This has been bugging me for a while now.
In my exam room, there’s a good 4-5 feet distance between where I sit and where the patient sits. I think it’s a comfortable distance for a conversation. It gives both the patient and myself adequate space. Often patients are bringing in their work bags, suitcases, briefcases, sometimes their groceries even! I’m okay with all of that because there is plenty of room. But there are a few patients who insist on pulling up their chair right to my desk. I mean, we are now sitting face to face with a small desk between us. If I crossed my legs, my foot would hit the patient’s shin. During these encounters I just want to yell out, “Personal space, people!!!! Personal space!!”
Would you get right up and personal with your doctor? It’s a professional encounter – I am not their best friend, but sometimes, I suppose I am their confidante, so I can see how getting close to me physically might be comforting to some. But it really, really, really bothers me when certain patients do it. Are they trying to see what I write in their chart? Are they thinking that the closer they get to me, the more I’ll believe their story? Frankly, it’s kind of creepy. And of course, it’s always the patient that rubs me the wrong way to begin with – the patient who comes in monthly for the pain pills, or the one that has fibromyalgia and needs constant hand-holding and reassurance that he doesn’t have some rare degenerative neuromuscular disorder that three neurologists haven’t been able to diagnose.
I need to figure out a way to politely ask these patients to move away from my desk. I suppose I could use the “patient confidentiality” angle, as I do use electronic record and when I am going from screen to screen, the appointment schedule is visible.
Any advice?
The Urban Dr. Mom 
I will say things like, “You don’t want to get too close to me today because my coffee breath is especially bad this morning!” Or “body odor is especially pungent…” Or simply ask them to back away. Some people really have no idea they are too close and no one ever tells them. I figure it is my job to clue them in so it doesn’t affect other aspects if their life.
Those are great ideas! Thanks! And funny thing is that I’m often super aware of and worried about the coffee breath so I will definitely try that one! Thanks!!
I’m an introvert, so I’m all about the personal space. That being said, I didn’t mind being physically closer to patients or parents as long as I’m the one who initiates it. I think that would be the key for me. If I do it, I’m okay with it (though the patient might not be–haha), but if someone moves in so closely to me without my foreseeing it, well then, yes, that would make me uncomfortable.
Maybe you need to rearrange your desk so that when they sit so close, you can push or wheel your chair back. 😉
I agree – maybe you need to rearrange furniture. I have yet to be in a position in have a patient invade my personal space so I can’t give any other advice on that one yet.
See, my exam room was already rearranged almost 2 years ago and so far it’s been working well. It’s just a few patients that are doing this “pull up the chair to me” and I just can’t figure out another configuration. But next time I think I will ask them to move back.
From a patient perspective, it weirds me out when my doc has to get so close to listen to my heartbeat or check my thyroid (I knows it’s necessary, but I’m big on maintaining my personal space, too). I would straight up tell them that you work better with a little breathing room, that it’s just a personal nuance.
It’s always great to hear the patient’s perspective. Thanks so much!