I kind of figured that I would not get much disagreement with my previous post (at least from patients). It is easy for me to criticize my own profession and feel fairly safe, but turning the spotlight on patients makes is riskier.
My purpose in writing these posts is to get both sides looking at things through the other\’s perspective. In this post I don\’t want to get patients feeling sorry for doctors; I want them to understand how they can either help or harm that relationship.
So here are the Patient Rules:
Rule 1:Â Your doctor can\’t do it alone
The best doctor can do very little with patients who ignore instructions. Sometimes noncompliance is partly due to physicians not explaining things well, but medical compliance is ultimately in the hands of the patient.
I am mystified as to why some patients will ignore nearly everything I say and yet continue coming in for regular appointments. It is frustrating, causing some physicians to get angry with these patients (and even discharge them). I figure it is the patient\’s dollar that is being spent, not mine.
Going to the doctor has no therapeutic benefit in and of itself. If you disagree with what is recommended, don\’t pretend you agree and then ignore your doctor\’s advice. I would much rather have a patient tell me \”I am not going to take that medication\” than have them accept the prescription and not get it filled. Your doctor prescribes them for you, not for him/herself.
Rule 2:Â Be Honest
![\"Webb\"](\"http://distractible.org/wp-content/uploads/2008/08/webb.jpg\")
Nobody likes to look silly. I think the main reason most people are untruthful is that they are embarrassed about the truth. But sometimes symptoms are strange, like the man having a heart attack who described it as \”a cold feeling when I take a deep breath.\” Sometimes symptoms are embarrassing, like a testicular lump. Sometimes you just don\’t want to feel like a wimp, so you downplay your pain.
While I can sympathize with this feeling, I don\’t see any good reason to be anything but truthful with your doctor. Yes, your symptom might sound strange. Yes, you may have flubbed up and not followed instructions properly. Yes, you may be afraid of what some of your symptoms may mean. But the goal is to fix (or prevent) problems, and trying to do that with bad information is an exercise in futility.
We physicians hear it all. There are very few things a person can say to me in the exam room that will surprise me. My job is to help people, not judge them as \”weird\”, \”crazy\”, \”wimpy\”, or \”panicky.\” Don\’t worry about making a good impression on your doctor. Just give the facts. That will give the best chance to get the desired outcome.
Rule 3:Â I don\’t play favorites
![\"00e7_1_sbl\"](\"http://distractible.org/wp-content/uploads/2008/08/00e7-1-sbl.jpg\")
I have over three thousand patients. I try to do right by all of them. I build relationships over years and even develop quasi-friendships with some patients. But I am professionally obligated to keep emotional distance. Overly liking or disliking a patient will cloud my judgment, and so I try to treat everyone the same.
It drives me (and my staff) crazy when patients come in and demand \”special treatment\” because \”Dr. Rob knows who I am.\” It is worse if people try to pretend they are my friends by using my first name. Yes, there are special circumstances where I do see a patient who walks in, but that is dictated by the medical condition, not by how well I know the person.
Doctors I take care of can be the biggest offenders. I try to make it clear from the outset that I will treat them like any other patient and not necessarily give them better access because they are doctors. If I have to give them special access, then something is wrong with the system. Besides, special access for some generally means worse access for others.
Rule 4: Don\’t mess with the staff
My staff takes an incredible amount of abuse at the hands of some of my patients. It surprises me what they are willing to say to my nurses and clerical staff but not to me. In general, people see them as an obstruction to being able to see their doctor, and so have little patience for any delay.
There are certainly times that my staff is worthy of criticism, and I expect to hear some complaints. But in general, it is not the individual staff\’s fault for things not running well, it is our system that causes problems. We have a system for the entire patient experience in our office, and it works most of the time. There are times, however, when circumstance makes things fall apart. There are also times when the deficiencies of the system are exposed.
My staff has a very demanding job. Remember that you are not their only responsibility – you may be the 100th job for the day. If they don\’t meet your expectations, yelling at them won\’t fix the problem. Talk to me or my office manager. Better yet, put it in writing so that I have ammunition to change things, because chances are really good that your frustration correlates to a frustration I have.
One of the only reasons patients are discharged from our office is when they abuse my staff. A staff member is generally more valuable to me than a single patient, and I need to show my staff that they are valued by me. It is my job to discipline (or fire) my staff, not my patients\’.
Rule 5:Â If you don\’t trust, leave
Trust is the commodity we sell. People go to the doctor because doctors have unique knowledge and experience. The stakes are as high as they can get, so why would you go to someone you don\’t trust? I have seen many patients stick with doctors in whom they have lost faith \”because I don\’t want to hurt his feelings.\” That is ridiculous.
![\"trust_doctor\"](\"http://distractible.org/wp-content/uploads/2008/08/trust-doctor.jpg\")
When you go to a doctor you don\’t trust, you will be suspicious about every bad outcome and won\’t even trust when things go well. This is a no-win situation for the physician. It does not matter if everyone else says this is a good doctor; if you don\’t trust him, find another doctor.
I have some specialists I trust a lot and send many patients to. Invariably, some people won\’t have a good experience – perhaps the doctor had a bad day, was in a bad mood, or the two just didn\’t get along. If I hear that mistrust, I always suggest either a second opinion or a change of doctors. None of my colleagues want someone sticking with them if the trust is not there; it is a very high-risk situation from a malpractice standpoint and studies have shown that negative attitudes make bad outcomes much more likely.
Find a doctor you trust.
Please note that trusting a doctor does not mean you should not ask questions. In fact, I think a physician who does not want to be questioned is one you should not trust. Questioning is often the only way to build trust. Unanswered questions tend to undermine trust.
Rule 6: No news might be bad news
\”No news is good news\” can be a fatal assumption. Never assume that your doctor will call you if there is a problem. I get 50-60 new documents (labs, x-rays, consults, hospital notes) every day. I order hundreds of tests every week. I just cannot keep track of them all. Some will get sent to the wrong doctor and some results never get sent at all. Despite our best efforts to develop a system that will close this loop, there are some documents I just don\’t get.
A doctor\’s office is always on the brink of chaos – with an incredible amount of information coming in and going out, a large number of phone calls, insurance company headaches, and personnel situations that can throw the best system flat on its face. People forget that there are hundreds of other patients with thousands of test results the office is dealing with. We do what we can to tell patients test results (and with our computerized records, we do a better job than most), and I see that as our responsibility.
If you don\’t get your test results, call.
![\"thank-you\"](\"http://distractible.org/wp-content/uploads/2008/08/thank-you.jpg\")
One more point: we aren\’t that much different from you. We have good days and bad days. My staff cry sometimes when they are mistreated by patients. I get discouraged and emotionally drained. It really helps to hear thanks. I don\’t expect it all the time, but when I do get a card or a nice phone call saying I am appreciated, it can really help.
********
It can happen. Doctors and patients can get along. Like any relationship, it takes effort and give-and-take on both sides. The benefits of such a relationship are very satisfying and truly life-changing.
[…] Go to Part 2 – Patient Rules Share and Enjoy: […]
Getting along part 2: Patient rules…
My purpose in writing these posts is to get both sides looking at things through the others perspective. In this post I dont want to get patients feeling sorry for doctors; I want them to understand how they can either help or harm that relationship….
A very good point that the relationship between doctor and patient needs to be worked on.
We have been with our paed for almost two years and sometimes I have felt like the ‘relationship’ wasn’t happening.
We worked at it though, because I have trust issues with doctors in general, we both had to work quite hard but now I really trust him with my daughter’s life and I am thankful that we took the time.
I think he almost knows my daughter as well as we do now…
and she loves him for it.
A very good point that the relationship between doctor and patient needs to be worked on.
We have been with our paed for almost two years and sometimes I have felt like the ‘relationship’ wasn’t happening.
We worked at it though, because I have trust issues with doctors in general, we both had to work quite hard but now I really trust him with my daughter’s life and I am thankful that we took the time.
I think he almost knows my daughter as well as we do now…
and she loves him for it.
Dr. Rob-I’ll second everything you stated! I especially agree with the honesty issue, and the thank-you’s. I send cards to mine on holidays, and when they’ve helped me or my husband through any troubling heath issues. When they go the extra mile, I toss in a gift card to a local eatery to enjoy a night out. In the end that’s what we all want… a little pat on the back for a job well done.
Dr. Rob-I’ll second everything you stated! I especially agree with the honesty issue, and the thank-you’s. I send cards to mine on holidays, and when they’ve helped me or my husband through any troubling heath issues. When they go the extra mile, I toss in a gift card to a local eatery to enjoy a night out. In the end that’s what we all want… a little pat on the back for a job well done.
Another great post including some things that would not have occurred to me. I will be more forgiving of office chaos! I think I do OK on the other 5.
Re: chaos
I did leave a GYN that l liked because when I called to find out the results of my thyroid bloodwork, her staff told me it was “fine”. My previous retiring doctor had asked me to ask the new doctor for thyroid bloodwork and to compare the results with previous tests, so I kept calling back asking and each time they would say…it was “fine”. Finally in desperation I insisted that I find out the NUMBERS on the thyroid test so I could compare with my previous tests. This time the staff-person agreed to call back with actual numbers. That is when I found out that the doctor had all the “add-on” bloodwork SHE wanted, but she had neglected to order the thyroid tests! The “fine” became …no test was done! I considered that incompetence and left her practice. For me “trust” was broken. I felt lied to. It seemed incompetent. Maybe it’s all in a day’s work for most doctors to be that disorganized.
I do try to be nice to staff people, but some of them make it VERY hard! My endocrinologist does not like writing prescriptions (I go every 4 months so it’s not my doing) so I am left to ask the drugstore fax the office for refills. His staff ignores the faxed requests from the drugstore so every few months I end up suddenly off thyroid meds for 1-2-3-4 days while I call the office daily to try to push them along. Rather than rail at the staff, I complained to my endocrinologist about his staff’s inability to get back to the drugstore to approve refills in time for me to not run out of meds and the doctor had a screaming rant about drugstores and insisted that I should change to an online pharmacy! I tried but the process was an ordeal and I WANT to get my medications a few blocks from my house where I have gotten them for over 20 years!
The “honesty” one rang a bell because my Dad who managed to live to 92 DESPITE his poor communication with his doctor used to refuse to tell the doctor symptoms because he figured that an undiagnosed illness does not exist! ha ha ha! He died of an undiagnosed illness so in the end he was wrong! They still have not finished the autopsy and it’s been 3 + years, but that’s ANOTHER department in the medical field.
I currently have a TERRIFIC GYN and a TERRIFIC GP and a very-cranky-old-man Endocrinologsit who is brilliant never the less.
Keep up the good work, Dr. Rob!
Another great post including some things that would not have occurred to me. I will be more forgiving of office chaos! I think I do OK on the other 5.
Re: chaos
I did leave a GYN that l liked because when I called to find out the results of my thyroid bloodwork, her staff told me it was “fine”. My previous retiring doctor had asked me to ask the new doctor for thyroid bloodwork and to compare the results with previous tests, so I kept calling back asking and each time they would say…it was “fine”. Finally in desperation I insisted that I find out the NUMBERS on the thyroid test so I could compare with my previous tests. This time the staff-person agreed to call back with actual numbers. That is when I found out that the doctor had all the “add-on” bloodwork SHE wanted, but she had neglected to order the thyroid tests! The “fine” became …no test was done! I considered that incompetence and left her practice. For me “trust” was broken. I felt lied to. It seemed incompetent. Maybe it’s all in a day’s work for most doctors to be that disorganized.
I do try to be nice to staff people, but some of them make it VERY hard! My endocrinologist does not like writing prescriptions (I go every 4 months so it’s not my doing) so I am left to ask the drugstore fax the office for refills. His staff ignores the faxed requests from the drugstore so every few months I end up suddenly off thyroid meds for 1-2-3-4 days while I call the office daily to try to push them along. Rather than rail at the staff, I complained to my endocrinologist about his staff’s inability to get back to the drugstore to approve refills in time for me to not run out of meds and the doctor had a screaming rant about drugstores and insisted that I should change to an online pharmacy! I tried but the process was an ordeal and I WANT to get my medications a few blocks from my house where I have gotten them for over 20 years!
The “honesty” one rang a bell because my Dad who managed to live to 92 DESPITE his poor communication with his doctor used to refuse to tell the doctor symptoms because he figured that an undiagnosed illness does not exist! ha ha ha! He died of an undiagnosed illness so in the end he was wrong! They still have not finished the autopsy and it’s been 3 + years, but that’s ANOTHER department in the medical field.
I currently have a TERRIFIC GYN and a TERRIFIC GP and a very-cranky-old-man Endocrinologsit who is brilliant never the less.
Keep up the good work, Dr. Rob!
Dr. Rob, my response was way too long to format correctly on here, so I bet you can guess where it is. I hope you don’t mind.
Thank you, very much.
Dr. Rob, my response was way too long to format correctly on here, so I bet you can guess where it is. I hope you don’t mind.
Thank you, very much.
Great post, thank you. I especially appreciated the advice about lab results. I see a rheumatologist frequently and my current doc will never call with blood test results, which I always interpreted to mean that “everything was fine.” I’m certainly going to be putting in a phone call to m docs from here on out.
Great post, thank you. I especially appreciated the advice about lab results. I see a rheumatologist frequently and my current doc will never call with blood test results, which I always interpreted to mean that “everything was fine.” I’m certainly going to be putting in a phone call to m docs from here on out.
[…] Rules for Doctors & Rules for Patients […]
I didn’t write my most recent blog post because of yours, obviously from the dates involved, but now that I see it – you may be interested in mine. 😉
http://cushings.blogspot.com/2008/08/veteran-patient-gripes.html
I didn’t write my most recent blog post because of yours, obviously from the dates involved, but now that I see it – you may be interested in mine. 😉
http://cushings.blogspot.com/2008/08/veteran-patient-gripes.html
You’ve described the good side of my relationships with most of my doctors, particularly my primary care physician and my first breast cancer surgeon, both of whom have been kind, thoughtful, inquisitive, and appreciative — all of which add up to a mutually enjoyable and helpful relationship.
For those times when a patient and doctor just don’t seem to hit if off, it seems critically important to offer the patient a second choice. After my first breast cancer surgeon moved on to a teaching hospital, I was left with her replacement at our local hospital. Although her replacement is no doubt a fine doctor, we didn’t have an easy connection with one another. As it happened, the hospital had turned their breast care center into a “boutique” approach, offering just the one doctor to all women needing breast cancer care. In the end, I wound up driving an hour further to see my original surgeon.
In other words, giving patients an option (rather than ignoring their phone calls and efforts to connect) is an awfully good rule. No one is right for everyone. There’s no reason for a hospital to limit access for care to just one doctor.
You’ve described the good side of my relationships with most of my doctors, particularly my primary care physician and my first breast cancer surgeon, both of whom have been kind, thoughtful, inquisitive, and appreciative — all of which add up to a mutually enjoyable and helpful relationship.
For those times when a patient and doctor just don’t seem to hit if off, it seems critically important to offer the patient a second choice. After my first breast cancer surgeon moved on to a teaching hospital, I was left with her replacement at our local hospital. Although her replacement is no doubt a fine doctor, we didn’t have an easy connection with one another. As it happened, the hospital had turned their breast care center into a “boutique” approach, offering just the one doctor to all women needing breast cancer care. In the end, I wound up driving an hour further to see my original surgeon.
In other words, giving patients an option (rather than ignoring their phone calls and efforts to connect) is an awfully good rule. No one is right for everyone. There’s no reason for a hospital to limit access for care to just one doctor.
Dr. Rob — spot on — fair and notable for the points that should be obvious, but for some reason, aren’t always.
I do have a couple of questions for you — based on my own experience, and complaints I hear from patients…
You suggest that patients need to chase down results from tests — amen! — but sometimes that’s easier said than done. I was diagnosed 8 weeks ago with pneumonia and sent for a chest x-ray. I got the runaround for almost three weeks as I tried to get the results of the chest x-ray. I was polite, but persistent. Among those “hundreds of phone calls” — at least four of them might have not taken place if someone had been able to provide the results on the first call? Bottom line — controlled chaos — how much could that be alleviated by a bit more organization? Or by using EMRs? I know you use them — but most practices do not. Wouldn’t everyone benefit?
And second — please remember that when we come to see you, we are not well. That’s the entire reason we are there. Granted, we are all human and granted, we all have good days and bad days, our doctors included. But we rarely visit you on our good days! So please remember that (with the exception, perhaps, of a well visit) we are already starting the visit because there’s something wrong with us. We might be on top of our game, and great communicators, 99% of our days — unfortunately, the nature of your work, is that we’re there to see you on the 1% that aren’t good days.
I do appreciate your perspective and will most certainly write about it. Here’s what I’ve had to say previously about good doctor-patient communication:
http://patients.about.com/od/therightdoctorforyou/a/docpatientcomm.htm
Thanks Dr. Rob.
Trisha Torrey
Dr. Rob — spot on — fair and notable for the points that should be obvious, but for some reason, aren’t always.
I do have a couple of questions for you — based on my own experience, and complaints I hear from patients…
You suggest that patients need to chase down results from tests — amen! — but sometimes that’s easier said than done. I was diagnosed 8 weeks ago with pneumonia and sent for a chest x-ray. I got the runaround for almost three weeks as I tried to get the results of the chest x-ray. I was polite, but persistent. Among those “hundreds of phone calls” — at least four of them might have not taken place if someone had been able to provide the results on the first call? Bottom line — controlled chaos — how much could that be alleviated by a bit more organization? Or by using EMRs? I know you use them — but most practices do not. Wouldn’t everyone benefit?
And second — please remember that when we come to see you, we are not well. That’s the entire reason we are there. Granted, we are all human and granted, we all have good days and bad days, our doctors included. But we rarely visit you on our good days! So please remember that (with the exception, perhaps, of a well visit) we are already starting the visit because there’s something wrong with us. We might be on top of our game, and great communicators, 99% of our days — unfortunately, the nature of your work, is that we’re there to see you on the 1% that aren’t good days.
I do appreciate your perspective and will most certainly write about it. Here’s what I’ve had to say previously about good doctor-patient communication:
http://patients.about.com/od/therightdoctorforyou/a/docpatientcomm.htm
Thanks Dr. Rob.
Trisha Torrey
The “call if you don’t get test results” rule is all very well, but it does involve the lab being organised enough to be able to process tests to a predictable schedule, and the doctor actually being organised enough to tell you “these should be back on date1, so if you’ve not heard by date2, call me”.
The “call if you don’t get test results” rule is all very well, but it does involve the lab being organised enough to be able to process tests to a predictable schedule, and the doctor actually being organised enough to tell you “these should be back on date1, so if you’ve not heard by date2, call me”.
Just a thought….
In this electronic age in which I know you participate, you should be able to print out a list of labs which came in that day. In a perfect world, your lab(s) would electronically send those over in a way your EMR/EHR system could use with no touch of a person’s hand. In an imperfect world, someone has to enter the data into it. I know my PCP pulls my labs up off of the computer and if I’ve had any labs done in this health system (which consists of many hospitals, labs, clinics, etc.), they can be accessed by her.
So, why not a printed list daily of new lab results with ranges and to whom they belong? A simple database actually.
Just a thought….
Just a thought….
In this electronic age in which I know you participate, you should be able to print out a list of labs which came in that day. In a perfect world, your lab(s) would electronically send those over in a way your EMR/EHR system could use with no touch of a person’s hand. In an imperfect world, someone has to enter the data into it. I know my PCP pulls my labs up off of the computer and if I’ve had any labs done in this health system (which consists of many hospitals, labs, clinics, etc.), they can be accessed by her.
So, why not a printed list daily of new lab results with ranges and to whom they belong? A simple database actually.
Just a thought….
It is MUCH harder than it sounds. Here’s the biggest rub: all of this takes significant time, yet we don’t get an extra dime for doing a better job. It’s not about money, but when your margins are tight, you don’t go looking for more un-reimbursed work.
It is MUCH harder than it sounds. Here’s the biggest rub: all of this takes significant time, yet we don’t get an extra dime for doing a better job. It’s not about money, but when your margins are tight, you don’t go looking for more un-reimbursed work.
Ok….I understand that. Someone has to file the labs or put the info in the EMR somehow, though, so it seems to me a person quick at data entry would be much cheaper than someone filing sheets of paper. Maybe not.
So many questions and ideas but not enough time….and probably this isn’t the place.
Ok….I understand that. Someone has to file the labs or put the info in the EMR somehow, though, so it seems to me a person quick at data entry would be much cheaper than someone filing sheets of paper. Maybe not.
So many questions and ideas but not enough time….and probably this isn’t the place.
Dr. Rob -Patients and doctors should get together and demand that the payor system start paying for coordination of care so that EMRs and good doctor to doctor or doctor to other provider communication happens to help the patient.
However, I must say that you need to back off about the staff. I know that there are patients who are inappropriate with staff. But my experience is that more often than not, the staff do the bare minimum to make me feel welcome. Do your staff understand that it is not my job to know your system, your forms, your protocols for running your business. I come with my medication list, my insurance card and a humble attitude and then am lectured about how I didn’t fill out a form correctly (a poorly photocopied form that is hard to read). Do you know how far a simple – “thank you for coming in today” would go? And yet, not one receptionist has ever told me that.
Do they listen to the patient? Do they stop, make eye contact and really hear what they are saying? Or is their ear to the phone, fingers on the keyboard and putting a clipboard in front of patient without saying hello. The doctor generally knows to do these things, but your staff should do it as well. It would go a LONG way in defusing confrontations.
As for ‘it’s rarely their fault that the system is backed up”, that’s fine, but what are you doing to keep them in the loop as to wait times and emergencies that have popped up? Are they calling your appointments in the afternoon to let them know you’re running an hour late? What are you doing to respect your patient’s time?
I understand that being a doctor can be a thankless job, but if you truly want good doctor-patient relationships, then you need to communicate back to them about what’s happening. There’s a reason that patient’s get frustrated at your staff and your proactively communicating with them could defuse a potential bomb with a bit of compassion and understanding.
Dr. Rob -Patients and doctors should get together and demand that the payor system start paying for coordination of care so that EMRs and good doctor to doctor or doctor to other provider communication happens to help the patient.
However, I must say that you need to back off about the staff. I know that there are patients who are inappropriate with staff. But my experience is that more often than not, the staff do the bare minimum to make me feel welcome. Do your staff understand that it is not my job to know your system, your forms, your protocols for running your business. I come with my medication list, my insurance card and a humble attitude and then am lectured about how I didn’t fill out a form correctly (a poorly photocopied form that is hard to read). Do you know how far a simple – “thank you for coming in today” would go? And yet, not one receptionist has ever told me that.
Do they listen to the patient? Do they stop, make eye contact and really hear what they are saying? Or is their ear to the phone, fingers on the keyboard and putting a clipboard in front of patient without saying hello. The doctor generally knows to do these things, but your staff should do it as well. It would go a LONG way in defusing confrontations.
As for ‘it’s rarely their fault that the system is backed up”, that’s fine, but what are you doing to keep them in the loop as to wait times and emergencies that have popped up? Are they calling your appointments in the afternoon to let them know you’re running an hour late? What are you doing to respect your patient’s time?
I understand that being a doctor can be a thankless job, but if you truly want good doctor-patient relationships, then you need to communicate back to them about what’s happening. There’s a reason that patient’s get frustrated at your staff and your proactively communicating with them could defuse a potential bomb with a bit of compassion and understanding.
That is exactly my point. It is my fault or my office manager’s fault if the system is messed up. We are the ones who need to know and are likely just as frustrated as they are. Or if there is a staff who is rude or uncaring, it is my job as their boss to know about it and take action. If I don’t then it is again my fault, not theirs. Do you blame a kid for being spoiled, or the parents?
It is fine to get frustrated with staff, but people chewing them out, cursing at them, and basically showing their … that is entirely inappropriate.
That is exactly my point. It is my fault or my office manager’s fault if the system is messed up. We are the ones who need to know and are likely just as frustrated as they are. Or if there is a staff who is rude or uncaring, it is my job as their boss to know about it and take action. If I don’t then it is again my fault, not theirs. Do you blame a kid for being spoiled, or the parents?
It is fine to get frustrated with staff, but people chewing them out, cursing at them, and basically showing their … that is entirely inappropriate.
NYT’s picked you up again, Dr. Rob: Click here for “Six Ways to Be a Better Patient”
NYT’s picked you up again, Dr. Rob: Click here for “Six Ways to Be a Better Patient”
A medical face mask or shield seriously muffles the speech of a health care professional or other person, including technicians and staff members who communicate or otherwise interact with a hearing-disabled patient in the course of a procedure or advising patients and family members during a consultation. I suggest (nay, appeal) to the pro doing the talking to slow down and enunciate with more care than usual when the patient is hoh. Usually, a normal tone and voice sound level will suffice if you slow down a bit. A brief pause between sentences will also help the hoh listener enormously to understand what you are saying. Should the patient ask you to repeat, don’t show impatience; the ailing + hoh patient’s problem becomes much more intense due to their mounting frustration in not being able to understand you.
A medical face mask or shield seriously muffles the speech of a health care professional or other person, including technicians and staff members who communicate or otherwise interact with a hearing-disabled patient in the course of a procedure or advising patients and family members during a consultation. I suggest (nay, appeal) to the pro doing the talking to slow down and enunciate with more care than usual when the patient is hoh. Usually, a normal tone and voice sound level will suffice if you slow down a bit. A brief pause between sentences will also help the hoh listener enormously to understand what you are saying. Should the patient ask you to repeat, don’t show impatience; the ailing + hoh patient’s problem becomes much more intense due to their mounting frustration in not being able to understand you.
Cathy: Tell me personally or write it down. An e-mail to our office administrator is a good idea. I don’t know about other docs, but I really do listen when patients complain about staff.
Steevo – Yep. Agree, but I was trying to not get terribly hammered over there. It is amazing how happy people are to praise me when I give rules for docs but think I am arrogant for giving rules for patients. Everybody wants others to bear the responsibility. I hear the same from physicians who blame everything on patient noncompliance – it is a problem, but doctors have an role in maximizing compliance.
Jen: A good relationship for a chronic problem is the best therapy out there. Even the grumpiest docs out there have good relationships with some patients.
Cathy: Tell me personally or write it down. An e-mail to our office administrator is a good idea. I don’t know about other docs, but I really do listen when patients complain about staff.
Steevo – Yep. Agree, but I was trying to not get terribly hammered over there. It is amazing how happy people are to praise me when I give rules for docs but think I am arrogant for giving rules for patients. Everybody wants others to bear the responsibility. I hear the same from physicians who blame everything on patient noncompliance – it is a problem, but doctors have an role in maximizing compliance.
Jen: A good relationship for a chronic problem is the best therapy out there. Even the grumpiest docs out there have good relationships with some patients.
How would you prefer patients handle complaints they have with staff? I have never once complained to any doctor about his staff but I have left practices in the past because of conflicts with certain staff members. I also knew that to complain would probably make me look worse in the doc’s eye than his employee. One of our mutual blogger friends had an issue like this last year and everyone was telling her to bring it to the doctors attention, but when she did she received a letter and was fired from the practice. So just what is the proper way to handle complaints without damaging the dr./pt. relationship? Or without just leaving the practice.
How would you prefer patients handle complaints they have with staff? I have never once complained to any doctor about his staff but I have left practices in the past because of conflicts with certain staff members. I also knew that to complain would probably make me look worse in the doc’s eye than his employee. One of our mutual blogger friends had an issue like this last year and everyone was telling her to bring it to the doctors attention, but when she did she received a letter and was fired from the practice. So just what is the proper way to handle complaints without damaging the dr./pt. relationship? Or without just leaving the practice.
Dr. Rob, you are getting hammered over at the NY Times. I knew they would turn on you when you came out with your patient rules.
I work at a small community hospital in a rural area which is in a federal designated under-served area. However, I am not an idealistic humanitarian. I live in a smaller town because I have grown to despise city life. I enjoy treating all sorts of patients. And as a family practice doctor, I actually have a strong financial incentive to practice in a rural area. Like many other such communities, we don’t have enough doctors to meet the demand for our services.
Here are my rule for my patients —
1. If I wanted to know your opinion about my office or my staff or the way I perform my duties, then I would have asked you.
2. Just because you read a book or stayed at the Holiday Inn Express, don’t presume that you know what I know. I will be happy to explain anything to you, as long I understand it myself. I am not only well educated, but I also have a lot of experience that you will never understand or share.
3. I am not a representative of your insurance company complaint department.
4. I will do my best to treat you with the least expensive medicine on the market that will do the job effectively. But, sometimes you have to pay for that medicine all by yourself (see #3).
5. I try very hard to be on time. I usually see you within ten minutes of your appointment time. If I am delayed then feel free to reschedule. I am almost certainly late because someone has a greater need of my time and presence.
6. If you can’t make it to your appointment, then call and let me know BEFORE YOUR APPOINTMENT! You are making someone else who is sick wait longer to be treated. Forget to call 3 times and you will need to find another doctor.
7. If you don’t like to take medicine, don’t believe in “germ theory,” or think homeopathic medicine is a good thing, then don’t see someone who is a Doctor of Medicine.
8. Don’t ever say this to me — “Well, the guy/gal at the GNC store told me…”
9. If you don’t want your kids to get immunized, then I will think you are an idiot (yes, even if you are Amish).
10. I can’t diagnose your rash over the phone…
Dr. Rob, you are getting hammered over at the NY Times. I knew they would turn on you when you came out with your patient rules.
I work at a small community hospital in a rural area which is in a federal designated under-served area. However, I am not an idealistic humanitarian. I live in a smaller town because I have grown to despise city life. I enjoy treating all sorts of patients. And as a family practice doctor, I actually have a strong financial incentive to practice in a rural area. Like many other such communities, we don’t have enough doctors to meet the demand for our services.
Here are my rule for my patients —
1. If I wanted to know your opinion about my office or my staff or the way I perform my duties, then I would have asked you.
2. Just because you read a book or stayed at the Holiday Inn Express, don’t presume that you know what I know. I will be happy to explain anything to you, as long I understand it myself. I am not only well educated, but I also have a lot of experience that you will never understand or share.
3. I am not a representative of your insurance company complaint department.
4. I will do my best to treat you with the least expensive medicine on the market that will do the job effectively. But, sometimes you have to pay for that medicine all by yourself (see #3).
5. I try very hard to be on time. I usually see you within ten minutes of your appointment time. If I am delayed then feel free to reschedule. I am almost certainly late because someone has a greater need of my time and presence.
6. If you can’t make it to your appointment, then call and let me know BEFORE YOUR APPOINTMENT! You are making someone else who is sick wait longer to be treated. Forget to call 3 times and you will need to find another doctor.
7. If you don’t like to take medicine, don’t believe in “germ theory,” or think homeopathic medicine is a good thing, then don’t see someone who is a Doctor of Medicine.
8. Don’t ever say this to me — “Well, the guy/gal at the GNC store told me…”
9. If you don’t want your kids to get immunized, then I will think you are an idiot (yes, even if you are Amish).
10. I can’t diagnose your rash over the phone…
Robin, ref your question about computer entry of patient records, I don’t work in health care, but have relevant experience from construction Quality Control, Progressing and Quality Assurance systems.
What will need to happen is that you need to punch the computer record, and file the paper copy as well, in case the computer operator makes a transcription error. Even with Optical Character Recognition scanning systems they’re not 100% accurate, and a 1 character error in medicine is the difference between “A1 health” and “dying of something” sometimes.
Robin, ref your question about computer entry of patient records, I don’t work in health care, but have relevant experience from construction Quality Control, Progressing and Quality Assurance systems.
What will need to happen is that you need to punch the computer record, and file the paper copy as well, in case the computer operator makes a transcription error. Even with Optical Character Recognition scanning systems they’re not 100% accurate, and a 1 character error in medicine is the difference between “A1 health” and “dying of something” sometimes.
Great points- our family’s been lucky enough to have great relationships with all of our primary care doctors. Part of it is just that we’ve had fantastic doctors, but I also try to be a good patient, especially since I have children with complicated health issues. I think that a little mutual respect and communication goes a very long way in maintaining a good relationship over the years.
And it’s good to see you over at the NYT again- I’m glad that you’re getting some recognition (even if it’s not all positive).
Great points- our family’s been lucky enough to have great relationships with all of our primary care doctors. Part of it is just that we’ve had fantastic doctors, but I also try to be a good patient, especially since I have children with complicated health issues. I think that a little mutual respect and communication goes a very long way in maintaining a good relationship over the years.
And it’s good to see you over at the NYT again- I’m glad that you’re getting some recognition (even if it’s not all positive).
[…] rules | Dr Rob over at Musings of a Distractible Mind has got a great post up titled Getting along: Part 2 – Patient Rules. Normally, posts by doctors about rules for patients usually involve patients leaving their brains […]
I live in Virginia, and in this state, a patient can contact Quest Diagnostics directly to get blood work results. I ususally wait ~3 weeks, then ask for them by filling out their request form. So much easier than calling a doctor’s office and asking for a copy.
Most of the radiology labs I’ve dealt with will give you copies of your films/reports, but with some, you have to run a gauntlet of clerks before getting your results.
I had a friend who was a clerk in the radiology dept at a community hospital, out in a nice sububan area. She said there was no system for dealing with fax requests for films/reports, whether coming from a patient or a doctor’s office. She said that they did not log the requests in, there was no record if a request was filled or who took care of it, or if a request was lost. In the end, they had no idea if requests were being taken care of or not. And no one was held accountable for this.
And then she went on to the subject of new films/reports filed in the wrong place, or simply discarded…..
How is a patient supposed to manage this unmanageable situation? Who’s responsibility is it for this mess?
I do want to note that when I lived in South Jersey, my family doctors’ office was so well run. The oldest doctor in the practice was from Scotland, and she ran a tight ship! No office staff goofing off, talking about their personal lives while the phone rings and patients wait. The clerks in that office spent their work time working. Paperwork was not misfiled, phone calls were returned, insurance referrals and prescription refills were handled promptly, copies of medical records were copied at the first request.
Obviously, it can be done. Like any well-run business, someone has to be in charge, and keep on top of things. Their office was not constantly on the verge of chaos. They had procedures for handling all the work that needed to get done, and it got done efficiently. Because a person at the top expected it, period.
Dr. Rob, honestly ask yourself – Why is your office operating on the brink of chaos? Is there not enough office staff? Is the staff not certain how to handle all the different types of paperwork that must get done? Do they think you won’t notice if things fall through the cracks?
Thanks for the good writing, BTW.
I live in Virginia, and in this state, a patient can contact Quest Diagnostics directly to get blood work results. I ususally wait ~3 weeks, then ask for them by filling out their request form. So much easier than calling a doctor’s office and asking for a copy.
Most of the radiology labs I’ve dealt with will give you copies of your films/reports, but with some, you have to run a gauntlet of clerks before getting your results.
I had a friend who was a clerk in the radiology dept at a community hospital, out in a nice sububan area. She said there was no system for dealing with fax requests for films/reports, whether coming from a patient or a doctor’s office. She said that they did not log the requests in, there was no record if a request was filled or who took care of it, or if a request was lost. In the end, they had no idea if requests were being taken care of or not. And no one was held accountable for this.
And then she went on to the subject of new films/reports filed in the wrong place, or simply discarded…..
How is a patient supposed to manage this unmanageable situation? Who’s responsibility is it for this mess?
I do want to note that when I lived in South Jersey, my family doctors’ office was so well run. The oldest doctor in the practice was from Scotland, and she ran a tight ship! No office staff goofing off, talking about their personal lives while the phone rings and patients wait. The clerks in that office spent their work time working. Paperwork was not misfiled, phone calls were returned, insurance referrals and prescription refills were handled promptly, copies of medical records were copied at the first request.
Obviously, it can be done. Like any well-run business, someone has to be in charge, and keep on top of things. Their office was not constantly on the verge of chaos. They had procedures for handling all the work that needed to get done, and it got done efficiently. Because a person at the top expected it, period.
Dr. Rob, honestly ask yourself – Why is your office operating on the brink of chaos? Is there not enough office staff? Is the staff not certain how to handle all the different types of paperwork that must get done? Do they think you won’t notice if things fall through the cracks?
Thanks for the good writing, BTW.
Actually, our office is always sited by most patients as a very tight ship. Read my post Here about life in my practice. Yet no matter how well YOU are organized, the deluge of information coming in and the high percent that gets sent to the wrong doctor or not sent is incredible. Phone calls abound, and patients walk-in asking for stuff. The number of offices that are truly “tight ships” is very small.
Actually, our office is always sited by most patients as a very tight ship. Read my post Here about life in my practice. Yet no matter how well YOU are organized, the deluge of information coming in and the high percent that gets sent to the wrong doctor or not sent is incredible. Phone calls abound, and patients walk-in asking for stuff. The number of offices that are truly “tight ships” is very small.
[…] people seized on my words in my last post: A doctor’s office is always on the brink of chaos – with an incredible amount of information […]
I don’t think the physician office is the only place that routinely operates on the brink of chaos: most medical facilities are this way. Notice Rob said not “in” chaos but on the BRINK of chaos. My guess is that it very seldom if ever gets to actual chaos. It’s just the nature of the business, all the unplanned, unscheduled, and predictable events that may happen at almost any time. Also, most medical offices and facilities have contingency plans for the vast majority of things that can cause chaos, but nothing is perfect.
Knowing this should empower patients to avoid adding to the risk of chaos, such as being on time to appts, bringing all necessary papers and information to appts and following up as is necessary or requested.
I believe those who begin to see themselves as active partners in the relationship with their physicians (instead of customers to be served) stand to benefit the most in terms of health outcomes.
I don’t think the physician office is the only place that routinely operates on the brink of chaos: most medical facilities are this way. Notice Rob said not “in” chaos but on the BRINK of chaos. My guess is that it very seldom if ever gets to actual chaos. It’s just the nature of the business, all the unplanned, unscheduled, and predictable events that may happen at almost any time. Also, most medical offices and facilities have contingency plans for the vast majority of things that can cause chaos, but nothing is perfect.
Knowing this should empower patients to avoid adding to the risk of chaos, such as being on time to appts, bringing all necessary papers and information to appts and following up as is necessary or requested.
I believe those who begin to see themselves as active partners in the relationship with their physicians (instead of customers to be served) stand to benefit the most in terms of health outcomes.
Hey Dr. Rob, great post – I linked to it on ChronicBabe.
This is one of the first times I’ve seen a physician acknowledge that the doctor-patient relationship is a two-way street… that we all have responsibilities for keeping the relationships with our doctors strong. So bravo to you – as a young woman with multiple chronic illnesses (thus, multiple health care providers) I know how challenging it can be to find and keep a good doctor.
Many people in my position lose hope that there are great docs out there – I think they forget sometimes that part of their responsibility as patients is to seek out good providers and develop trusting, honest relationships. It’s not just up to the doctor to make everything “perfect” or “right.” And it’s an imperfect system, full of imperfect doctors and patients. We could all stand to have a little patience with each other.
Thanks again for writing this.
Hey Dr. Rob, great post – I linked to it on ChronicBabe.
This is one of the first times I’ve seen a physician acknowledge that the doctor-patient relationship is a two-way street… that we all have responsibilities for keeping the relationships with our doctors strong. So bravo to you – as a young woman with multiple chronic illnesses (thus, multiple health care providers) I know how challenging it can be to find and keep a good doctor.
Many people in my position lose hope that there are great docs out there – I think they forget sometimes that part of their responsibility as patients is to seek out good providers and develop trusting, honest relationships. It’s not just up to the doctor to make everything “perfect” or “right.” And it’s an imperfect system, full of imperfect doctors and patients. We could all stand to have a little patience with each other.
Thanks again for writing this.
Maggie May: Thanks so much for getting that. I actually posted about that today.
Thanks Chronic Babe! I am glad you saw both sides of it. Some people (especially on the NYT blog) don’t seem to notice I gave both sides. The idea is to set some guidelines that will improve relations. There are idiots on both sides, but if people don’t understand the other side, they won’t be able to improve things.
Maggie May: Thanks so much for getting that. I actually posted about that today.
Thanks Chronic Babe! I am glad you saw both sides of it. Some people (especially on the NYT blog) don’t seem to notice I gave both sides. The idea is to set some guidelines that will improve relations. There are idiots on both sides, but if people don’t understand the other side, they won’t be able to improve things.
I’ve often wanted to show my appreciation to my physicians that I feel have either gone above and beyond or just held it together on what I could tell was a very difficult day, meaning I didn’t feel short-changed with the results of my appointment. I always wondered if it was considered inappropriate, unprofessional. What I often want my physicians, mainly pain specialists, to understand, is that the appointment that I’ve been waiting for that he might rush through will determine my levels of comfort and functionality until the next three month appointment. I’ve learned to not call often. Chronic means I’ll be with him for a long time, hopefully, and I don’t want the dreaded “problem patient” label. My last pain specialist’s office actually had an urn on a bookshelf at the front desk that said “Ashes of Problem Patients”. It sounds like I have in common with some here, the staff can be a real problem. They can be beyond rude. I can stand at the front desk and wait to be greeted and they will continue a conversation, it’s like a fast food place sometimes! And they are the link to who you need to speak to, or your lab results. It’s unfortunate that we as patients have to learn to distance ourselves from our conditions as well. I make my lists for appointments days ahead and try to avoid being emotional. But I always break out in hives………fear of being a problem patient.
I’ve often wanted to show my appreciation to my physicians that I feel have either gone above and beyond or just held it together on what I could tell was a very difficult day, meaning I didn’t feel short-changed with the results of my appointment. I always wondered if it was considered inappropriate, unprofessional. What I often want my physicians, mainly pain specialists, to understand, is that the appointment that I’ve been waiting for that he might rush through will determine my levels of comfort and functionality until the next three month appointment. I’ve learned to not call often. Chronic means I’ll be with him for a long time, hopefully, and I don’t want the dreaded “problem patient” label. My last pain specialist’s office actually had an urn on a bookshelf at the front desk that said “Ashes of Problem Patients”. It sounds like I have in common with some here, the staff can be a real problem. They can be beyond rude. I can stand at the front desk and wait to be greeted and they will continue a conversation, it’s like a fast food place sometimes! And they are the link to who you need to speak to, or your lab results. It’s unfortunate that we as patients have to learn to distance ourselves from our conditions as well. I make my lists for appointments days ahead and try to avoid being emotional. But I always break out in hives………fear of being a problem patient.
I’m not a doctor, but I do perform diagnostics for a living. (okay, on computers, not people)
One rule I thought I would suggest: When you have found somebody you can trust, don’t try to do their work for them. By all means, if you have found some information on the internet that you are curious about, by all means bring it up; but coming in having already made up your mind on what is wrong and/or what will fix it does neither doctor nor patient any good.
I’m not a doctor, but I do perform diagnostics for a living. (okay, on computers, not people)
One rule I thought I would suggest: When you have found somebody you can trust, don’t try to do their work for them. By all means, if you have found some information on the internet that you are curious about, by all means bring it up; but coming in having already made up your mind on what is wrong and/or what will fix it does neither doctor nor patient any good.
I actually read this list in the NYT Blog and posted it on my blog. My blog is from a patient’s perspective and I completely agree with your list. Doctor-Patient relationships are a two way street. We as patients have to take more responsibility. I could only imagine how difficult it is to manage an office where you are not dealing with “normal” customers. These customers are worried about their health, which makes them even more sensitive. Thank you for your insight.
I actually read this list in the NYT Blog and posted it on my blog. My blog is from a patient’s perspective and I completely agree with your list. Doctor-Patient relationships are a two way street. We as patients have to take more responsibility. I could only imagine how difficult it is to manage an office where you are not dealing with “normal” customers. These customers are worried about their health, which makes them even more sensitive. Thank you for your insight.
Hi! I found this post via Chronic Babe. I am a 31 year old systemic lupus patient with bonus short-segment Hirschsprung’s disease. I was diagnosed with lupus with when I was 19, so for the past 12 years I’ve been a frequent flyer in the healthcare system here in Vermont. Inpatient and out, more specialists than I could count from medicine and surgery. However, I have also worked in the same hospital at which I am treated for 8 of those twelve years, so I feel like I have some understanding of both sides.
Cumulatively, I have listened to hundreds of hours of healthcare horror stories from my fellow patients, and ‘worst patient ever’ stories from my co-workers. These tales always distill down to two genres: bad humans and/or bad systems. My frustration and anxiety levels as both a patient and a healthcare worker went down when I realized a few simple truths, many of which are covered by your posts here. Thank you for bringing them to a wide audience! I think that a lot of provider-patient miscommunication can be avoided by decreasing anticipatory reactiveness based on stereotyping. I hope your lovely blogging will help.
Hi! I found this post via Chronic Babe. I am a 31 year old systemic lupus patient with bonus short-segment Hirschsprung’s disease. I was diagnosed with lupus with when I was 19, so for the past 12 years I’ve been a frequent flyer in the healthcare system here in Vermont. Inpatient and out, more specialists than I could count from medicine and surgery. However, I have also worked in the same hospital at which I am treated for 8 of those twelve years, so I feel like I have some understanding of both sides.
Cumulatively, I have listened to hundreds of hours of healthcare horror stories from my fellow patients, and ‘worst patient ever’ stories from my co-workers. These tales always distill down to two genres: bad humans and/or bad systems. My frustration and anxiety levels as both a patient and a healthcare worker went down when I realized a few simple truths, many of which are covered by your posts here. Thank you for bringing them to a wide audience! I think that a lot of provider-patient miscommunication can be avoided by decreasing anticipatory reactiveness based on stereotyping. I hope your lovely blogging will help.
Since becoming an adult, it feels I’m a professional patient more than anything else. I have several conditions which require different doctors and specialists to manage long-term, plus I’ve recently been diagnosed with Stage IV Ovarian Cancer, which I’m still fighting; I’m getting ready to start my second regimen of Chemotherapy later this week. I’ve learned most of these rules, or variations of them, over the years ~ through trial and error ~ on my own, and mostly they’re based on sound advice.
I know my doctors can’t do it alone; I’ve taken to sending faxes to my doctors to explain what’s happening: my symptoms, how often they occur, as well as changes in my medications or with my eating/exercise routines. That gives my doctors a heads-up so they’ll know if they want to see me first, or send me for tests before any appointment. Sometimes, X-rays or bloodwork should come first; all kinds of things may need to be done before you sit down face-to-face with your physician.
Do doctors play favorites? Sure they do. Do they realize it? Do any of us realize we play favorites when it’s happening? No, we don’t. We have to give them a break on this, people; they’re human, just as human we are.
When it comes to the staff, you have to be nice to them, and I make every attempt to do so ~ it never hurts to have a friend on the inside when you need something. Hopefully, the doctor will wind up being my friend, too; but, I can’t count on that, so I’ll take a nurse, nurse practitioner, office manager — anyone who might be able to help if I need it.
However, I also have a job to do as their patient; I have to keep them informed as to what’s happening on the other side of the phone/desk. If I’m treated poorly ~ if I call for test results and get run-around for two weeks; if I send a fax to my doctor and find someone has taken and hidden it for a week ~ I must notify the office / doctor of what’s happening; the only way to do that effectively is by putting it in writing and submitting it to the Office Manager or the doctor.
The only way the doctor can take any action about these situations is if I’m willing to put my name to written complaints about them. Otherwise, I’m just another rude patient yelling at their employee(s) for no good reason ~ what I say won’t carry any weight if I do that. If you’re not willing to put your name to it, then it’s probably best if you just keep your mouth shut. Don’t abuse or belittle people just because you’re having a bad moment/day/week/month/life.
Even if you’re part of an HMO, or other “socialist-type” healthcare system, you still have a choice on whether you stick with a particular doctor or not. If you don’t like the doctor, you don’t trust the doctor, or you’re frightened of the doctor, go out and find yourself another one. You owe it to yourself, to your health, and you owe it to the doctor. No one would want to continue treating a patient who doesn’t trust them, doesn’t like them, is in fear of them, or – for some other reason – doesn’t want to be near them. Were I that doctor, I’d want to get as far away from that patient as humanly possible. Who would want to work like that? Would you want to work for/with someone who wanted nothing to do with you?
You always have a choice. Yes, you might have to drive farther to see someone else; that much is true. Yes, you might have to pay more out-of-pocket to see someone else; that much is true, as well. You’ll have to weigh how much the decision to change doctors is worth to you vs. what it might cost; no one can make the decision for you. But, try to keep in mind that you aren’t the only person affected by your choice. If you decide to stay with a doctor you have issues with, you’re asking a lot of that doctor. You’re asking the doctor to engage in an antagonistic relationship with you, and you’re not giving the doctor a choice. How fair is that?
It would be like someone hiring you to do a job, AFTER deciding they hate you ~ BUT, they decide not to tell you that. They decide to keep secret from you how much they hate you; they’re just going to wait until you do something to make them angry, THEN you’re going to get it. Talk about unfair! If you hire someone to be your doctor ~ someone you don’t trust, you don’t like, or you’re afraid of ~ you’re doing the same thing. And, unfair is unfair.
Doctor/patient relationships only work when they’re based on mutual trust and respect; you have to give trust and respect first, in order to receive any in return. Be patient with each other, be open and honest, and work hard at keeping the lines of communication open. If you do that, respectfully, you should do well in communicating with your doctor. It IS worth the effort when it works.
Susan/MinPin
minpin71163@sbcglobal.net
Since becoming an adult, it feels I’m a professional patient more than anything else. I have several conditions which require different doctors and specialists to manage long-term, plus I’ve recently been diagnosed with Stage IV Ovarian Cancer, which I’m still fighting; I’m getting ready to start my second regimen of Chemotherapy later this week. I’ve learned most of these rules, or variations of them, over the years ~ through trial and error ~ on my own, and mostly they’re based on sound advice.
I know my doctors can’t do it alone; I’ve taken to sending faxes to my doctors to explain what’s happening: my symptoms, how often they occur, as well as changes in my medications or with my eating/exercise routines. That gives my doctors a heads-up so they’ll know if they want to see me first, or send me for tests before any appointment. Sometimes, X-rays or bloodwork should come first; all kinds of things may need to be done before you sit down face-to-face with your physician.
Do doctors play favorites? Sure they do. Do they realize it? Do any of us realize we play favorites when it’s happening? No, we don’t. We have to give them a break on this, people; they’re human, just as human we are.
When it comes to the staff, you have to be nice to them, and I make every attempt to do so ~ it never hurts to have a friend on the inside when you need something. Hopefully, the doctor will wind up being my friend, too; but, I can’t count on that, so I’ll take a nurse, nurse practitioner, office manager — anyone who might be able to help if I need it.
However, I also have a job to do as their patient; I have to keep them informed as to what’s happening on the other side of the phone/desk. If I’m treated poorly ~ if I call for test results and get run-around for two weeks; if I send a fax to my doctor and find someone has taken and hidden it for a week ~ I must notify the office / doctor of what’s happening; the only way to do that effectively is by putting it in writing and submitting it to the Office Manager or the doctor.
The only way the doctor can take any action about these situations is if I’m willing to put my name to written complaints about them. Otherwise, I’m just another rude patient yelling at their employee(s) for no good reason ~ what I say won’t carry any weight if I do that. If you’re not willing to put your name to it, then it’s probably best if you just keep your mouth shut. Don’t abuse or belittle people just because you’re having a bad moment/day/week/month/life.
Even if you’re part of an HMO, or other “socialist-type” healthcare system, you still have a choice on whether you stick with a particular doctor or not. If you don’t like the doctor, you don’t trust the doctor, or you’re frightened of the doctor, go out and find yourself another one. You owe it to yourself, to your health, and you owe it to the doctor. No one would want to continue treating a patient who doesn’t trust them, doesn’t like them, is in fear of them, or – for some other reason – doesn’t want to be near them. Were I that doctor, I’d want to get as far away from that patient as humanly possible. Who would want to work like that? Would you want to work for/with someone who wanted nothing to do with you?
You always have a choice. Yes, you might have to drive farther to see someone else; that much is true. Yes, you might have to pay more out-of-pocket to see someone else; that much is true, as well. You’ll have to weigh how much the decision to change doctors is worth to you vs. what it might cost; no one can make the decision for you. But, try to keep in mind that you aren’t the only person affected by your choice. If you decide to stay with a doctor you have issues with, you’re asking a lot of that doctor. You’re asking the doctor to engage in an antagonistic relationship with you, and you’re not giving the doctor a choice. How fair is that?
It would be like someone hiring you to do a job, AFTER deciding they hate you ~ BUT, they decide not to tell you that. They decide to keep secret from you how much they hate you; they’re just going to wait until you do something to make them angry, THEN you’re going to get it. Talk about unfair! If you hire someone to be your doctor ~ someone you don’t trust, you don’t like, or you’re afraid of ~ you’re doing the same thing. And, unfair is unfair.
Doctor/patient relationships only work when they’re based on mutual trust and respect; you have to give trust and respect first, in order to receive any in return. Be patient with each other, be open and honest, and work hard at keeping the lines of communication open. If you do that, respectfully, you should do well in communicating with your doctor. It IS worth the effort when it works.
Susan/MinPin
minpin71163@sbcglobal.net
[…] assume that no news is Gg news. As physician blogger Dr. Rob points out, a doctor’s office is always on the brink of chaos — with an incredible […]
[…] Excerpt from Getting along: Part 2 – Patient Rules […]
Even in November, this stil applies… thank you for this one, Dr. Rob… it helped me to put things into perspective a bit 🙂Reflections entry from It’s All About the Walls
Amanda
Even in November, this stil applies… thank you for this one, Dr. Rob… it helped me to put things into perspective a bit 🙂Reflections entry from It’s All About the Walls
Amanda