Better by Atul Gawande: Chapter 4

The fourth chapter of Atul Gawande's Better moves the book into its second section, titled "Doing Right." This is one of three core challenges Gawande laid out in the book's introduction and which we briefly touched upon in one of our earlier discussions. The chapter is titled "Naked" and concerns the exam room etiquette that doctors and patients expect from one another and often uncomfortably tiptoe around.




What surprised me about exam room etiquette is that doctors seem uncomfortable with it. I have never got that vibe from any of my doctors. Basically they ask you to remove clothing in a professional way and they examine you as necessary, and then tell you if you're healthy. I didn't see it is as a problem, but apparently it is.

Interestingly, Gawande relates anecdotally that some patients and doctors find that having a "chaperone" present makes things worse. That is, asking a female nurse to come in when a male doctor is examining a female patient makes the patient more nervous than before, because she perhaps did not sense a cause for concern that the chaperone arouses. The use of the term chaperone is terrible - my opinion is just say you're asking a nurse to come in and assist, then ask her for gloves or something to make it seem like she was useful.

Most of all it's about trust. Have you had doctors that for whatever reason you didn't establish trust with? Did you switch to a new one?