For years the trend has been a continued critique about physicians and their bedside manner, or lack thereof. It is an important topic as we have moved from a time of paternalistic care to a collaborative model where patients and doctors work together to improve wellness for each individual. This is a patient-centered model, so that autonomy and lived experience is taken into account when making medical decisions. These are all important things in the progress of medicine, but what is being forgotten is the patient’s responsibility also to bring a respectful tone and presence to the encounter.
Too often, medical front desk staff are being abused by patients who have not gotten their expectations met 100 percent. Whether it be having to reschedule because they were more than 15 minutes late for their appointment (mind you, 15 minutes is often the allotted time for said visit), they didn’t get prescribed the (inappropriate) medication that they wanted, or some other beef they have with the visit. Some patients are even more rude on the phone, having no face-to-face buffer to provide social etiquette reminders. Racist remarks by elderly patients to black and brown providers are often endured because “they aren’t going to change now.” The number of times that individuals are inappropriate with female providers, calling them sweety or sugar, is countless. I can go on, but I shouldn’t have to.
When a physician is inappropriate with a patient, there is institutional recourse. Patients can complain to their insurance company, the medical system, boards, and real repercussions exist. They can even give a bad yelp review, and those negative reviews highly impact many practices. But other than documenting in the medical record, or eventually discharging the patient from the medical practice, for the most part, practices are charged with putting up with the abuse as long as it is not to that point yet. I have no way to give a patient a bad review if they treat my staff poorly.
What I propose is that turnabout is fair play. If we are grading doctors on Yelp, through Medicare and Medicaid yearly reviews — and this will be a significant basis for reimbursement in the future — let us not forget that the patient has to keep it professional and respectful. Should we be rating patient’s on their insurance as well? I think not. But I think that everyone — our doctors and providers, and especially our nurses and our front desk staff — deserves to be treated with respect. Let’s at least start the conversation about what behavioral expectations we have for the patient side of this relationship. It will mean some hard conversations, but I hope we can all continue to foster this important partnership while maintaining respect for each human we encounter.
Anna Gladstone is a family physician.
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