Personal Space.

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?