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some i had a realization today...
I have come to the conclusion that the root of all patient dissatisfaction comes down to three things
1) not having instant concierge access to their doctors when they don't actually pay for concierge medicine
2) not having around the clock instant message / inbox / email access to their doctors - because our society is all electronic now and want instant satisfaction
3) not being insta-cured like the pokemon center. they watch too much Star Trek (like me! paramount plus is awesome ) in which Dr McCoy/Crusher/ Bashir/Robert Picardo's hologram EMH doctor / (i never watched star trek enterprise or discovery so i dont know those doctors names), Dr T'ana, Dr Mbenga etc... are using painless hyposprays to cure everything and tricorders to instantly diagnose something...
because the vast majority of patients who are satisfied ... just need some communication and taking a few moments to spell things out for them...
but those that are never satisfied can always fall under one of the three above.
now all patients should have a doctor who listens and is empathetic. I am saying after the doctor has done all of those "by the book proper steps," then the remaining issues are 1-3.
I always take great care to ensure all the "proper steps" such as open communication, frequent communication, and showing empathy and "aww you poor thing" is demonstrated to patients. I do that whole "family doctor" open the conversation by "asking about the family or the pets" thing. those "by the book steps" are usually sufficient to get the patient to open up and work with you collaboratively.
I am saying AFTER the doctor does everything right and by the book, when patients are STILL not satisfied, it is usually due to 1-3 as above.
for those patients I often ask... so what do YOU want to do?
then I get some very outlandish answers lol.
Addendum: I must reiterate - we must do our part by being empathetic, open, kind, and understanding of certain "social determinants of health, cultural competency, that DEI stuff..." that interfere with the patients situation. if all patients were as self sufficient as we are, then they would not need to see us and we would be out of a job...
but I am saying AFTER we do the right by the books "good doctor" approach and we have "gotten the ball out of our court," then I have noticed unsatisfied patients fall under 1-3.
Addendum 2 : to give some concrete examples , one brand new patient was a young 30s non smoker who was recently admitted to local hospital with cough and found ti have hilar LAN and nodules - transthoracic needle biopsy diagnosed lung adeno egfr positive . Saw Heme onc already on Tagrisso . Hosptial navigators helped schedule to see me two weeks after discharge . I prepped the entire visit ahead of her visit (primarily to save me time during the visit but also to show patients I care ) and the visit went smoothly . Restrictive lung disease will get better with time . Some air trapping maybe a bronchodilator will help. Utmost care and empathy given . She was a nice person overall. But this patient just had to chime in “it’s so hard to see you ! I waited so long!”
I responded you know there are other pulmonologists .
Yeah but you have the highest reviews and I wanted to see you .
Thanks for your praise but I have to attend to the patients who already scheduled .
This is a tame and lighter example of a very nice patient whose disappointment was rooted in how a scarce resource (I’m not saying I’m he scarce resource in just making an analogy ) was not given to a patient and the patient was not allowed to cut in line and this was the root of her disappointment .
This was a pleasant encounter actually but still highlights my point
Addendum #3:
I think I will place a sign in my waiting room. I will custom make a sign. It will say something like
"The patient is always right. But the customer is not always right."
I think that captures the frustrations of outpatient medicine in a succinct and pithy way.
I have come to the conclusion that the root of all patient dissatisfaction comes down to three things
1) not having instant concierge access to their doctors when they don't actually pay for concierge medicine
2) not having around the clock instant message / inbox / email access to their doctors - because our society is all electronic now and want instant satisfaction
3) not being insta-cured like the pokemon center. they watch too much Star Trek (like me! paramount plus is awesome ) in which Dr McCoy/Crusher/ Bashir/Robert Picardo's hologram EMH doctor / (i never watched star trek enterprise or discovery so i dont know those doctors names), Dr T'ana, Dr Mbenga etc... are using painless hyposprays to cure everything and tricorders to instantly diagnose something...
because the vast majority of patients who are satisfied ... just need some communication and taking a few moments to spell things out for them...
but those that are never satisfied can always fall under one of the three above.
now all patients should have a doctor who listens and is empathetic. I am saying after the doctor has done all of those "by the book proper steps," then the remaining issues are 1-3.
I always take great care to ensure all the "proper steps" such as open communication, frequent communication, and showing empathy and "aww you poor thing" is demonstrated to patients. I do that whole "family doctor" open the conversation by "asking about the family or the pets" thing. those "by the book steps" are usually sufficient to get the patient to open up and work with you collaboratively.
I am saying AFTER the doctor does everything right and by the book, when patients are STILL not satisfied, it is usually due to 1-3 as above.
for those patients I often ask... so what do YOU want to do?
then I get some very outlandish answers lol.
Addendum: I must reiterate - we must do our part by being empathetic, open, kind, and understanding of certain "social determinants of health, cultural competency, that DEI stuff..." that interfere with the patients situation. if all patients were as self sufficient as we are, then they would not need to see us and we would be out of a job...
but I am saying AFTER we do the right by the books "good doctor" approach and we have "gotten the ball out of our court," then I have noticed unsatisfied patients fall under 1-3.
Addendum 2 : to give some concrete examples , one brand new patient was a young 30s non smoker who was recently admitted to local hospital with cough and found ti have hilar LAN and nodules - transthoracic needle biopsy diagnosed lung adeno egfr positive . Saw Heme onc already on Tagrisso . Hosptial navigators helped schedule to see me two weeks after discharge . I prepped the entire visit ahead of her visit (primarily to save me time during the visit but also to show patients I care ) and the visit went smoothly . Restrictive lung disease will get better with time . Some air trapping maybe a bronchodilator will help. Utmost care and empathy given . She was a nice person overall. But this patient just had to chime in “it’s so hard to see you ! I waited so long!”
I responded you know there are other pulmonologists .
Yeah but you have the highest reviews and I wanted to see you .
Thanks for your praise but I have to attend to the patients who already scheduled .
This is a tame and lighter example of a very nice patient whose disappointment was rooted in how a scarce resource (I’m not saying I’m he scarce resource in just making an analogy ) was not given to a patient and the patient was not allowed to cut in line and this was the root of her disappointment .
This was a pleasant encounter actually but still highlights my point
Addendum #3:
I think I will place a sign in my waiting room. I will custom make a sign. It will say something like
"The patient is always right. But the customer is not always right."
I think that captures the frustrations of outpatient medicine in a succinct and pithy way.
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