Compassion [kuhm–pash-uhn] noun
A feeling of deep sympathy and sorrow for another who is stricken by misfortune, accompanied by a strong desire to alleviate the suffering.

Compassion Corner is a weekly series from Patient Worthy that will focus on the subject of compassion in the healthcare and rare disease space. In this series, we explore the role of compassion in this field and what it means for caregivers, patients, and others.

The National Institute of Health published a report whereby the WHO states that the transmission of COVID-19 can occur by way of physical contact and respiratory droplets. The WHO therefore strongly suggests that people adhere to its advice to wear masks and to practice physician distancing.

But what effect do the new measures have on doctor-patient relationships?

Non-verbal communication between doctors and patients is a critical factor in their relationship. Satisfaction in the relationship affects the patient’s adherence to their doctor’s advice and to the clinical outcome. Facial expression and even subtle voice modulation are lost through mask-wearing.

A group of doctors in Hong Kong tested the effect that wearing masks had on their patients. The patients perceived the doctors as not having empathy. This reaction was surprisingly evident in situations where a doctor-patient bond had already been established.

And What About Distancing?

The practice of greeting patients with a handshake is a concern. Also, a handshake at the end of a doctor-patient session is generally an indication of patient satisfaction. In society, the pandemic is very likely to have a permanent effect on this cordial greeting.

The optimum distance during consultation appears to conform with the recommendation by the WHO although a greater distance would be preferable. It is anticipated that the non-verbal practice of leaning towards the patient which creates a more positive effect may also be in decline.

A Beneficial Effect

In searching for a beneficial effect of distancing and masking in doctor-patient relationships we can turn to health services. The continuation of health care at the height of the pandemic should translate into patients’ confidence in our health care system and in its workers.

Witnessing the precautionary measures taken by our health care workers may encourage patients to also use appropriate measures to prevent the virus.

A Face Shield as an Alternative

A face shield is an excellent alternative to wearing a mask. Some of the advantages would be visibility of non-verbal facial expression, increased coverage of the face and eyes, preventing wearers from touching their face, and possible reuse of the shield if it is sterilized.

Other Factors

Anxiety and fear of being exposed to the virus may have an effect on the patient-doctor relationship. Such factors as violence against physicians which was reported in Mexico and India would have a definite impact as well.

A Timely Introduction to Telemedicine

Telemedicine may have emerged as a winning combination of keeping patients safe from infection while allowing access to healthcare during the pandemic. Its services are delivered via audio calls or video consultations which is preferable. However, the success of video consultations relies on high-quality Internet connections, and in many cases, it relies on the patient’s comfort level.

Telephone consultations are more accessible and affordable. However, the challenge of such a massive increase in the need for such services presents a substantial challenge.

In conclusion, the answer to whether or not COVID-19 has or will have a significant negative or positive effect on doctor-patient relationships has not yet been established. It is, however, a clinical concern and it is incumbent upon policymakers to address this critical issue.