female wheelchair patient with specialist (© Spotmatik - stock.adobe.com)
ANN ARBOR, Mich. — When you’re lying on a hospital bed, how your doctor interacts with you can make a big difference in your experience as a patient. A new study suggests that one simple change by physicians — having them sit down instead of standing over patients — may significantly improve how patients perceive their care.
Researchers from the University of Michigan and Veterans Affairs Ann Arbor Healthcare System reviewed 14 studies examining how a doctor’s posture affects patient perceptions in hospital settings. Their findings, published in the Journal of General Internal Medicine, indicate that patients tend to view seated doctors more favorably.
“The studies measured many different things, from length of the patient encounter and patient impressions of empathy and compassion, to hospitals’ overall patient evaluation scores as measured by standardized surveys like the federal HCAHPS survey,” notes Nathan Houchens, MD, a U-M Medical School faculty member and VA hospitalist who worked with U-M medical students to review this evidence, in a media release.
This may seem like a small detail, but in the high-stress environment of a hospital, these perceptions can have meaningful impacts. Patients who feel their doctors communicate well and care about them tend to be more satisfied with their care overall. They may also be more likely to follow treatment plans and have better health outcomes.
The idea behind this effect is rooted in nonverbal communication and social psychology. When a doctor stands over a patient’s bed, it can create a sense of hierarchy or intimidation. By sitting down, the doctor puts themselves at eye level with the patient, which can feel more equal and collaborative.
This doesn’t mean doctors need to pull up a chair for every brief interaction. The studies reviewed looked at more substantial conversations, like discussing diagnosis and treatment plans. For these important talks, taking a seat could make a real difference.
However, getting doctors to consistently sit down may be easier said than done. Several studies noted that even when instructed to sit, doctors often remained standing. Reasons included lack of available seating, concerns about efficiency, and worries about hygiene for patients in isolation.
Houchens suggests hospitals could encourage sitting by ensuring each patient room has a dedicated chair for clinicians and by creating a culture where sitting with patients is the norm. With minimal cost and effort, this small change in body language could lead to more positive hospital experiences for patients.
“We hope our work will bring more recognition to the significance of sitting and the general conclusion that patients appreciate it,” says Houchens.
Paper Summary
Methodology
The researchers conducted what’s called a systematic review. This means they searched multiple medical research databases to find all relevant studies on their topic. They used specific search terms related to doctor posture and patient perceptions in hospitals. Two researchers independently reviewed each study to decide if it should be included based on predetermined criteria.
They then extracted key information from each included study and assessed the quality of the evidence. This approach allows researchers to gather and analyze all available evidence on a topic to draw broader conclusions.
Key Results
Out of 14 studies reviewed, 10 found at least one positive outcome when doctors sat down to talk with patients. These benefits included patients feeling the doctor spent more time with them (even when the actual time was the same), viewing the doctor as more compassionate, and rating communication as better.
Three studies found no difference between sitting and standing, and one study actually found patients preferred standing doctors. However, the researchers note that most studies had a high risk of bias, meaning their results might not be completely reliable.
Study Limitations
The main limitation of this review is that the included studies were quite different from each other. They used various methods to measure outcomes and looked at different aspects of patient perceptions. This makes it hard to directly compare results across studies.
Additionally, most studies had a high risk of bias, which means their results might be influenced by factors other than just the doctor’s posture. For example, doctors who choose to sit might also have better communication skills in general. The review also only included English-language studies, so it might be missing relevant research published in other languages.
Discussion & Takeaways
While the evidence suggests sitting down can improve doctor-patient communication, the researchers emphasize that more high-quality studies are needed to be certain. They recommend a large, well-designed trial to definitively test the effects of doctor posture on patient perceptions and outcomes.
Despite the limitations, the researchers argue that sitting down is a low-cost, easy-to-implement change that has potential benefits and little downside. They suggest hospitals consider ways to encourage doctors to sit during important conversations with patients, such as ensuring chairs are available in rooms and promoting a culture where sitting is expected. Ultimately, this small change in body language could be one way to improve patients’ hospital experiences and potentially their health outcomes.
