Should you acknowledge patients away from hospital?

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I want you to contemplate this situation: You are stopping at the supermarket near your place of work at the end of the day. As you are getting items for your dinner, you sense a pair of eyes staring at you. For a second, you freeze: Shall you smile or not? Shall you just nod? Or not respond at all?

I am not describing a romantic encounter from a paperback book. I have just seen a patient I examined earlier.

Dr. Anagha Parkar from Haraldsplass Diakonale Sykehus in Bergen, Norway.Dr. Anagha Parkar from Haraldsplass Diakonale Sykehus in Bergen, Norway.

Now, if the patient smiles first, then I am off the hook, I can smile back like normal people do. However, if the patient is waiting for me to show recognition, I have two options: If no one is around, a small nod, but if anyone is around, I ignore the patient.

Why am I being so concerned about such an episode? As I see it, it is my well-trained reflex of doctor-patient confidentiality that causes this behavior.

I have experienced a terrified look from a young male patient who was in the shop with (obviously) his girlfriend. From his look, I understood he was hoping I would not show recognition, maybe because he had not told her about his hospital visit, and that is his right, of course. So, I ignored him, and I think he was relieved.

Then I have also experienced a great big smile from a patient who immediately informed her husband who I was, and I got even bigger smiles. Earlier that day I told her: no liver metastases. So, being the doctor with good news, a lot of positive energy was being sent my way. Not all encounters are bad.

But I sometimes wonder if some patients think doctors are being arrogant when we ignore them outside of the hospital setting. But all in all, I'd rather be considered arrogant than breach doctor-patient confidentiality. So to all patients out there reading this: Smile to your doctor first, if you want a smile.

And to all the doctors out there: What do you do? Just consider how we would feel if we smiled first and the patient ignored us!

Dr. Anagha Parkar is a radiologist at Haraldsplass Diakonale Sykehus in Bergen, Norway.

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