Observation Is Key for Primary Care Doctor

When I walk into an exam room, I am looking at how the person looks overall. If they have lost weight, I want to acknowledge it.  If they are depressed, I need to be aware of it.  If they are acutely ill, I need to address it.  Much of the overall assessment of a patient comes from first glance.

There are certain patients who seem to be overly focused on their problems. They seem to define themselves by what is wrong.  For these patients, I make a point to compliment them when I walk in.  I find that this almost puts them back on their heels - as they are often chomping at the bit to tell me their problems, and then get hit with "you look great today," or "that's a very nice dress you are wearing."  Perhaps I can do a little to defuse their obsession.

Patients like to comment on how I look as well.

"Doc, you look like you lost weight."  or "You're eating well lately, doc."  This can happen in back to back rooms.  I guess people figure I see their weight, that gives them license to comment on mine.  It takes some getting used to.
"You look tired."  I may feel tired, but I try not to let it show, but hearing this always makes me worry about how I am coming across.  You don't want your doctor to have concentration problems when they are thinking about your medical care.
"I like your beard."  I have had a beard for the past fourteen years, but people continue to comment on it as if I just grew it out.  I don't think any of my patients know what I look like clean-shaven.  I usually just say "thanks" and go on.  I don't want them to be uncomfortable.
It does pay to be observant.  It is part of what makes a good doctor.

I just try not to comment on peoples' beards.