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One of the areas that health care struggles with is customer service.  It is a continuous problem because we often lose sight of the focus being on the people we are caring for as opposed to checking off boxes to get paid.  Many of us know this from personal experience but yet will often times fall into the same trap.  I came across a post on the subject and a top ten list of inappropriate behaviors doctors and therapists should avoid. 

Most of us have had direct experience with seeing a doctor or therapist, whether it’s for a checkup or some sort of problem we’ve identified. Some docs are a pleasure to see. I once had the kindest physician who was the epitome of an old-fashioned French country doctor. I’m not sure if he was my best doctor ever (he tended to treat my concerns with a “wait and see” attitude), but he certainly had a fantastic bedside manner and never kept me waiting more than a few minutes.

I appreciated that even more when I went to see my most recent doctor. He was far more gruff, business-like, and running more than 20 minutes late for our appointment. He didn’t apologize for keeping me waiting, and while he listened to my family history with detached professionalism, he went through his canned speech about needing to exercise regularly and other kinds of things with the kind of empty delivery you find in a person who’s said the same thing so many times it has lost all meaning.

Doctors and therapists both can keep bad habits, and they are the kinds of things that turn patients off from them. Patients rarely feel it’s appropriate to address these bad habits directly with the doctor (especially if they intend to keep seeing them), so it was with some relief I came across Dr. Dominic Carone’s blog entry about the “10 ways doctors can lose their patients.”

 

Here are the first few to whet your appetite:

10. Not accepting lists of symptoms or timelines from patients. If you see patients, you know they range on a continuum from poor historians who have no idea why they are there to see you and those who arrive with carefully constructed histories that they are eager to give you as soon as you walk in. Just about the worst thing you can do when this happens is to tell the patient that you don’t want the list and do not even want to look at it. That connotes a dismissive attitude to the patient and it makes them feel like all of their work was for nothing – work that was done in the hopes it would help you figure out what was wrong. You may have very good reason at the time not to look at the list such as time pressure, but at least take the list and say you will later take a look at it. It will likely provide you some useful information.

9. Asking patients to choose what type of medication they want to take. When a patient has a medical condition in need of medical treatment, the physician is looked to provide their advice as to what medication to take. They don’t want to be given a list of three possible medications, told to research them at home, and come back with a decision. From a patient’s perspective, this is why the doctor went to medical school, not me.

8. Long wait times and no apology and/or rushing the patient once coming in. While no patients want to wait long, they will generally accept the wait time if they are pleased with the care you provide, or if it the initial visit, know that you have a good reputation. However, if the patient waits long and you then walk in and do not acknowledge the wait, explain why there was a wait, and apologize for the wait, it will significantly aggravate the patient. Rush the patient after a long wait and no apology and it will worsen the situation further.

7. Poor bedside manner. This is an easy one and has been addressed extensively by others, but don’t do things such as repeatedly looking at the clock, repeatedly interrupting patients, focusing more on you than the patient, talking rudely, making poor eye contact, etc. Follow the Golden Rule and you will easily establish rapport the majority of the time.

I’ve experienced each and every one of these with my regular physician, but I’ve also heard plenty of stories of people who’ve experienced these kinds of bad habits with their therapists and psychiatrists.

My biggest pet peeve is making an appointment for the morning, knowing that the chances of the doctor or therapist running behind is far less likely earlier in the day than later in the day. So when I arrived recently for an 11:00 am appointment, only to have to wait nearly 25 minutes before being asked to come into the exam room, I have to stop my face from turning into something out of a horror movie. If you’re running nearly a half hour behind with just 2 or 3 hours of your day behind you, that says something.

But the absolute worst thing about late professionals is their lack of awareness they are even running late, and the lack of any apology for doing so. I understand emergencies or a patient who needs a little extra time — that’s perfectly fine in my book. Simply offer a brief explanation to me when you come into the room, as well as a brief apology, and all is forgiven.

When a professional can’t even offer that, I do question whether this professional is the right one for me. Because basic manners and common decency are something all doctors and therapists should not only have, but practice daily. It demonstrates a lack of respect for your patient — you know, a fellow human being — when you treat them as just another cog in your daily assembly line of patients.

Nobody wants to be treated that way. So if you’re a doc or a therapist, and you recognize yourself in some of these bad habits, now’s a good time for a wake-up call. After all, it’s never too late to change.

Here is the rest of the top ten list:

6. Not being responsive to challenging questions. Provided that a patient is being respectful, there is no reason to become upset when a patient asks questions challenging a diagnosis or course of treatment. Most patients are generally accepting of your expertise but they may have heard or read something that has given them legitimate questions. Your answers can help reassure the patient that your diagnosis and treatment is correct. Patients are also usually more impressed when you tell them you have no problem with them seeking a second opinion rather than demanding they only accept one point of view and/or becoming overly defensive. Also, patients (or families) sometimes come up with questions that can lead you to entertain an idea you did not previously think of that can improve care. Don’t shy away from this. Embrace it.

5. Disrespectful staff. While the patient may like the care you provide, there are a host of other people they need to interact with before and after the appointment. This includes the receptionist, billing staff, nurses, and others. If these individuals are rude and disrespectful, the patient will likely switch to another provider whose friends and family say have better ancillary staff. It is like owning a restaurant with good food but a terrible hostess and waitress. Many people will just choose a different restaurant. Train your staff to treat your patients they way they would want to be treated (and teach them how to manage patients who are rude) and you will have a happy client base.

4. Drab and dreary office space. No one likes to go to the doctor. Take some time to make it a more enjoyable experience. Have comfortable seats in the waiting area and waiting room, put some nice art up on the walls (geared towards children if it is a pediatric office), have a TV on with cable (with cartoon options for children), soft music, etc. Whether right or wrong, offices that are bare, uncomfortable, and cold looking convey a message that the patient perspective is not being considered.

3. Being unavailable when needed during routine business hours. When the answering service repeatedly picks up the phone during normal business hours, it is extremely frustrating for patients. Same with staff not returning phone calls or being absent for 1.5 hours during lunch time. Patients need to have access to staff during normal office hours to make appointments and ask questions.

2. Cancelling/rescheduling appointments too often. Patients are understanding when a doctor needs to cancel or reschedule but not if it happens too often. This was highlighted in the recent trial of Dr. Conrad Murray, whose former patient testified that after two follow-up appointments were cancelled he felt that the doctor blew him off. The patient never followed up with Dr. Murray again.

1. Making decisions that cause patient harm that were easily avoidable. While patients will sometimes give doctors a second chance, they won’t be inclined to do this if harm occurred to the patient or a family member that could have easily been avoidable. This is especially true if the harm happened to a child. As a personal example, I recall repeatedly explaining to my pediatrician that my child’s cough and wheezing was persistent and affecting her breathing, only to be repeatedly told that it was only allergies, despite the fact that she was cleared by an allergist and was not improving with allergy medications or a nebulizer. Finally, and only by pressuring the physician to do more, was a chest x-ray ordered. Diagnosis: double pneumonia and a week long hospital stay. Totally avoidable. The new pediatrician is very responsive and we have been very pleased for many years.

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