Comments on: How doctors can show respect to patients

By: SunnyD

SunnyD — Tue, 12 Jan 2010 21:58:18 +0000

My internist often wears jeans but in the short time he has he focuses totally on me and doesn’t take other calls. I could not respect him more. When I am seen by an orthopedist I often have to wear shorts. Frankly I find it less intimidating when the physician is wearing a simple polo shirt rather than a suit.

The physicians I see are often the same age as me. They don’t know what to call me and I don’t know what to call them. We end up saying “you” a lot. I didn’t know until reading this website that physicians don’t like to be called “doc.” The only physicians that I would consider giving that title are the ones I not only greatly respect but really appreciate and like.

How about spending the very short time you have focused totally on the patient and their needs rather than routinely taking calls and responding to staff interruptions in the middle of an appointment?

All patients understand that from time to time there will be emergencies so they will have to wait. They also understand that from time to time someone will need longer than planned…and someday they may be that person. However, when a physician consistently keeps patients waiting a long time it indicates to me that they do not have any respect for their patients’ time.

As Baby Boomers become heavier users of health care services I believe that a huge shift has to occur in the way that patients are treated. They are quite capable of understanding a lot, have quite a bit of technical information readily available to them and may need more detailed information about their condition in order to feel comfortable with the treatment plan. (My surgeon was stunned that not only had I watched the operation live on the internet but had also performed it in animation and read quite a few PubMed articles about it. Fortunately he was willing and able to communicate with me at the higher level I needed. My research allowed us to spend the limited time discussing the benefits of the surgery rather than getting a simple explanation of how it is done.)

Baby Boomers in general do not have the same awe of authority figures that characterizes many in the WWII generation. Respect has to be earned.

Finally, what is it with those 10 year old magazines? One of the first things that I look for in a group is whether they have some decent reading material. I am spending several hundred dollars for a few minutes of your time and if you keep me waiting beyond my appointment time the least you can do is show respect for me by having some decent reading materials available.

By: Sarah

Sarah — Sat, 09 Jan 2010 00:08:48 +0000

My last primary care physician treated me like an intelligent person, up until one visit when I informed him of a recent hospitalization in a psychiatric ward. There was an almost palpable shift in his treatment of me, and he no longer took any of my questions or issues seriously.

I had bowel problems severe enough that I thought I would have to quit my job… But irritable bowel syndrome is to be expected in hysterical young women, right? (I was incontinent of large amounts of mucus from my rectum, which I don’t think is a common symptom of IBS.) I had a question about a medication he had prescribed (mefloquine), because the label warned that patients with a history of psychiatric illness should not take this medication, and I had been hospitalized that year, and the year before, and was on medication; his response was to ask my psychiatrist. (She was like, “I’m a psychiatrist; I don’t know anything about antimalarials!”)

This is not the only doctor I have seen who seems to have decided that crazy patients are not worth listening to… and I acknowledge that I may well be a more-difficult-than-average patient. In which case, I have to commend the doctors who do make the effort to treat me like a human being.

If i sense a doctor doesn’t respect me as a person, then i leave their practice. But i remain concerned for other patients who don’t have that option, or who don’t have the self-confidence to admit that they are being condescended to. I have thought about writing to this doctor, but why would he listen to me? I’m just a crazy person.

I have heard enough stories of women being treated condescendingly in childbirth that I am afraid of what might happen to me when that time comes, when I am in pain and unable to advocate for myself.

Doctors, please don’t treat your patients like crazy people. Or they might end up becoming crazy people… around doctors! Thank you for reading.

By: ED

ED — Fri, 08 Jan 2010 00:39:47 +0000

The one thing for me – respecting informed consent with cancer screening. No doctor respects a woman’s right to choose which means it’s difficult to get health care if you have made an informed decision not to screen or wish to follow a reduced schedule to protect yourself from harmful over-treatment.
Also, doctor’s who use their power to hold birth control pills to force women into preventative checks that have nothing to do with the initiation and safe use of the Pill are unethical and I suspect, breaking the law.
I have finally found a Dr and signed all her disclaimers, but it’s still an uneasy relationship – even though she acknowledges my risk of this cancer is close to zero and the risks of a false positive and over-treatment are high, Dr’s are programmed to put ticks in boxes, especially for women’s health.
Men are entitled to risk information and make informed decisions, women are treated like children – ordered, lectured, kept ignorant, misled and treated like targets.
An ethical Dr who respected my right to choose preventative health checks and was honest (rather than engage in scare-mongering) is my ideal Dr.

By: JenJen

JenJen — Thu, 07 Jan 2010 19:37:13 +0000

Respect is a lot more than how you dress or whether you call me Jenny or Miz ___. It’s also about not wasting our time and paying attention to what you’re doing. Constant delays in getting seen, then waiting 30 minutes undressed in a cold exam room with nobody ever checking in or letting you know how much longer it will be. Return trips for lab procedures because the office didn’t bother sending in for insurance approval so you get turned away and have to take more time off work to go back and try again. EVERY time I go for a test, I hear at least one person turned away because of this – “oh, Mrs whozit, I see the test has been ordered, but they didn’t send it in for approval” and have had that happen myself more than once. I recently wasted hours trying to get a prescription that turned out to be both (a) completely wrong and for a disease I don’t have and (b) pulled off the market a year ago. (Dodged a bullet there, actually. I’d be really sick if I had gotten on this particular drug) And I go to a place that uses all the latest EHR/order entry doodads. I understand that managing the schedule and attention to detail can be in conflict, but honestly, that’s what would feel like respect to me, moreso than whether the doctor is wearing dress pants.

By: Steve Butler

Steve Butler — Thu, 07 Jan 2010 15:02:16 +0000

The one concern I would caution about calling patients/clients out by name is privacy. I am attorney, but also have to greet clients in a waiting room. I call clients by first name because I feel that it is less likely that other individuals in the waiting room will be able to easily identify the person that I am assisting. (I also explain this to clients when they are offended that I am now more formal with them on introductions.)

Whenever a medical professional requires personal information, I would suggest that the person be taken to a private area. I am always appalled when I hear medical conditions being discussed loudly in a waiting area. It is also important that medical establishments stop using sign-in sheets. I don’t want every other patient that visits that day to know that I was also in the office.

I think that this is a very good post, and much of the information is applicable to any professionals that deal with clients on a daily basis. Thank you for sharing your experiences.

By: Michael Leiter

Michael Leiter — Thu, 07 Jan 2010 13:36:29 +0000

Great post.
People have such a refined sensitivity to the subtle indicators of respect and consideration from others. In our research with health care providers, we find that small improvements in their day-to-day communications among themselves can have far-reaching benefits for their engagement with work.

So, maintaining a refined sensitivity is a strong discipline, well work the effort.

All the best,
Michael
www,workengagement.com/crew
@workengagement

By: Ralph

Ralph — Mon, 21 Dec 2009 21:46:34 +0000

We often ask how the patient wants to be called and write it on a white board in the room. It is important to show respect to your patients. It goes both ways ,though. Patients should show respect to the physician as well. Showing up for the appointments on time and being neatly dressed is part of it…

By: Happy Hospitalist

Happy Hospitalist — Mon, 21 Dec 2009 13:50:27 +0000

If you lived life always worried about the way things should have been, you’ll end life wondering what life could have been.

By: Classof65

Classof65 — Sun, 20 Dec 2009 21:36:35 +0000

If I’m not mistaken, the title of this piece has to do with customer service and what we believe would improve it, so the “happy hospitalist” and “nuclear fire” are out of line to belittle our remarks.

But they are correct in their attitude that if we’re unhappy with the service we should take our business elsewhere. And I have. I doubt that my absence from the offending clinic will be noticed or have much impact — they are the only medical office within 40 miles — but I feel better about “voting with my feet”, knowing that I am no longer supporting a “service” that is demeaning to its patients.

By: Nuclear Fire

Nuclear Fire — Sun, 20 Dec 2009 00:18:48 +0000

@Anon 1054: Introducing yourself as Dr. ___ is not about the honorific but about the job description, especially in an age where medical students, PAs, ARNPs, dietitians, nurse managers etc. wear the white coats and most doctors no longer do. I do agree that calling people by their first name is quite strange to me and even though my patients call me by my first name (with permission and without any negative thoughts about it on my part) I still feel awkward using anything but polite honorifics with them.

@Anon 233: I think you hit two great points. Neat and clean is what is important. I’d also add that I’ve called a few older staff physicians for criticizing younger colleagues for “informal” dress when that dress was new, clean and fashionable whereas their sports coat was ratty, threadbare ill-fitting and long out of fashion. Glass houses and all that. Second, the long sleeves and ties etc. are concerning to me for infection. I roll the sleeves on my dress shirt to above my elbows, don’t wear ties or anything below the elbows and wash my hands before each exam. It’s good medicine and shows clear respect.

Finally, to all who think they are not treated well, why do you keep going to the same place? My mother hated how at Sam’s Club they all call you by your first name. She thought it was very disrespectful. She complained many times but was told it was policy. I finally told her either stop going there or don’t complain to me about it anymore. Thankfully, she wrote them a final complaint letter and enclosed her cut up membership card. I have nothing against Sam’s but if a business isn’t suiting your needs, go elsewhere. Support good physicians who are willing to treat you with respect and make all sorts of good choices. On the other hand, if you prefer to go to the discount, cut-rate price cattle-market, what do you expect? You aren’t going to get Kobe beef at McDonald’s.

I have patients who travel hundreds of miles to see me and and some drive over two states. I think that’s a little extreme but when I ask them why it’s mostly about piece of mind. And I’m not talking about a concierge service. These are low middle class or poor patients on fixed income. If they can do it, so can a PhD.