In an era of electronic medical records and reliance on lab tests, scans, and evidence-based medicine, the importance of a full physical exam that is comprehensive but does not worsen the patient’s pain is imperative. My exams are thorough, but I save the most uncomfortable part of the examination for last and frequently ask during the exam if my touch is painful. To help myself and others in our office, I derived an acronym for the best way to treat patients with chronic painful condition without exacerbation of their pain.
L Learn the patient’s personal history.
E Encourage positive life behaviors.
A Acknowledge the importance of touch.
R Reduce the victimization mentality.
N Never give up trying to improve the quality of a patient’s life.
Some patients have picked up on my “hug” therapy. Recently, one patient informed the front desk checkout secretary that I had forgotten something. The secretary interrupted my next patient to tell me that my previous patient said I had forgotten to give her something. I got to the front desk and my patient said, “I didn’t get my exit hug.”
Apparently, hug therapy is working.
Treating patients with chronic pain can provide a challenge in any setting. Even patients with no overt physical deformity can be hurt with a gesture as simple as a handshake. The medical community must set a precedent by educating the public that a firm handshake is not the only way to convey strength, wholeness, and competence in business. Other greetings need to be embraced and explored based on individual level of comfort and familiarity. Patients deserve compassion and personalized attention; physical touch conveys this. We must all just think before we squeeze.
Iris Zink is a nurse practitioner at the Beals Institute in Lansing, Mich.
- Shiel WC, Jr. Dr. Shiel’s patented handshake for arthritis patients. www.medicinenet.com/script/main/art.asp?articlekey=20192. Reviewed June 6, 2004. Accessed July 7, 2010.
- Morrison T, Conaway WA. Kiss, Bow, or Shake Hands, 2nd ed. Adams Media: Avon, Mass.;2006.