Thursday, July 7, 2016

Basic Expectations on Physician-Patient Communication and Exam Room Experience

It wasn’t so long ago that patients blindly trusted their physicians’ good intentions and silently accepted their prescription for treatment. Patients usually went where they were told, did what they were told to the best of their ability and just accepted what they were given. Nowadays, healthcare consumerism, patient engagement, and the empowered patient are all the rage. People are starting to question their doctors and demanding participation in all steps of the healthcare diagnosis and treatment process. Some are going as far as wanting to review, add to, and even edit their own medical records maintained by their physicians.

I get the fact that the internet and technology have enabled this new era of patient-physician communication and engagement. What I don’t get is why so many physicians and medical practices continue to fail so miserably all for want of some simple communication methods and information-sharing. There are some simple things that can be done before, during and after an office visit that don't require fancy technology and which can greatly improve outcomes and patient-physician engagement.

Before the Encounter

Make it easy for me to reach you


I shouldn’t have to search for a phone number at which to contact your office or a specific department within your practice. If you have different contact info for scheduling vs. billing vs. something else, make sure that information is clearly available. Many times when I contact a doctor’s office, I have to navigate a difficult phone tree, and even then I hardly ever get to speak with a person but rather get routed to voicemail.


Let me handle administrative tasks BEFORE my visit

The last thing I want to do when I get to the doctor’s office is balance a clip board on my lap and complete history, physical and insurance forms. There’s no reason why I shouldn’t be able to download these forms from the comfort of my own home or office and complete them there. Better yet let me complete them online and print out a copy for myself.


Help me prepare for my visit

For optimal outcomes, certain medical specialties and/or procedures often require some sort of preparation prior to being performed. Like filling out the H & P/Insurance forms, it would be best for me and you to know what I can expect and what I may need to do BEFORE I get to your office.


Remind me of my appointment 48-72 hours before it occurs

I know it’s not your responsibility to make sure I don’t forget my appointments but in an age where most people have smart phones, is a text message reminding me of my upcoming appointment an unreasonable expectation?


Give me something good to consume while I wait

I pretty much expect that I’ll have to spend some time waiting to be seen. My smart phone is my failsafe source of entertainment. What can you give me to read, watch or listen to that may actually provide more value than me just checking out my Twitter feed?


During the Encounter

Greet me in a calm, unrushed manner

The fraction of a minute following the moment I hear you knock on the exam room door are probably the most stressful seconds of the entire encounter. A little eye contact – and even a slight smile – will go a long way at putting me at ease.


Listen to what I have to say and don’t rush me

On average, physicians wait 18 seconds before interrupting a patient’s narratives of their condition. Be above average and don’t interrupt me while I explain ‘what brings me to your office’ - at least for the first minute or so. You have my permission to interrupt me after two minutes.


Look at me when asking me a question or explaining something

Eye contact goes a long way in establishing a human connection. How many of you can relate to either or both of these comments?


“My doctor doesn’t face me. He just types into his laptop” and “It seems like my doctor always keeps one hand on the doorknob.”


Avoid complex terminology/medical jargon

Don’t overestimate my health literacy and/or how nervous I may be about being in your exam room in the first place. And keep in mind that I may be too embarrassed to ask clarifying questions because I don’t want to reveal my lack of understanding of what you just told me.


Try to ask questions to assess my understanding, repeat potentially confusing or complex explanations as needed, and encourage questions.

After the Encounter

Make sure I understand The Next Steps

If there’s anything that I must do besides take two aspirin and call you in the morning, please make sure you are clear about what I can expect and what I need to do. Ideally, have me walk out of your office with printed information and instructions.


Let me know who I can contact if I have any questions

It’s likely I may have forgotten something important. Or maybe I need clarification about a specific instruction you gave me during our encounter. Sure I can ‘just call the office.’ But you can bet I’ll feel much better and secure if I know exactly how and when I can get in touch with your office.


We patients need to understand what we’re being told and have simple information about our treatment and medicines

Provide test results on a timely basis

I maybe expecting the worst possible outcome for any lab work or imaging exams you ordered or performed so please don’t make me wait any longer than is absolutely necessary learn the results.


It's Not Rocket Science!

None of the above require any fancy, high-cost, hard to operate technology. By keeping the above in mind and communicating effectively, we build trust and cooperation between each other as equal partners in the delivery of modern health care. Now that’s empowerment!

What are some basic expectations you have when it comes to communicating with and interacting with a doctor and her or his office staff? Share your thoughts here. And consider following me on Twitter for more on healthcare data, technology and services.

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