Once upon a time there was a man named John. One day, John’s wife reminded him that he needed to schedule an appointment with his physician. He knew she was right, so he called his doctor’s office immediately and scheduled a visit.
On the way to the doctor’s office, John decided to call and confirm his appointment, but when he dialed the number he was surprised that he could not reach the doctor’s staff. When he tried a second time his call was immediately transferred to voicemail, and when he arrived he found that the waiting room was filled with many patients, who were waiting patiently.
The staff seemed very busy, so John understood why his phone calls had not been answered. He checked in and wrote his name down, and before he could blink he was politely asked to have a seat. John picked up a magazine and read it. Then he read another, and another after that. After about twenty minutes of waiting, John began to get frustrated. He watched as many of the people who had been sitting in the waiting room when he arrived were invited to the other side of the door, and even some that had come in after him. Waiting for the nurse to call his name felt like hoping to win the lottery. It felt bad to watch as more and more people were called back and he was left sitting, but John told himself that he was just being paranoid.
Finally, 39 minutes after he arrived, John heard his name being called. He felt angry about being made to wait but was also happy to finally see the other side of the door. The staff was unapologetic about making him wait for so long, and John thought they were insensitive. “I’m probably just overreacting,” he thought to himself. His vital signs were taken quickly (although the scale felt like it took forever.) Finally, John was escorted into an exam room, where he was left alone. He wondered to himself, “Do I sit on the chair? Do I sit on the exam table?” Nobody had given him any information, so he didn’t know what to do. Then he found himself waiting again. He realized that the exam room was just an extension of the waiting room.
After 10 minutes, John cautiously peeked his head out of the door of the exam room, wondering if he had been forgotten. A passing staff member told him that the doctor would see him soon. “Oh. Okay great, thank you!” he replied, as if he had just been told something profound. “I shouldn’t be so impatient,” John thought to himself. During the next 20 minutes, John sat in the exam room and wondered, “What is actually in all these cabinets anyway?” Then it happened. Dr. Doe entered the room.
At home, John had many important questions he had wanted to ask Dr. Doe, but with so much time going by and him having gotten so frustrated and angry, he almost forgot why he’d made the appointment in the first place. Dr. Doe politely apologized for the long wait and John instantly felt about 4% better. He wondered if the doctor was to blame for the long wait. The doctor’s badge was inscribed with an impressive title from a local university. John was comforted by knowing that his doctor was intelligent and knowledgeable.
Dr. Doe confirmed from his records that John had been allergic to penicillin since birth. The doctor typed away on a fancy electronic medical record tablet, rarely looking up at John. There had been no handshake and the doctor displayed no personality, no feeling of warmth or care. John found himself feeling disappointed in his doctor, but then asked himself, “Am I trying to date this guy or be treated by him?” Dr Doe quickly examined John and left the examination room after 8 minutes. John hadn’t been able to ask any questions and was left feeling dissatisfied in ways he couldn’t describe.
This story is not a fairy tale, and it is not about a specific clinic or clinician, but I am confident that most readers will find it very familiar. Think about this: A 2013 study conducted by Vanguard Communications analyzed 3,617 online reviews of physicians. It found that 43.1% of the reviews included complaints about poor bedside manner, and 35.3% included complaints about poor customer service.
Most patients are not concerned about their doctor’s intelligence or knowledge, but they are frustrated by their physicians’ lack of interpersonal skills. This data coincides with research published in the Journal of General Internal Medicine (Lopez et al, 2012), which showed that patients were more than twice as likely to describe a physician’s empathy rather than their knowledge. For better or worse, patients judge experiences with their clinicians in the same way that they judge other service industries. Many of us use the same criteria for critiquing our doctors as we do for restaurants, banks, and other retail establishments.
So … are we wrong? Was John wrong? Is it unreasonable to prefer that a visit to the doctor feels like a visit to the mall rather than like a trip to the DMV? Many patients are surprised when they see their doctor at the exact scheduled and agreed-upon time, and that seems the reverse of how things should be. Still, many medical establishments double book their timeslots to increase their volume of patients. While this can be financially beneficial, these decisions should prompt doctors to remember that we are all patients.
I am a patient. Long waits are frustrating and can create a non-therapeutic atmosphere. I believe a large part of being a good doctor is remembering what it is like to be a patient. Most of us expect and desire the same thing from our visits with our physicians. Good bedside manner. A sense that people care. Good customer service. Nobody wants a clinician with poor listening skills who interacts with arrogance and indifference.
When I started Mindful Medicine, I made a promise to myself that I would always remember what it is like to be a patient. Being accessible to my patients is important. Minimizing wait times is important. Listening, understanding, and making a human connection are an immensely important part of patient care. I vowed this would be the cornerstone of the type of treatment I provide, even if it meant a financial sacrifice. Double booking will never occur. Instead, spacing out visits to reduce wait times and to give patients more time with me will be the norm. No one should ever leave their doctor’s office feeling the way John did in the story above. I believe this can be achieved. Do you?