If I had to declare my affinity for hugging, I would say that I am a medium-level hugger. I readily hug family members, particularly when the hug is initiated by one of my relatives. However, I don’t go around seeking hugs, nor am I the kind of hugger who holds on tight and sways with the hug. I’m also not one of those non-hugging huggers who stands back, leans forward from the waist, and pats you crisply on the back as though afraid of contracting head lice.

The act of hugging becomes more complicated with colleagues and patients in the medical field. I tend to fall on the side of DNHW, also known as “do not hug at work.” But I know many colleagues who have a different approach, who have told me that they think hugging patients is therapeutic. I ask them in response, “Therapeutic for who, the patient or the provider?”

I have been hugged by patients a handful of times, and in most cases I didn’t see it coming. All of a sudden, they were wrapping their arms around me. I tried to extricate myself as quickly as humanly possible without appearing uncomfortable.

I have colleagues who practice in hospice, palliative care, and other specialties where patients routinely die and grief is a constant. Touch can be important for some people in those environments, and I can see how hugging might play a more normalized role. However, I have worked with families coping with the death of a loved one without incorporating hugging, and I still was able to provide comfort and optimal medical care.

Part of my non-hugging approach may be related to an experience I had at the time of my grandmother’s death many years ago. As my family mourned, we held hands and put our arms around each other. A hospital staff member who I did not know interrupted this intimate moment by grabbing and squeezing the breath out of me, popping my back in the process. I know this person meant well, but I was shocked at the intrusion.

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Additionally, the imbalance of power between the patient and the provider drives my concern about hugging patients, which is different from friends or family members on equal footing sharing a hug. This point was made by Mark Kuczewski, PhD, director of the Neiswanger Institute of Bioethics at Loyola University in Chicago, in a piece in the January 2018 issue of Advisory Board. Kuczewski pointed out that patients agree to being touched during a physical exam but may feel pressured to accept a hug offered by their provider. “There’s a power imbalance,” Kuczewski said. “Patients want to please their doctors. A patient is not going to say ‘Please don’t do that.’ They are going to go along with it.”

So for me, the safest way to ensure that patients do not feel uncomfortable or coerced into engaging in physical contact is to simply refrain from hugging them.

Reference

Hugging your patients: is it empathetic—or crossing a line? Advisory Board website. https://www.advisory.com/daily-briefing/2018/01/08/hugging-patients. Published January 8, 2018. Accessed July 31, 2019.