A patient walks in for his appointment, excited to have finally made it to the doctor. Pushing himself to be seen (after incessant nagging from a parent or a spouse), he finally makes the appointment, and several weeks in advance, to boot.
He’s finally here.
He’s made it despite all of the excuses in the book.
It’s been just 3 weeks.
It only hurts when I turn left.
I googled it and it will pass (and thus, by the way, he’s graduated and earned a degree from Google University)
(see Byrdie article to which I contributed titled, The Truth About Self Diagnosis On The Internet)
He took off a full day off from work. Prepared. Made a list. Checked it twice.
.. and finally his moment is here. He sits in the waiting room and waits. And waits. And waits.
45 minutes into last month’s Vogue sitting on the coffee table, his name is called and he walks into the abyss of the inside.
He’s made it in.
It’s over. And it all happens so fast. He can’t even remember what the doctor said.
How the doctor said to take the medications. What the name of that syndrome was. When he needed to get the bloodwork done. If he needed to be fasting. The next time he needed to return. The other 7 points on his list!!!
Head hung low, feet shuffling toward the exit in a walk of defeat, he heads to the checkout counter, where he ponies up the co-pay and utters choice commentary under his breath. Or maybe even documents it all in his own post, under the very same commentary section of his own, fantastic blog.
The patient described above is patient number 30 in the doctor’s eight-hour workday, and that’s only number 30 of the 40 scheduled overall. The day is still young. Or is it? The day thus far has been spent listening to multiple complaints, completing a stack of paperwork, clicking several hundred times on the computer screen of the electronic medical record and logging in all the values needed to legally count these as a visit. Urgent calls must be returned, refills need to be sent, and specific problems solved.
A 10-minute lunch is gobbled up in between. The ER calls to let the doctor know a different patient has arrived there, with crushing chest pain, and needs some input on a few details.
A cold cup of coffee is downed. Black.
A colleague pulls the doctor over to the side to consult about an urgent case. Needs another opinion.
The doctor’s next patient (the one from up top, reading the Vogue magazine in the waiting room) is here 10 minutes late. Only 10, no biggie. Oh wait, but he’s got to fill out the 10 pages of necessary paperwork.
Why? Because insurance says so.
Ok, 10 more minutes. Patient is now getting called in by the medical assistant, straight on the scale, then on to vital signs, followed by an array of questions regarding depression and other screens which the government mandates us to ask.
15 minutes pass.
Dr. X calls the doctor to speak about the patient that was referred to him earlier that same day. 5 minutes, maybe 7.
42 minutes into the scheduled appointment time the doctor walks into the room. The patient unfolds his list and announces the need to discuss seven topics listed. Doctor rushes through. Topic #1 on the list is covered, with no time for the rest.
The next 4 patients are already tapping their fingers against exam tables with impatience in their exam rooms, with 2 more outside, reading, once again, last month’s Vogue. The doctor is late.
(Facebook reviews have already been formulated in their thoughts, to be typed into relevant community pages later, urging followers not to visit this particular doctor’s office. 60 likes ensue.
(read my frustration on the topics of docs reviewed on FB in Two Sides To Every Story, Unless it’s On Facebook)
It’s a no-win situation and we must fix things NOW.
How do we bridge this gap? How do we go about giving the patient the appropriate time needed to feel satisfied and complete?
Pointers For Both Perspectives.
Realistic visits. Ensure visits are realistic and within expectations. Bring with you one main issue to discuss, or two smaller ones. This makes the visit more manageable, and allows the doctor to approach your medical dilemma head on while not feeling rushed to cover a lot of ground.
Think back to when you were in school and you needed to complete an exam in 30 minutes. When there were 5 questions on the test, it was usually less intimidating than when there were 30. You could take more time with each question to ensure you read it precisely, approach the topic from the correct angle, and then answer with confidence after weighing all options. As the patient, I’d like my medical dilemma to ideally be approached in the same way.
Split visit. If you need to cover more ground, schedule another follow up. Splitting the visit into two parts is beneficial for both parties because it allows the doc to not feel overwhelmed and allows you more face time to air out your grievances.
Write it down. Bring in your complaint, written down, so that you don’t suddenly remember additional topics when the doctor is ready to step out. Write out exact symptoms on paper, along with any specifics and how long you’ve felt that way. “Nausea, fever to 101, dry cough and muscle aches for 5 days,” would be a good way to start. This will allow you to concisely talk about your present illness without a chance of forgetting an important fact (plus, your doctor will be uber impressed).
Bring medications. If you take a lot of medications, bring the names with you. Make sure it’s typed or written legibly. It makes things go much quicker when the doctor can simply scan down a neat list. No extra time trying to figure out a name, or a dose. And don’t forget over-the-counters and herbals.
From the doctor’s end, there are also ways to improve flow (and prevent the patient from feeling rushed):
Prepare the patient. Have the patient prepare a descriptive list of their top two issues to discuss at today’s visit, even at the waiting room. They can hand this to the receptionist as they arrive or have it handy to discuss. This helps prevent feeling pressed for time, as they have what they want to discuss written down and don’t remember last-minute topics as you’re stepping out the door. On your end, no need to creatively wrap things up when time starts feeling tight as you know what they’d like covered.
Repeat info. Repeat the main points of your diagnosis and plan at the end of the visit so that the patient has this information clear in his head and walks away both understanding and satisfied.
Set goals. Set goals to attain until your next scheduled face time.
Address all. Ensure all questions or uncertainties are addressed.
Wrapping things up with a summary is crucial in earning patient appreciation. Ask if everything is understood and if there are any further questions. Patients will leave feeling confident, which is key in their satisfaction and in their scheduling a follow up to see you. A win-win.
Let’s work on not feeling rushed, from either end. Together, doctors and patients can work to fill in the widening gap in our fragile health care system, by approaching topics like these head on and trying to find solutions together.
There is always room for improvements, and we will make the necessary strides, one change at a time, until we get closer to where we’d like to be.