• Home
  • Practice Focus
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
    • How I Do It
    • TRIO Best Practices
  • Business of Medicine
    • Health Policy
    • Legal Matters
    • Practice Management
    • Tech Talk
    • AI
  • Literature Reviews
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Career
    • Medical Education
    • Professional Development
    • Resident Focus
  • ENT Perspectives
    • ENT Expressions
    • Everyday Ethics
    • From TRIO
    • The Great Debate
    • Letter From the Editor
    • Rx: Wellness
    • The Voice
    • Viewpoint
  • TRIO Resources
    • Triological Society
    • The Laryngoscope
    • Laryngoscope Investigative Otolaryngology
    • TRIO Combined Sections Meetings
    • COSM
    • Related Otolaryngology Events
  • Search

Evaluating the Appropriateness of Contact with Patients outside the Physical Exam

by G. Richard Holt, MD • July 8, 2018

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
Print-Friendly Version

The patient–physician relationship is perhaps a singularly unique one with respect to physical contact, given the importance of the physical examination and the physician’s responsibility to understand and connect with the patient as a “person,” and not just a body of anatomy and cellular physiology.

You Might Also Like

  • Evaluating Dysphagia: Maximize exam and swallow studies for diagnostic success
  • Patients Make Us Better: Here Are Some Ethical Lessons Patients Teach Their Doctors
  • What Is a Physician’s Obligation to Disclose ‘Near-Miss’ and ‘No-Harm’ Events to Patients?
  • Roles of Altruism, Empathy, and Compassion in Modern Clinical Practice
Explore This Issue
July 2018

Human touch can be a form of body language not dissimilar to a smile or a head nod—it can convey a sense of understanding and connection. However, depending on the patient, the strength of the mutual patient–physician relationship, and the context of the particular encounter, one must consider the important elements of proper, ethical, and professional physical contact with the patient outside the conduct of the diagnostic physical examination. If one considers the fundamental concept of physician physical contact to be respectful, comforting, and appropriate, these three guidelines can be considered prior to initiating a gesture that involves touching the patient.

There are two other, equally important, principles to be considered: respecting the patient’s person and self-determination. Given the complexity of the human psyche and personality, patient acceptance of a contact gesture from a physician depends a great deal on their definitions of personal space, their view of the professional relationship, the power differential perceived in the relationship, and their need for comfort or friendliness demonstrated by a gesture contact. Most physicians, through intrinsic and experiential awareness, insight, and understanding, should be able to discern when an empathetic or friendly gesture would be appreciated by the patient and, perhaps more importantly, when it might not be appreciated.

Given the above considerations, an otolaryngologist may wish to exhibit caution and temperateness by asking the patient if she would appreciate and agree to a contact gesture of support and empathy, and inquire what would be an acceptable gesture to the patient, if the patient agreed. A light touch on the arm or shoulder, held for a short time, might be a simple way to convey one’s professional empathy and an understanding of her anxiety and worry. Conversely, it is almost always acceptable to express your concern to the patient through appropriate words and an encouraging and hopeful facial expression.

Of greater ambiguity is whether or not to initiate or accept a “hug” with the patient. Since this is more contact than a touch on the arm or shoulder, it should be considered with greater discretion, and more often is a product of a solid, long-standing patient–physician relationship, in which a clear understanding of the intent, purpose, and propriety of the gesture has been affirmed by both patient and physician. Another word of caution: Regardless of the gender of the patient and of the otolaryngologist, if there are only two persons in the examining room, with the door shut for privacy, a misstep could come down to patient versus physician, and the differential of power may not favor the physician in this situation. If one is considering offering or extending a contact gesture of support or empathy, it might be better delivered in an environment where other, non-biased individuals are present. Unfortunately, the medical profession is at some risk for scrutiny regarding physical contact considered to be inappropriate, so a heightened sense of propriety must be exerted at all times.

Pages: 1 2 3 4 | Single Page

Filed Under: Departments, Everyday Ethics, Home Slider Tagged With: Ethics, patient care, patient exams, patient relationshipsIssue: July 2018

You Might Also Like:

  • Evaluating Dysphagia: Maximize exam and swallow studies for diagnostic success
  • Patients Make Us Better: Here Are Some Ethical Lessons Patients Teach Their Doctors
  • What Is a Physician’s Obligation to Disclose ‘Near-Miss’ and ‘No-Harm’ Events to Patients?
  • Roles of Altruism, Empathy, and Compassion in Modern Clinical Practice

The Triological SocietyENTtoday is a publication of The Triological Society.

Polls

Would you choose a concierge physician as your PCP?

View Results

Loading ... Loading ...
  • Polls Archive

Top Articles for Residents

  • Applications Open for Resident Members of ENTtoday Edit Board
  • How To Provide Helpful Feedback To Residents
  • Call for Resident Bowl Questions
  • New Standardized Otolaryngology Curriculum Launching July 1 Should Be Valuable Resource For Physicians Around The World
  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment

    • Otolaryngologists Are Still Debating the Effectiveness of Tongue Tie Treatment

    • Is Middle Ear Pressure Affected by Continuous Positive Airway Pressure Use?

    • Rating Laryngopharyngeal Reflux Severity: How Do Two Common Instruments Compare?

    • 22 Symptoms Common to Patients with Superior Canal Dehiscence Syndrome

    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment

    • Rating Laryngopharyngeal Reflux Severity: How Do Two Common Instruments Compare?

    • Is Middle Ear Pressure Affected by Continuous Positive Airway Pressure Use?

    • Otolaryngologists Are Still Debating the Effectiveness of Tongue Tie Treatment

    • Complications for When Physicians Change a Maiden Name

    • Excitement Around Gene Therapy for Hearing Restoration
    • “Small” Acts of Kindness
    • How To: Endoscopic Total Maxillectomy Without Facial Skin Incision
    • Science Communities Must Speak Out When Policies Threaten Health and Safety
    • Observation Most Cost-Effective in Addressing AECRS in Absence of Bacterial Infection

Follow Us

  • Contact Us
  • About Us
  • Advertise
  • The Triological Society
  • The Laryngoscope
  • Laryngoscope Investigative Otolaryngology
  • Privacy Policy
  • Terms of Use
  • Cookies

Wiley

Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies. ISSN 1559-4939