Stop being a doormat for your patients

One of my goals is to help doctors be happier in their day jobs. This does not mean you put on a fake smile, and grin and bear it through your day. What it does mean is you consciously set your boundaries for what you need. Stick with them and let others know. Because the truth is, you teach people how to treat you.

This is not only reserved for your spouse, your teenage daughter, or your yardman. This is for all people. Seriously. Everybody.

Here’s an example: Let’s say you have a patient who notoriously doesn’t listen to your sage advice. For a long while, you have been trying to get her to quit smoking, to exercise, eat better, or be consistent with her blood pressure medication. Or maybe you have simply recommended she apply an ointment to her eyelid for three weeks to improve some inflammation.

But, each time this patient comes in, it’s the same old story: She didn’t have time to eat right or walk around the block three times a week. She didn’t like that the ointment felt greasy (even though she was only supposed to use it at bedtime), so she stopped it after two days instead of two weeks. She didn’t really put any effort out to quit smoking. All her family smokes. Why should she quit, when she’ll be surrounded by second hand smoke?

Haven’t you all heard this before? Let’s face it: We can’t really put their feet to the fire or a gun to their heads to make them do as we suggest. But we can draw the line in the sand. We can say, “I’m sorry, but I won’t be able to schedule your cosmetic procedure until you quit smoking because studies have shown — and I have seen in my practice — that patients who continue to smoke heal poorly.”

Or, we can say, “Because you are not taking your blood pressure medicine properly and you aren’t trying any of my suggestions about exercise or stress reduction, I am going to instruct my office to only schedule your appointments with me at 8am on Mondays. That will require you to make an additional effort to get here early and wade through the traffic. I will be available to you for emergencies, but I reserve my prime time appointments for my patients who work with me to improve their health issues.”

And finally, we can say, “Go back and try that greasy ointment for another 12 days, as I originally requested. You still have inflammation of your eyelid because you didn’t use the medication as I prescribed it. We can’t know if the treatment didn’t work if you don’t actually do the treatment, now can we?”

What happens when you quit being Dr. Doormat? You release the negativity that surrounds patients who are not compliant. Sometimes, your patients will start towing the line. Other times, they go elsewhere and start the same story with another doctor. Sometimes, you must release the good to make room for the great. If they go, your practice is freed up (as is your heart) for patients who are sincere in improving their health, and who will work with you to make a difference in their health.

It’s time to roll up your sleeves and roll up your doormat.

Starla Fitch is an ophthalmologist, speaker and personal coach.  She blogs at Love Medicine Again and her upcoming book, Remedy for Burnout: 7 Prescriptions Doctors Use to Find Meaning in Medicine, will be available this summer. She can also be reached on Twitter @StarlaFitchMD.

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