beware the patients redux


patient beware redux 10.2.14

Several weeks ago I wrote about the world-class service provided by a physician seeing my kids for the first time. Here’s an update describing the follow-up visit, as well as a very different experience while accompanying Cara to her doctor a few days later.

the kids

We arrived at the office a few minutes before the scheduled 11:45 AM appointment. I walked to the front desk where a youngish woman didn’t look up as I signed the boys in, focused instead with a grim intensity on applying white-out to printed forms in front of her. Between the time we sat down and finally got called into the patient room I (1) started and finished Gravity’s Rainbow, (2) researched and authored a treatise on the parallels between nihilism and the feelings evoked when I listen to anything by Coldplay, and (3) watched Jackson visibly grow half an inch.

We received the magic invitation to the office’s inner sanctum roughly 35 minutes after arriving. The boys’ boredom quickly escalated as follows:

12:20 – Silence broken by increasingly hostile verbal horseplay between Max and Jackson.

12:25 – Through some unspoken, magical mental alignment, both simultaneously decide that the world’s new coolest game is “Find Inane Ways to Annoy Dad While He Tries to Read.” Favored techniques: funny voices; facial contortions; invading dad’s body space.

12:32 – Boys experiment with rolling stools. Key elements: creating movement without using their feet; elevating and decreasing stool height, preferably while making noises consistent with the vertical space traveled.

12:40 – Boys lie stomach-first atop rolling stools and repeatedly launch themselves across the room. Bonus points for doing it in close proximity to the door where the doctor will presumably enter at some point before the sun sets.

12:45 – Physician graces us with his presence.

Having learned from my prior visit to this office, I declined to stand up or otherwise do anything that would suggest I’m a human being capable of communication. The doctor has taught me well – I know that I’m nothing more than the guy with the insurance card that allows him to bill for the two boys whose names he doesn’t know unless he reads the chart. (And even then … )

The appointment for both boys takes less than 10 minutes. With limited exceptions, the physician avoids eye contact with any of us. He disappears out the door with Usain Bolt-like quickness. He’s in his late 30’s but I swear the guy has the fastest first 3 steps of any human I’ve ever encountered.

I walk back to the front desk to schedule our next visit to this Kafka-esque setting. The receptionist still sits there whiting out forms, still not acknowledging the existence of any person near her. I’m thinking the only task that could simultaneously involve such concentration and barrels of white out involves altering patient experience surveys that link directly to said employee’s compensation structure. I leave, happy to be gone.

the wife

We arrive at the office exactly at the scheduled time. Parking is tight, so I drop Cara off while I search for a space. When I get into the office 3 minutes later, Cara’s engaged in a smile-filled conversation with the receptionist. The billing person, sitting next to her, smiles and says hello as I walk in. Cara introduces me to the receptionist, who has built a friendly relationship with her over the phone in the weeks leading up to this visit. We talk for the next 8 minutes at which point we’re escorted into the patient room.

Less than 5 minutes later the doctor comes in and has (gasp!) an actual conversation with my wife. He explains what he’s going to do. She asks questions. He answers them. One specific query gets lost in the mix and I raise it again. He answers it.

This is a strange experience.

Nothing has prepared me for something approaching normal human interaction in a medical setting. Before the physician leaves the room he mentions to Cara that he’d appreciate it if she filled out online rating systems describing her experience at the office. He tells her that the receptionist will give her information about the relevant websites before we leave. I feel like an anthropologist watching an heretofore undiscovered tribe, desperately wanting to record everything I see and hear but fearing I’ll miss something earth shattering in the process.

We walk into the waiting room where the receptionist hands Cara a sheet of paper with the aforementioned web addresses of the ratings websites. Consistent with the doctor’s statements, she says that it would mean a lot to them if Cara took the time to evaluate them. They talk for another 3 minutes about the doctor’s instructions, the receptionist addressing Cara’s concerns and providing supportive feedback. We leave. My wife is visibly happier upon her departure than when we went in.

analysis

After reading “the kids” section of this post, you might reasonably ask, “Why are you still going to that idiot?” I have a three-pronged answer to that question: (1) I’ve been to enough doctors’ offices to know that this is the norm, not the exception; (2) the next-best physician who may offer a better user experience will necessarily work farther away from my house than Dr. Personality, so any savings in time I may enjoy from a more efficiently-run office will be lost in a longer commute anyway; and (3) medically he’s great, so I’ll tolerate monthly visits to hell with gritted teeth because it’s the best thing for my kids’ health (though not my sanity).

The most depressing aspect of this tale is the fact that I found the visit to Cara’s physician so remarkable. In any other service-related industry, what he and his staff do would be merely acceptable, not noteworthy. But put them in a medical setting and I react like they’ve solved a fundamental mystery of the universe.

my challenge to providers

As patients, we have to sign all kinds of documents when we go to medical facilities giving the practice the rights to our first-born in the event that we don’t live up to our payment obligations. So I’d like to counter with a proposal for those on the other side of the waiting room: how about whenever a new patient comes into a facility, the treating practitioners take the time to physically sign a written pledge that they’ll (a) see you on time, (b) contact you before you arrive at the office if you won’t be seen within 30 minutes of your scheduled appointment, (c) make a $25 donation – that’s about what they typically collect for your copay nowadays, no? – in your name to a charity of your choosing if they fail to comply with (b), and (d) compassionately and thoroughly answer your questions in language that’s easy to understand. Anyone brave enough to take that one on?

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