Bart Barrett

Unhappy with the service you receive from your doctor? Want to tell them how they can do a better job? Here is a list of things patients all deserve from their doctors, feel free to share it with your physician.

Patients deserve-

1- A smile. They deserve one from the receptionist and from the doctor. They are the reason we all have a job!

2- A doctor who is on time. Patients understand that we have emergencies but also know that we do not have emergencies every day. Repeated long waits tell patients that we are uncaring and disorganized. My personal solution to the problem is to schedule same day illness appointments at the end of the morning after I am done with scheduled patients. My scheduled patients then have the time they need.

3- A meaningful apology. When I am behind more than 30 minutes I give out Starbucks Gift Cards as an apology. This 5 dollar gesture lets them know that their time is important.

4- Access. When patients are sick and want to be seen, we need to see them. If that means working late or working through lunch we need to do that. If we are not available when they need us, what good are we to them?

5- Timely responses. We need to return our phone calls every day and notify patients of test results as soon as they come in. Worried patients should not have to worry needlessly. When we communicate quickly we tell them we care.

6- Listening. I am not a naturally good listener and I am easily distracted by the computer screen. I have trained myself to step away from the computer and to sit down when there is something important to communicate. A minute or two of my undivided attention means a lot.

7- Eye contact. Computers make this harder, but it is important. No one wants to look at the back of our head when they talk.

8- Clear explanations. Doctors too often rush through instructions at an unintelligible pace. In my office I type out instructions that the patient can pick up as they leave. I have learned to be specific and clear. I don’t just write “ice your leg three times a day”, I have learned to write “Ice your leg for 20 minutes three times a day.”

9- Honesty. When I don’t know something, I say so. When something is outside of my area of expertise, I share it. Patients know we are human and appreciate it when we admit it.

10- Time. Some patients need a lot of it. Instead of rushing and trying to handle 6 things in 10 minutes, I ask patients if it would be okay to bring them back in a week or two for a longer visit. When I say that I want to make sure I have enough time to address all of their concerns appropriately and that it is hard to do a good job when I rush, they always understand.

When I first started in practice I did none of these things well (I do not naturally communicate warmth, I am more of a problem-solver type). As a result my patient satisfaction scores were only average. It took years of effort to incorporate these behaviors into my practice. The result has been happier patients, high patient satisfaction scores, a happier office staff, and a happier me!

- Bart

Thanks for reading. Comments and questions are welcomed, and shares are truly appreciated (just click the button)

“You doctors just want to give me poison and I am not going to take it!” I have been accused of many things in my 20 years of practice but intentional poisoning was something new and the patient's words surprisingly harsh. He was angry from the moment I walked into the room. He was first offended when I questioned his reasons for not taking the medications his cardiologist had prescribed. He had experienced some slight swelling of his legs, decided that this side effect was too severe and made the decision on his own that the medication was unsafe. He was convinced that the doctor had put his health in danger and that I wanted to do the same.

When I explained that this was a relatively common side effect with this medication he became angry. “Why would you prescribe a medication when you know there are side effects?” He was nearly shouting and his faith was contorted in anger. He was MAD!

“Because it is an effective drug and the side effects only happen ten percent of the time!” Was my reply.

He would have none of it. It was his opinion that no doctor should ever prescribe any medication if there were any side effects. I tried to explain to him the nature of side effects and how they were outweighed by the benefits of treatment. I spent the next 20 minutes trying to explain to him the nature of heart failure and why medicines were crucial for his health. I explained how the medications worked and why the side effects were reversible or manageable. He argued with me every assertion I made. He told me that doctors were dishonest people who cared more about money than they did people, unscrupulous individuals who would just as soon poison someone as treat them.

I finally gave up. As calmly as I could I told him that if he was going to refuse care for his heart failure that I would not be his doctor. If he didn't trust me it would be impossible for our relationship to continue. I explained that my preference would be for him to remain a patient and be healthy but that remaining a patient and being healthy would mean following my instructions. He continued to argue with me so I opened the exam room door and gestured for him to leave. “You will need to find another doctor,” I told him, and sent him on his way.

After he left I composed a letter summing up what had happened (detailed documentation is required when a patient is dismissed) and put it in the mail. I reviewed our conversation and concluded by saying,

“You made it clear that you do not trust doctors, myself included. The physician/patient relationship has trust as its foundation. Your good health and medical treatment is dependent on you following expert medical advice. Our lengthy conversation today proved to me that you are unwilling to do this.

If you wish to remain a patient in my practice, you will need to accept and follow my recommendations, and schedule appropriate follow up visits. If you are willing to follow my recommendations and respect my judgment and opinions, please schedule a visit to move forward with your care.

If you plan on continuing to argue with my recommendations and refuse to comply with treatment plans, I must insist that you seek care elsewhere.”

I had my staff send the letter via certified mail, convinced that I would never see him again. Which is why I was so taken aback when I saw his name on the schedule 5 weeks later. I entered the room cautiously, prepared for another conflict.

It never came. He was incredibly apologetic from the outset. I asked him what changed his mind. He told me it was the letter! He realized that I was serious about his health and decided right then that he didn’t want to see anyone else.

His dramatic change of heart was something else I had not seen in 20 years of practice. I was truly impressed with his humility and told him so. We agreed on a new medication plan for his heart and blood pressure and arranged a follow up visit. It was a very pleasant encounter.

It was also educational. He taught me that people can change, even those who seem intractable and unreasonable. He reminded me of the power of forgiveness and the beauty of a fresh start. I am actually looking forward to our next visit.

- Bart

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