attended a medical clinic and 23.3% (n=59) attended other clinics including obstetrics, gynaecology and ophthalmology and so on.

Of the 100 non-OPD patients, 52 attended ED, 20 attended AMAU, 21 attended ASAU and 7 attended others (minor operations and Clinical Decision Unit).

Of the total of 353 patients who completed the questionnaire, 42.5% (n=150) were seen by a consultant, 28.6% (n=101) were seen by an NCHD, 3.4% (n=12) were seen by both a consultant and NCHD and 25.5% (n=90) were unsure of what grade doctor they were seen by.

Of the 353 patients, 79% (n=279) of doctors introduced themselves, 11% (n=39) did not introduce themselves, 8.5% (n=30) could not remember if a doctor introduced himself/herself and 1.4% (n=5) of responses were left blank.

A percentage of 89.7 (n=315) of patients felt that an introduction made a difference to their healthcare visit, 8.5% (n=30) felt it did not make a difference and 2.2% (n=8) were unsure or did not answer.

Overall, of the 267 patients who answered the feedback/comment section, there were a variety of positive responses received. The most common phrases included: ‘it is nice to know the doctor you are seeing’ (14.6%), ‘more friendly’ (11.6%) and ‘more personal’ (9.7%). In total, 71% of doctors shook hands with the patients.

Discussion

This study aimed to assess whether doctors were introducing themselves to patients and if so whether this was associated with the patient’s perceived satisfaction with their consultation. The majority of patients reported positive medical encounters. We are pleased to report that 79% of doctors introduced themselves and 71% shook hands with the patient. This is reassuring as it has been previously reported that more than half of patients expected greetings with a handshake and a full self-introduction by the attending doctor.9 10

In situations where the doctor did not offer an introduction, 50% of the patients reported that they knew the doctor from previous hospital visits. A large proportion of these patients were seen by a consultant, except for three follow-ups that were seen by NCHDs. All of these patients were reviewed in the OPD setting. In a non-OPD setting (ED, AMAU and ASAU), only 5 of the 100 patients that we surveyed did not receive greetings in the form of a handshake and/or introduction, indicating that the first encounter in a busy hospital environment normally consists of some form of introduction.

The majority of the sample were older than 65 years (n=94), and we identified that approximately one-third of patients who did not remember if the doctor introduced themselves came from this age category. We assume there is a possibility these patients could not recall this information due to the severity of acute illness or distractions within a clinical setting that may have impaired their memory. Our interview did not ask directly whether patients can recall the attending doctor’s name.

This study was designed as a ‘snap-shot’ of activity in a busy hospital setting and for this reason a convenience sampling method was used. This method had the advantage of allowing retrieval of information from patients directly after their interaction with a doctor. We believe this led to a more accurate response than if the sampling had been done at a later date or by postal survey. It was not our intention to provide a detailed analysis of patient/doctor interactions across all areas of hospital activity and all levels of patient acuity.

The convenience sampling was performed in a random fashion in an attempt to obtain an accurate picture of doctor/patient interactions on any particular day. Doctors were not informed in advance of the sampling that the survey was to take place. This was to avoid potential bias in behaviour on the part of the consultants and NCHDs.

A very small proportion of the samples interviewed were from a non-caucasian ethnic background, so generalisations on diverse ethnic groups may not be made. Larger ethnic variations in other hospital settings may yield different findings as it is well established that preferences for doctor–patient interactions may differ according to a patient’s ethnicity.9 The issue of whether to include a handshake as part of the introduction may become more controversial when dealing with certain ethnic groups.

It is reassuring that consultants were significantly better at introductions/handshakes than NCHDs although this is not universal.

Overall, we are encouraged by the result that 79% of doctors introduced themselves by name and that this was perceived positively by the patients interviewed. This figure could rise to almost 90% of patients in the study if we were to assume that some patients already knew their doctors from previous visits, although best practice dictates that knowledge of the doctor’s name should always be checked.11 Those who did not introduce themselves however indicate that further work needs to be done in this area if the legacy of Dr Kate Granger’s #hellomynameis campaign is to be honoured.

Main messages

  • Between 80% and 90% of doctors introduce themselves.

  • Introductions improve patient satisfaction.

  • Consultants were better at introductions than non-consultant hospital doctors.

Current research questions

  • Reasons for lack of introductions need to be elucidated.

  • The effect of a public campaign on introductions should be studied.

  • Larger ethnic/cultural influences may be a fruitful area of further study.

Acknowledgments

We wish to acknowledge all patients and staff who participated or assisted with this study.

References

Footnotes

  • Contributors The writing, processing and analysis of the article were done by PG with input from EMD. SFS, AG and MO carried out the study.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.