Our perfect patients: how physicians can mold our practice to optimize everyone’s satisfaction

An internist recently shared a story about an elderly couple – both were her patients.  One day, the woman remarked, “I love you, because you tell me what you think.”  The doctor was flattered that her style was appreciated.  She felt that she was being the good Screen Shot 2014-11-02 at 10.46.28 PMdoctor she had wanted to become.  Then, the woman continued: “But my husband, he hates you because you tell him what you think.”  Does this belong in the “you can please some of the people some of the time” category?

Along those lines, there is another great story. After drinking together for the evening, one man said to the other, “If everyone were like me, everyone would want to be with my wife!”  The other man retorted, “If everyone were like me, no one would want to be with your wife!”

We each have a unique blend of styles, mannerisms, ways of communicating and priorities.  This makes us attractive to different friends, partners and even patients.  And yet, as healthcare providers, we are expected to see all comers – to care for everyone who walks into our office.  But does that mean we should?  Can we really satisfy all of them?

For many years, I had limited hours in my practice, as I was involved in many additional activities during the day.  I recall a patient who called to schedule a consultation and was rude to our receptionist, insisting that he be seen earlier than the next available appointment. I contemplated acquiescing and offering him an earlier appointment.  Then, I realized that we were just not a good fit.  I called and discussed the situation with him, honestly explaining that I wasn’t in the office everyday and suggesting that being a patient in our office would be a frustrating experience for him.  Instead, I recommended that he see another physician.  I’m sure it saved us a lot of discord.

For a variety of reasons, many of us feel obliged to accept everyone who makes an appointment into our practice.  Sometimes it’s pressure from our institution; at other times, it’s pressure from ourselves to have a successful practice.  Although it’s important to learn to communicate with a variety of people, there are just some people who we will never work well with.  Just as with any relationship, it’s wise to set up some ground rules.  We can discuss with our patients how we want to interact with each other, what our expectations are, and what the consequences will be if those expectations aren’t met.  What happens when patients repeatedly come late or cancel appointments?  If they don’t follow the recommendations that you, together, have agreed upon?  If they are rude to your staff? How do your patients want you to discuss their test results, their prognosis, and possible treatments?  What are you willing to agree to?  Personal phone calls to relay lab results?  Round the clock availability? Multiple phone calls/emails between visits?

There are many variables in practicing medicine, and all too often, we fail to take the time to discover what would work best for us and to communicate that clearly to our patients. It’s difficult for sure to tell a patient that we aren’t the best doctor for him or her.  But when we do, the patients we keep are happier and more satisfied.  And that translates into a less stressful and more enjoyable practice for us.

About Helane Fronek

Over the past 28 years I have had a fascinating and fulfilling career in medicine, initially practicing as a general internist and then as a procedural specialist, caring for patients with vein disorders. As Assistant Clinical Professor of Medicine at UC- San Diego School of Medicine, I’m thrilled to be teaching medical students crucial communication skills along with many other aspects involved in the practice of medicine.
This entry was posted in building relationship with patients, effective communication in healthcare, first impressions, honesty in medical care, physician coach, physician coaching, physician communication, physician fulfillment, physician work life balance, work life balance and tagged , , , , , . Bookmark the permalink.

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