The power of respect
Last week, I went to see my dermatologist for a full body check to make sure I don’t have melanoma. I showed up for my 3:00pm appointment a few minutes early and the receptionist said in a gruff voice, “You’re late. You had a 2:15 appointment. You can wait for the doctor to finish her office hours and be seen at the end of the day if you want”.
Hmmm….that was a little confusing since I had 3:00 in my calendar for many weeks – I made the appointment well in advance knowing that the dermatologist would need extra time for this type of appointment. So I told the receptionist that I thought there must be some mistake and asked if she could check again. By now she was really annoyed with me and said “No, you had a 2:15 appointment and it says right here that they tried to call you to confirm and your phone was out of service.” Now I was sure there was a misunderstanding since they had called to confirm my 3:00 appointment a few days earlier. So I asked her to please check that she had my name right. This time she said that I was correct (but did not offer an apology). She handed me some paperwork and said, in an accusing tone, that I was supposed to come every year and since I hadn’t been there in 3 years I had to fill out the medical history from scratch.
By the time I was called in to see the doctor (45 minutes later) I was not in a very good mood. The visit with the doctor was very pleasant and took only about 15 minutes. But overall it had been a very unpleasant (and lengthy) experience and I certainly was not anxious to repeat it in a year.
The office staff, in my opinion, are the most important people on the healthcare team and they need to be trained to believe this. They make the first impression and have tremendous power to determine the way the rest of the visit will go. If the receptionist in my dermatologist’s office had just treated me with respect, we both would have had better afternoons.
Roni Zeiger, MD, the former Chief Health Strategist at Google and recent co-founder of Smart Patients, wrote a great piece several weeks ago entitled “Prescribe Respect”. He starts it by saying:
I’ve been noticing recently that the most important thing I can do in clinic is listen respectfully and come up with a shared plan that feels like the patient owns it at least as much as I do. When it goes well it almost feels like I’m handing out a prescription for respect.
So as doctors, we need to respect the expertise that patients bring to the table – they are the experts about their own symptoms and their own bodies. And we need to respect their ability to make the right medical decisions for themselves.
But we also need to make sure that everyone the patient comes in contact with – beginning with the person who schedules the appointments – understands the power of respect.
Beth (Dr Nash), you have this completely right! The waiting isn’t just a matter of the inefficiency, it’s a matter of feeling further de-valued in the process. I recently attended a session by Victoria LaBalme who said “Has anyone ever been to a doctor’s office where the receptionist acted as if you were a disruption to their day?” …. We all nodded… She said, “I call them rejectionist” It is ever so true. Feeling valued and respected in the process is from everyone in the process. I saw an X-ray receptionist that we used to see nearly monthly for my daughter, she came around the counter and hugged us. Respect, value, friendship. It can happen.
Thanks for your great input. How sad that we are surprised when we are treated respectfully! I have never heard “rejectionist” before – it is sadly apt.
boy HOWDY do you have this one right, Beth! The bureaucratization of healthcare – the gatekeepers, the bill-checkers, the appointment clerks, the endless waiting – has made grumps of us all.
On the provider side, given the Lucy-and-Ethel-in-the-candy-factory character of the number of patients to be seen daily in order to keep the wheels on the bus, revenue-wise, there’s been little room for creating customer service thinking. On the patient side, the healthcare system has become such a frightening time and money sink that patients avoid interacting with it until they’re actively ill, not realizing that healthcare includes STAYING healthy by working with clinicians to hang on to that happy status.
Imagine what could happen if patients and clinicians banded together to shift the system – that would be a real revolution, wouldn’t it?
Yes, we are in great need of a revolution! Sadly, we have come to expect (and accept) bad service at every step of the healthcare encounter.
Horrendous experience for you and terrible job by the “rejectionist.”
But as a rule I have great sympathy for the admins (disclosure: married to one). Many patients have not at all adapted to the times and accepted their responsibilities such as knowing their own health plans, or giving reasonable notice when they need a copy of a medical record or a referral or a prescription or to cancel an appointment or “how come the doctor didn’t call me back yet” and on and on. Listen to the obscenity-laced messages on your answering machine from patients who were not served instantly by a staff that is by any measure overworked and not highly paid. No excuse for the behavior you describe — we all know it happens a lot — but respect is a two way street and people are at the end of the day only human.
Thanks Beth. I have found that I make a point to let the doctor know if his/her office staff is efficient or rude. On a recent occasion, I left the office before my appointment due to the rudeness of the staff. The doctor did call me,and we tried again. I would say to all those in the medical field, that they should employ social workers to work with the front office staff to train them about the importance of their jobs, and how to treat the patients. I have seen this happen, and it can work.