Managing the Wait

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One very rainy day, I went to the grocery. I had to stock up because Mr. Weatherman said its going to be a wet and stormy week and my pantry is empty. As soon as I stepped into the grocery, I realized I was not the only one thinking that way. So with EVERYBODY else!! It looked like panic buying! The next hurdle was getting to the counters to pay! The lines were long and slow ūüôĀ

Waiting is not fun. I admire establishments who are able to manage waiting lines. I have a few good experience waiting.

I stayed in a hotel for a convention. During such time, rooms are filled up with delegates. Breakfast time will find you lining up to get in. Long, long line. My stomach is already grumbling. Out came the manager carrying mini sandwiches and offering drinks to those in line! I couldn’t help but smile.

I accompanied my aunt for an eye check up in a busy eye center. This center is known for its good doctors and good service. I was expecting a long wait. I went directly to the receptionist who got her name and gave me a form I helped my aunt to fill up. I gave the form back and we sat in a waiting area. After a few minutes, another person approached us and asked my aunt a few questions then he excused himself and told us to wait and he will get back to my aunt. He came back and led us to another area where my aunt’s eye was briefly examined using a machine. Then back to a sitting area where we waited. Not too many minutes after, we were asked to move to another area and enter a consultation room. We waited for a while again. My aunt was seen by an eye doctor who discussed her condition and medications. Another person came to lead us to the next area where we were asked if we want the prescriptions filled or we would like to proceed to payment. We paid and off we went. I am sure there was a line. But we moved from one station to another with a manageable wait in between stations. There was always someone attending to us. There was something being done to my aunt in between waits. It felt like we were progressing. The waiting became manageable.

Paying bills can also involve long waits. Stores have made use of numbers for queiung. You get the number. Find out what number is currently being served either by asking or through the dashboard displayed. You still wait but knowing your order in the line eases the waiting because your mind has been prepared to accept it. You can choose to do other things or come back at an approximate time. For those who chooses to wait, a television plays a video or show to keep you entertained.

Fast food needs to be fast! With several persons ahead of me before i get to the counter to order, the store manager starts to take orders from people in the line and calls the order in advance to the kitchen staff. I still have to wait but knowing its getting prepared and all I had to do in the counter is pay made waiting okay.

We can learn from these experiences to manage waiting time of patients in our clinic.

1. Make waiting bearable. Offer something to ease the wait. Something to eat or drink. Something children can do like coloring books or book to browse for children and parents or toys children can play with.

2. Give patients a sense that their visit is progressing. For pediatricians, it can start with getting measurements.If you have a nurse or an associate, have them conduct preliminary interview before they enter the consultation room. If there is fever, paracetamol can be given. If the presenting problem is known, for example diarrhea or fever, materials to read can be given for parents to read. Just like my eye center experience, the wait seem shorter.

3. If patients need to wait because you will not make it to the clinic on time, inform them of the approximate time of arrival. Under promise, over deliver.

There will be ocassions when waiting is inevitable. Managing it makes it acceptable. How is your patient waiting?

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Have You Got What It Takes to Face This ?

Furious. Loud. Intense. Crossed.

At one point in your practice (or even during training), you will meet a patient like this. Or sometimes, its the relatives.

Have you got what it takes to face her?

Patients reach this point for a thousand and one reasons. They are worried. They could be scared. They could be in pain.¬† They can complain endlessly. WE¬† NEED TO UNDERSTAND WHERE THEY ARE COMING FROM.¬† Uncertainty can make even the most reasonable person reach their wits’ end. They can become very, very sensitive about small things. With every word you say. Even with what you are not saying but your body¬† language is shouting.

WE NEED TO HAVE A LISTENING STANCE. We need to allow them to vent their frustration and anger as long as they don’t get themselves and others hurt. Listening is not just about keeping quiet.¬† If you are seated,its leaning forward a little to show interest in what is being said. Arms not crossed as if saying “I don’t want any of your stuff, ” but perhaps on the side. Establish eye contact. Nod a little at certain points.

WE NEED TO COMMUNICATE EMPATHY FOR WHAT THEY ARE GOING THROUGH.¬† Apologizing is important. But apologize for the inconvenience. Apologize for the resulting¬† anxiety (I apologize that this has caused¬† you to worry). Use of words that acknowledges or describes how they feel connotes empathy like ” I can see that this has made you uncomfortable”.

OFFER  SOMETHING YOU CAN DO AT THE MOMENT TO PROVIDE EASE. Say what you can do at the moment. Do not promise something you cannot deliver.  Tell her how you will address things at this time and what you can do afterwards. Be honest without sounding you do not care.

LISTEN TO WHAT THEY ARE SAYING BUT MOST IMPORTANTLY TO WHAT THEY ARE NOT. When a patient is  mean and crossed, could it be  a disguised cry out for help?

 

 

 

 

 

 

 

 

 

 

 

 

image courtesy of ohmega1982/freedigitalphotos.net

Different Strokes for Different Folks

Have you ever experienced liking someone so much that you feel so comfortable and so at ease?¬† Wouldn’t that be so great if that’s how every patient feels towards us?Would you think that holds the key to a long term patient – doctor relationship?

Patients come to see us  for a reason. For the most part because they have a health concern.  True.

But before they are patients , they are persons first. If we see that first in every patient , imagine the magic that it creates!

Different strokes for different folks. That i learned through time. Each person is different.  Personalities differ.

I had a newborn patient who fell ill shortly after birth. It looks like its a cyanotic heart disease.¬† Faced with such a condition, we held a family conference to be able to explain the situation.¬† For us, that would mean a whole bunch of people to explain to—mom, dad, grandparents, aunt, uncle etc. So there we were with a roomful of relatives. As we began carefully explaining why the patient turned toxic,possible courses and sequelae, my eyes saw different reactions from each one in the room.¬† Some were trying to absorb every word we were saying. Suddenly, one spoke with a tone¬† that seem to brush aside all the explaining we were doing. “So what’s the chance the baby will not make it?”

 

So there are patients who want details.

These patients bring a list of questions and concerns to be asked from us. They research about their conditions and can cite them during the consult.¬† They need their doctor to be thorough.They don’t like to be hurried.

 

Then there is one who wants things straight to the point.

No going around the bush.  They express with no uncertainty their preferences. They are quick to decide. They need their doctor to be straightforward and definite with their points.

 

There is the amiable patient.

This patient says yes to everything we say.  They follow every word and does not question for fear of offending even if what we are telling them might cause some difficulty.  They need a doctor  who would be sensitive to their unspoken needs because they are just too amiable to say it.

 

Adjusting our approach to these different folks will surely win their hearts.  Our desire to help them remains the same. The content of our conversations may be the same.  But our ways to bring them across may differ.

Different strokes for different folks!

 

Have you got other tips in dealing with different kinds of patients?

 

 

 

 

 

 

 

photo by renjith krishnan/freedigitalphotos.net

 

 

 

 

 

 

 

 

 

 

 

 

 

WIIFM?

wiifm choosing

Have you ever wondered what makes patients go to one doctor over another?

It’s always about WIIFM?  (What’s in it for me?)

WIIFM if I go to you?

 

Here’s an exercise for you.  C’mon,  stay with me here.  Get a blank sheet of paper.  Write three things that will make  your practice different and more attractive to patients.

If you wrote something like this

1. By appointment visits

2. Accepts credit card payment

3. 24 hour access

 

That’s a good  start. Lets make that  a bit better.  Imagine you are the patient. In each of the following set of two statements, which  connects to you faster and clearer?

 

Here’s one…

1. I see all my patients by appointment.

2. Manage the rest of your day. Be seen as soon as you arrive.

How about this?

1. We accept credit card payments.

2. Hassle  free consults because paying is as easy as a swipe of your card.

Here’s another…

1. 24 hour access

2. Get the worry off your mind. Call me anytime.

 

Number 1 statements are features of your practice.

Number 2 statements are benefits your patients will experience with  your practice.

 

People always want to know what’s in it for them.  When communicating what differentiates you from the rest try focusing on the benefits rather than the features of your clinic or practice.

 

 

Communicate benefits not features. 

 

image by renjith krishnan/freedigitalphotos.net

Chunk and Check

I had a patient born to a young, first time mom. The baby had  numerous problems involving the spine, limbs and brain.  Before I went to the room, I knew I had to do a lot of explaining. I found the mom alone obviously overwhelmed by what was happening.

Communicating what we know about diseases to patients is a skill we develop over time.

They deserve to know  everything we could possibly tell them. How the condition came about.  What caused  it.What could it lead to.And  to many,  what can be done to relieve them of their complaints.

 

All these we had to do without drowning them with medical jargon. Or giving too much or too little.

 

Here’s an  exercise.  Think of one disease we commonly encounter in a patient.  How do we explain it to a grade schooler, say a grade 5 student?  In simplest terms we could possibly use.

What I find helpful  is knowing what patients  already know.

I use it as my starting point. Some patients like to hear everything. Some just want to know how will life be different for them or their chances.

 

Conditions requiring  long explanation may need to be chunked into small bites. I check for understanding   before moving on to the next chunk.

 

I try to talk slow and observe body signals that suggest understanding or otherwise as I go along. Asking  for any thing that needs to be clarified or be discussed is a good way to end.

 

The mom I was talking to only wanted to know what could be done for the  moment.  I respected that.

 

 

Chunk and check for better understanding.

Walk in My Shoes

Walk In My Shoes

‚ÄúParang nasasakal‚ÄĚ. Chest heaviness. Cold and clammy. Shortness of breath. This is a patient‚Äôs narrative of a very scary experience.

And that patient was ME.

I was on my way home when I suddenly felt bad. Am I having a heart attack?  Oh no, too young  to exit!   I was contemplating whether I should bring myself to the emergency room.

The patient in me was in a denial stage saying, ‚ÄúI could be okay in a while.‚ÄĚ The doctor in me was already making a diagnosis. ‚Äú If this is a heart attack, I only have a few minutes. Going back to the hospital from the house could mean its too late. ‚Äú

And so I decided to bring myself in. Lying down on a stretcher, I was given oxygen by cannula. I kept on sitting up because I was very anxious. Will I end up in ICU? More than that, will I make it through? I see the people around me, their faces familiar but it does not relax me a bit. ECG was done. Blood was extracted for cardiac enzymes.

I was wheeled to the cardiovascular lab on a wheel chair for 2D echo. This was my scariest experience ever.

Hey this time, I was on the other side of the bed rail!

It’s a  very strange feeling to be the one lying on the bed instead of the one lording over it.  It was humbling to be wheeled around the same hallways I walked on everyday. My first time to ride a wheel chair too!  It was terrifying to wait what my attending doctors would tell me about my tests.

After this experience, I have greater respect for the patients who is in every inch vulnerable, scared and probably feeling helpless lying on the stretcher.

 I have better appreciation of the patients who chose to put their vulnerability  on our hands.

 I had greater understanding of what they truly needed from me as their doctor…because I have walked in their shoes.

Any ‚Äúwalk‚ÄĚ you wish to share?

Walk in your patient’s shoes. Your understanding will never be the same.

PS.  The diagnosis was GERD.  I was having coffee more than I should. Blame it on the  coffee recipe tasting  I was doing for a project.

Do You Know vs. Do You Care?

heartandstet

When I was an intern, I would hear elderly patients tell Dr. RA ‚Äúgagaling nako, nakita ko na¬† doctor ko.‚ÄĚ

He is a brilliant doctor.

Going on rounds with him, I realized why his patients would make such a comment. His warmth towards them, attention to what they were saying, reassuring their anxiety, and ensuring even the tiniest detail about their entire stay are the things that endears patients to him.

During residency training,  parents would make similar comments to some consultants. Patient feedback in the hospital would  be, almost always  about whether their doctor cared enough.

I  believe  that when patients come and see us, expertise is a given fact.

Pediatricians know children. Cardiologists know the heart. Orthopedic surgeons know the bones.

What they are figuring out  during the first encounter is whether we care enough.

Do we care enough to see them on time? Do we care enough to pick up  what they are truly feeling? Do we care enough to know  their circumstances? Do we care enough to verify their understanding? Do we care enough to offer  our time  beyond the clinic visits?

 

Can you please share  how  else we can show our patients we care enough? Please write in the comments below.

 

 

Patients come and stay because we cared enough. 

 

 

 

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