Most of us have had direct experience with seeing a doctor or therapist, whether it’s for a checkup or some sort of problem we’ve identified. Some docs are a pleasure to see. I once had the kindest physician who was the epitome of an old-fashioned French country doctor. I’m not sure if he was my best doctor ever (he tended to treat my concerns with a “wait and see” attitude), but he certainly had a fantastic bedside manner and never kept me waiting more than a few minutes.
I appreciated that even more when I went to see my most recent doctor. He was far more gruff, business-like, and running more than 20 minutes late for our appointment. He didn’t apologize for keeping me waiting, and while he listened to my family history with detached professionalism, he went through his canned speech about needing to exercise regularly and other kinds of things with the kind of empty delivery you find in a person who’s said the same thing so many times it has lost all meaning.
Doctors and therapists both can keep bad habits, and they are the kinds of things that turn patients off from them. Patients rarely feel it’s appropriate to address these bad habits directly with the doctor (especially if they intend to keep seeing them), so it was with some relief I came across Dr. Dominic Carone’s blog entry about the “10 ways doctors can lose their patients.”
Here are the first few to whet your appetite:
10. Not accepting lists of symptoms or timelines from patients. If you see patients, you know they range on a continuum from poor historians who have no idea why they are there to see you and those who arrive with carefully constructed histories that they are eager to give you as soon as you walk in. Just about the worst thing you can do when this happens is to tell the patient that you don’t want the list and do not even want to look at it. That connotes a dismissive attitude to the patient and it makes them feel like all of their work was for nothing — work that was done in the hopes it would help you figure out what was wrong. You may have very good reason at the time not to look at the list such as time pressure, but at least take the list and say you will later take a look at it. It will likely provide you some useful information.
9. Asking patients to choose what type of medication they want to take. When a patient has a medical condition in need of medical treatment, the physician is looked to provide their advice as to what medication to take. They don’t want to be given a list of three possible medications, told to research them at home, and come back with a decision. From a patient’s perspective, this is why the doctor went to medical school, not me.
8. Long wait times and no apology and/or rushing the patient once coming in. While no patients want to wait long, they will generally accept the wait time if they are pleased with the care you provide, or if it the initial visit, know that you have a good reputation. However, if the patient waits long and you then walk in and do not acknowledge the wait, explain why there was a wait, and apologize for the wait, it will significantly aggravate the patient. Rush the patient after a long wait and no apology and it will worsen the situation further.
7. Poor bedside manner. This is an easy one and has been addressed extensively by others, but don’t do things such as repeatedly looking at the clock, repeatedly interrupting patients, focusing more on you than the patient, talking rudely, making poor eye contact, etc. Follow the Golden Rule and you will easily establish rapport the majority of the time.
I’ve experienced each and every one of these with my regular physician, but I’ve also heard plenty of stories of people who’ve experienced these kinds of bad habits with their therapists and psychiatrists.
My biggest pet peeve is making an appointment for the morning, knowing that the chances of the doctor or therapist running behind is far less likely earlier in the day than later in the day. So when I arrived recently for an 11:00 am appointment, only to have to wait nearly 25 minutes before being asked to come into the exam room, I have to stop my face from turning into something out of a horror movie. If you’re running nearly a half hour behind with just 2 or 3 hours of your day behind you, that says something.
But the absolute worst thing about late professionals is their lack of awareness they are even running late, and the lack of any apology for doing so. I understand emergencies or a patient who needs a little extra time — that’s perfectly fine in my book. Simply offer a brief explanation to me when you come into the room, as well as a brief apology, and all is forgiven.
When a professional can’t even offer that, I do question whether this professional is the right one for me. Because basic manners and common decency are something all doctors and therapists should not only have, but practice daily. It demonstrates a lack of respect for your patient — you know, a fellow human being — when you treat them as just another cog in your daily assembly line of patients.
Nobody wants to be treated that way. So if you’re a doc or a therapist, and you recognize yourself in some of these bad habits, now’s a good time for a wake-up call. After all, it’s never too late to change.
Read the full entry: 10 ways doctors can lose their patients
9 comments
Remember, we, therapists, are humans too. We are not perfect. It’s sad that there are ones out there that don’t admit to errors & take the “I’m more important than you” attitude. As a therapist, I’ve always been thankful for my clients….they allow me to be a part of their lives during a time that is extremely difficult.I feel honored to be apart of their process & do my very best to honor that. It’s a shame that there are therapists out there that don’t feel that way.
I agree that physicians should apologize if they are late. Once I was sitting in an exam room and even though the door was closed I could hear through the wall that the physician was ordering nitroglycerin so I knew I would be in for a long wait – apparently a patient showed up to the doctor’s office with severe chest pain instead of going to the ER like she should have done. The first thing the physician did when she finally came in my exam room was apologize for the long wait. I told her I heard the word “nitroglycerin” and that I understood.
I also try to make my appointments in the AM to hopefully cut down on the wait time, but even early in the morning if a patient shows up with an emergency the physician has no option but to deal with it and that means a long wait for everyone else. I agree, though, that an apology goes a long way and I think most folks would be understanding.
Patients also need to do their part and be bright enough to go to the hospital with chest pain, instead of showing up at their dr’s office. I felt for the physician that day, because I knew she was going to have to deal with angry patients throughout the day because one patient was lacking common sense.
Disagree with # 9. I don’t have a problem with a physician offering different medication options. I actually find it to be respectful. There are situations where one drug is as good as another, and while I would like to hear the pros and cons of each I like that they consider me intelligent enough to weigh the options and make my own decision. If a physician thinks one option is clearly superior then I think most would say that.
Medical professionals being casual with time is annoying all right. My pet peeve, though, is being addressed by first name! Bugs me to no end. If physicians want us to address them by title, they should do the same with us. I swear, sooner or later, I’m going to just start calling one of them by first name.
People think I am absurd in trying to be on time for my patients in a psychiatric practice. My response is just this: I am not running an acute care practice, I am working in a specialty discipline and the people coming to me are expected to be fairly stable and in need of more expertise and assessment of mental health issues.
And what better way to begin an alliance than being on time. So if I ask a patient to be at the office at time X and he/she shows at such designated time, I should be ready to see them unless a legitimate issue has forced a priority above their meeting, and there rarely is such a disruption in my experiences in a outpatient setting. And when I am running late, the next sentence after “Hello, you are Mr/Ms X and I am Dr Hassman”, is very simply “sorry to keep you waiting, thank you for being patient.” And I can count on one hand the number of people with a cross reply to this.
In an age of 15 minute med checks, I am sorry to say this, but if people are accepting of their issues as simply a biochemical imbalance, you don’t need 15 minutes to talk about chemistry. I know better than that to believe that mental health does not fit a biopsychosocial model anymore, but, if no one else wants to fight a system that has dumbed down care to expecting to balance serotonin, dopamine, norepinephrine, and assorted other neurotransmitters to restore functional mood, thoughts, and cognition, than get ready to come in and live the adage: if you want to get better, take a pill, but if you want to get it right, then face the truth.
Not many people want to face the truth these days. I read today that 11% of Americans are on antidepressants. Stats like that just reinforce depression. But, it is easier to swallow a tablet than face the truth. Certainly see that attitude in our leadership in local, state, and federal government these days.
Pride and ownership, truly a dying concept in America of late. There’s a truth for you.
I’ve been too lazy to look up those studies on antidepressant use, in part because I have enough reading to do at the moment. I know there are a lot of prescriptions for antidepressants, but how many people actually take them? People don’t even finish a week of antibiotics much less a two month trial of a drug that potentially causes sexual dysfunction, sedation, insomnia, weight gain, chest pain, [insert something like heart explosion here]. I’ll see if I can dig something like that up, unless you know of something off the bat. I’ve always been curious.
Attitudes towards antidepressants are problematic. I’ve been left with the impression there is a fallacy or two – 1) Depression isn’t “as bad” as mania or psychosis, therefore 2) Antidepressants aren’t “as bad” as those nasty lithium-antipsychotic-anticonvulsant things that are taken for mania and/or psychosis therefore 3) I’m not “as crazy” but I still have a problem. Anyone who doesn’t think depression is “as bad” should chat with a mom with postpartum depression. And read a patient information sheet, antidepressants have horrible side effects.
Prescribing habits are an issue, and I wonder how many questionable prescriptions – including antidepressants – could be prevented by smiling and apologizing when appropriate.
Having been hit with a few chronic issues, particularly in the last year, I’ve come to understand the “pill-popping” culture. I don’t think we (in the US) always know what it’s like to suffer – day in, day out pain, hunger, sickness, and death. When something bad happens, we don’t know how to emotionally deal with it. We just don’t. Even if it’s minor in the grand scheme of things.
Pills are validation for many. It’s tragic, they shouldn’t be the only source of validation for people, and they shouldn’t feel like the only feasible option for being happy.
Anyway, I can only think of a handful of occasions where my psychiatrist has been on-time. There are only so many psychiatrists in my area who take insurance, and a few of those get psych floor duty in between appointments. He always apologizes and does not rush me out even if I’m okay. I just take a book and make my appointment times strategic if possible. It’s surprising what some friendliness can do.
Many times we providers are not aware of what time someone’s appointment is/was, nor do we often have any inkling of how long they may have waited. Often because we are rushing from room to room. This is easier to note in the age of electronic charting (where it’s listed on the screen) but still hard to know.
And the flip side of the coin…..the same patient who often just complained about having to wait is the same one who produces a 3 page list because they have “a few things they ARE going to talk to you about” giving no consideration that other people are there also waiting.
But this is really epidemic on both sides of that coin in that we see the world extending as far as our own concerns do. My problems are worse than the next guy….
I agree with JB that it’s a two way street. I also think having worked in a hospital and even being paged while I’m urinating makes me a very tolerant patient. I can count on one hand the number of times I even stopped for lunch during a work day. I just assume if the physicians are late that it’s all the behind the scenes stuff they’re having to deal with – waiting on lab results, an elderly patient who when asked their history starts back in 1940 and works their way up to the present, patients who made an appointment for one thing and then show up with several more problems they expect teh doctor to deal with, patients with a medical emergency, and on and on. There’s so much that happens that physicians can’t plan for and while it helps if a physician who is late (even though it’s likely not their fault) apologizes, patients need to learn to be a little more tolerant.
I once had a patient complain because it was too noisy and we kept her up the night before. I had to bite my tongue not to say something unpleasant. The reason it was so noisy was because someone in the next room had stopped breathing. I’m sure the patient’s family who was making funeral arrangements would have gladly traded places with the patient who had her sleep interrupted.
In 30 years of military practice I always apologized when running behind, and my staff always knew to let patients know I was behind and offer them the option of going out for coffee or to come back at my lunch or after work if more convenient. That said, 1100 is NOT an early appointment. My 1100 patient had 14 patients ahead of him; at just 1 or 2 minutes delay per patient –eg they have six layers of clothing on that need to come off for the exam, they “hate coming to the doctor” so pull out a year’s worth of complaints, they are emotionally distraught or having chest pain or a stroke or third degree burns to their face and hands (yes, I’ve had each of these book a 15 min ‘routine’ spot in my am clinic)–not to mention those who arrive just as their appt ends…25 min behind at 1100 is not bad. Book the first appt of the am or the first after lunch if you don’t want to wait. My needy patients always took the last of the day, which was fine by me it gave us more time.
I agree with this. My doctor won’t listen to what I have to say. I have tried what is out there. When I have done what they suggested, do my own work, read websites & then be told the internet is a bad place… I have to wonder. Its the professionals like this who continue to create a bad stigma for mental health.
I understand they aren’t qualified but when you ask for anotheral referral to have another psychiatrist & you are told its not a good idea, then there’s an issue.
I have found more info from the states & britian sites compared to what canada has to offer. I am to the point I don’t know where to go or who to ask for a referral.
I have resorted to contacting 1 of the local university psychological departmennts, whom I was told couldn’t help. But when you look @ the site, “we accept referrals from family physicians to public agencies”…. So I called. They told me if they couldn’t help, then they would help me find someone for severe anxiety, ptsd, depression, personality disorder.
I need to deal with the root of the problem & cope, NOT cover up the problem with pills. My psychiatrist told me if a female has issues with their productive system or a problem wirh the middle area, it will effect the brain. But here, you take a birth control even though a tubal ligation has been performed.
It makes you wonder who to talk to, where to go to for help & whom to trust.
Keep going, hold your head up high & smile or try to. We will get there sometime. I am not giving up.
Jody
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