Of course, I'm not referring to your doctor who, like Mary Poppins,
is practically perfect in every way. But let's just say that the rest of us
physicians have things we could do better...
1. Taking time to
actually stop and get to know the patient.
I know one lady who
says she has a better relationship with the checkout clerk at the grocery
store than with her physician. It's true that doctors have a legitimate need
to see a certain volume of patients in order to cover practice-expenses and
still have money to take home. This translates into a limited amount of time
per patient. However, some of the time-pressure doctors feel they are under
is of their own making, and even the same amount of time might be better
spent.
How is this any different from what a restaurant owner has to
do? The restauranteur has to supervise employees, handle deliveries, and
oversee the preparation and serving of food, yet still finds time somehow to
chat with the customers.
2. Sticking to appointment schedules.
Yes, medicine is unpredictable and doctors must meet the medical needs of
the patients in front of them before moving on to others. Patients
understand this. But scheduling ten different patients for a 1:00 p.m.
appointment is inexcusable.
3. Remembering what happened at the
last visit, what test they asked for and why they asked for it.
Need I say more?
4. Dealing with more than one chief complaint per
visit.
This is a variant of the time-pressure issue. With the
allotted time being only just adequate to cover one problem, woe to the
patient who has two or three. There is no easy solution apart from
scheduling another visit to handle an additional problem. But if you're the
patient, it's in your best interest to prioritize your problems and take
control of the agenda. Get the most important issue out on the table first
thing and before the doctor launches into an unrelated and time-consuming
tangent.
5. Diagnosing conditions for which "objective" tests are
not available.
Even modern medicine doesn't have good tests that
show every condition as an abnormal blood-level or as a spot on a scan. But
that doesn't mean that the untestable conditions don't exist or are somehow
less credible. For example, there is no confirmatory medical test for
migraine, but unless the 12% of the population experiencing this problem is
lying, there are a lot of folks out there for whom the tests might be
normal, but they aren't.
6. Staying interested in you when
there are no more tests to order or procedures to do.
This is not
a good time to drop the ball. Regardless of the outcome of a test or
procedure, there is still some unmet need to be addressed.
7.
Delivering on promises.
This one seems so needless. For example,
why would a doctor promise that records and films will go to a specialist
and then not follow through? Better not to make such promises in the first
place.
8. Picking up a telephone to call another doctor.
I don't understand why this occurs, but physicians often seem incredibly
reluctant to phone another doctor to sort out a question concerning their
shared patient. Sometimes they order a nurse or clerk to do it instead, or
leave the issue unresolved.
9. Respecting boundaries.
This bears explaining. Boundaries refer to the lines at which one person's
rights and responsibilities end and another person's rights and
responsibilities begin. Crossing a boundary without permission usually leads
to grief and resentment. An example of one doctor not respecting a boundary
with another doctor is when doctor #1 tells the patient to change the dose
of a medicine prescribed by doctor #2. This leaves the patient caught in the
middle.
10. Calling you back with results of procedures and tests.
Once patients have had, say, a scan, a colonoscopy or a blood-test, they
start worrying about all the most dangerous things that might turn up. A
simple phone call to the patient that nothing bad turned up on the tests and
that the details can be discussed at the next visit--even if it comes from
staff--prevents a lot of worry and sleeplessness.
There seems to be a
recurring theme here. Perhaps I'm revealing my age when I say I am reminded
of the chain-gang boss in Paul Newman's "Cool Hand Luke" movie who drawled,
"What we have here is a failure to communicate!"
(C) 2005 by Gary
Cordingley
About the Author
Gary Cordingley, MD, PhD, is a clinical neurologist, teacher and researcher
who works in Athens, Ohio. For more health-related articles see his website at:
http://www.cordingleyneurology.com
