I struggle with customer service. I truly never anticipated that it would be such a big part of my career. I never fathomed that it would be something that I struggle with on a daily basis. Well, honestly it does not happen every day and does not occur at every facility that I work at. Yet, it happens often enough that it has affected where I work, how I interact with clients and I often now it affects my ability to engage in meaningful patient encounters.

I am, often thrown off guard by what people comment about me. There is usually a statement that they will highlight, something I have said that tips them over the edge. Perhaps it is a difference in practice or application, but it is one thing I may have said during the encounter that sets them off, enough to write a complaint about my performance.

Not one of my colleagues would ever guess that I have this problem. Most of my peers see me as an extremely personable person; l am seen as friendly and funny, just perhaps just somewhat reserved. I have been told I have a RBF (resting bitch face) for which I just cannot truly change, or do not know how to change. People tell me to smile more, to smile with my eyes and body, to mirror the people I am speaking with, to compliment them or the patient more. I head the advice regarding sitting in the room with them, shaking their hands, perhaps even patting them on the back when I leave. I have read the books, taken the classes, and heard the speeches. To me, all of this seems fake, in genuine and insincere.

I guess I have always been awkward; I was an only child until I was 15 when my family decided to adopt another child. I have been told that I’m not one to make small talk, I do not ask or comment about the weather, politics or other current trivia, it honestly takes me awhile to warm up to people. I have few close friends and tend to keep to my family and myself. While I enjoy others company, I do not intentionally seek out parties, and I prefer quiet evenings at home. Especially after chaotic days in the emergency room.

I have been practicing for over 15 years, and the emphasis on customer service has grown exponentially in all arenas of medicine. From attempting to shorten wait times to customer centered medicine, where the patient now makes more of a decision in conjunction with the physician. I hate to bring race and gender into the equation, but I believe it does have a major impact. For many times these complaints stem from people not of my race and often times when they fail to acknowledge me as a physician and just call me Miss instead of Doctor you have to question if the slight is intentional.

Yet, with so many recurrent complaints of the same theme, it must be me, right? My question though is, does this make me a bad doctor, a horrible physician, and does this negate my education or my ability to provide excellent patient care? Do I have to have my patients love me, and how do I do that while complying with the thirty-minute door to doctor period, and the door to discharge time of two hours. By the way, my metrics are outstanding.

I do honestly try my best, I do enjoy each encounter, and often I do not understand where I have gone wrong on many of these occasions. I do not often sense that they have turned against me. I have beaten myself up trying to understand the flaw I have. I realize the importance of a good patient doctor relationship; I know that patients will follow the advice of a doctor they like more than a physician for whom will that they did not bond well. I have read the studies that show the poor customer service affects quality outcomes.

Although, I am not sure that I buy this aside from the previous indication that they would not follow the advice of someone with whom they were displeased. Yet I struggle often. I have had residents and nurses follow me, and they do not understand either; I try not to change my behavior when they do follow me in my encounter but maybe it is the subtle expressions of my RBF, or sighs or sarcasm. I just do not get it, I truly do not understand, and I do not understand why they do not mention anything to me but then write letters describing my errors.

I am nowhere close to where I need to be financially, and I still have just a bit less than half of my medical school loans remaining. Therefore, as I am not anywhere close to retiring or quitting this field that I have worked so hard to breach. I truly love what I do, I chose medicine to help people, and I chose pediatrics to ensure the health and safety of future generations.

I’ve been a great student my whole life, gifted and talented, advanced classes, graduated early from high school, honors graduate in medical school, passed all my exams and boards on my first attempts. I practice evidence based medicine; thus, no unnecessary tests or unwarranted antibiotics. This often puts me at odds automatically with what parents may demand or what they seem appropriate. Despite my best intentions, I often fail at pleasing people; this is a juxtaposition with my intentions to provide quality, and evidence-based medicine.

Some of my directors have been more than understanding and others less so. I do not know what the answer is; all I do know is that I truly love what I do. I am not overworked or burned out, and I will continue to provide quality care for all. Your comments, discussion, words of advice, sympathy, and condolences are appreciated.

The author is an anonymous pediatrician. 

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