No Dignity Required: Improving Patient Engagement by Elevating Humanity

By Lisa Goren

All it takes is a single visit to the doctor’s office to place one’s pride and self-esteem a dozen notches below baseline. I didn’t think much of my appointment, knowing it was just a routine scan at the dermatologist’s office, a new annual pilgrimage resulting from a diagnosis called Middle Age.

Entering the room, the medical assistant asked me to undress and, as is customary, pointed to the gown and the sheet that would further preserve my dignity. She instructed me to tie the gown in the back and then she promptly left. What ensued was a magician’s botched illusion as I transformed from confident professional to scrawny kid about to get shoved into my own locker. My slight stature of 5’1” makes “one size fits all” a true misnomer, particularly when coupled with three pieces of raggedy fabric that I’m supposed to tie behind my back.

In an effort to preserve any remaining self-respect, I sat on the exam table, carefully balancing a clipboard filled with paperwork on my crossed knees. The doctor promptly (?!) entered the room and began his exam. I really like that guy. He’s professional, seemingly smart, reasonable and builds rapport quickly. The exam lasted just six minutes, and I’m guessing we were both thankful for the efficiency.

But the exam itself was like the first night of Dancing with the Stars when the fumbling ex-NFL player fails to Padebure. I’ll give the doctor credit for avoiding eye contact, while continuing to communicate in a friendly manner. Try as he did to avert his gaze and cover all of my more private of parts, the exam came to a futile end when he asked me to flip myself over like a pancake and the back of my gown splayed open like a tilapia filet just before it is seared.

We shook hands when he left, something of a “let’s not do this again soon” knowing between us. While I did not feel violated by this doctor in any way, I did feel violated by the healthcare industry. Driving away, I wondered why we can’t do better or as well as our more “alternative” counterparts. I thought about my acupuncturist and massage therapist and the care they take to preserve my dignity. I am certain that in their training, they learn extensively about creating a healing environment, one in which the patient feels honored, respected and activated.

Conversely, I was anxious during most of the dermatologist appointment, which likely decreased my ability to think clearly, communicate genuine concerns and understand the information being conveyed to me.

You see, it’s about more than my self-respect; it’s about my ability to participate in my own care as an active partner, rather than a passive participant. A patient’s comfort and dignity is just as much about clinical care as taking vital signs. Sure, I leave my acupuncture and massage appointments feeling relaxed, but more importantly I leave excited to come back and motivated to take care of myself. Isn’t that what we want to cultivate in all of our patients?

Whether it’s providing new gowns of varying sizes, sending physicians and staff to experience true care by another provider or setting clearer expectations for the exam, there are myriad opportunities to bring copious amounts of humanity into the exam room. As complicated as reforming our current healthcare system is, improving the way we interact with patients could transform the patient experience.

Lisa Goren-Lisa Goren is a healthcare leadership speaker and consultant. She is passionate about helping healthcare leaders achieve excellence amidst industry transformation. You can visit her website at