Tag Archives: patient satisfaction

Part time doctor

So I am back on the hunt for a job, and it’s not been easy. Apparently, no one is wanting to hire a part time doc. I mean I understand that patients want reliability and availability, but I don’t think that’s an impossible thing to accomplish as a part timer.

My last two jobs I was part time, and it worked out well.  The last job I worked three days a week, and rarely had an issue with being able to see all my patients when they needed to be seen. If it was urgent and they couldn’t wait, there was always another doctor to see them in the office, and for quick issues most patients didn’t mind seeing another doctor. It was like seeing a doctor at an urgent care center, but with the benefit of their chart  already being there. And I took phone call, so if they ever had questions I always available to answer, and had their chart on my mobile app. My patients loved me, and always made it a point to only see me.

So, how do you feel about having a part time Doctor? Would it be an issue for you? What would it take for you to be comfortable having a part time Doctor? There being another doc in the office? Having a special email or phone number for the doctor? Feel free to be honest, I really wanna hear your thoughts!

Ask the Doc- Why isn’t my doc willing to hear out my ideas?

A reader wrote in about a concern she had with her dermatologist. Her concern is that her current treatment is causing more harm than good. She has tried to show him research studies that she has found about the issue, but he won’t read them. She has also tried to show the study to her PCP, but hasn’t had any success.

In the doctor-patient relationship, I believe it is very important that there is trust between both parties. Patients need to trust their physician’s judgement and believe that their doctor is looking out for their best interest. But this does not mean they cannot seek further explanation or information.Patients have a right and responsibility to be involved in their care and treatment, and advocate for themselves.

As a physician, I believe in addressing my patient’s concerns, even if they may seem trivial. I may not always agree with what my patients are saying, but I believe it is worth considering, even if it is to simply show my patients that I respect and care about their feelings. Doctors have extensive medical knowledge and training which guides their decisions, but that doesn’t give us permission to completely dismiss our patient’s opinions.

Although we may be open to our patient’s ideas, sometimes our hands are tied. We have to be careful about going off- protocol, as does anyone in any other profession. There are standards of care in medicine, and treatment plans constructed around evidence-based medicine. Deterring from these standards can cause major issues for a physician.If there were to be a negative outcome due to a physician going off label, or denying the recommended treatment, the physician can be held liable as well as feel the guilt of going against consistently proven methods and causing damage.

I think the real issue here is that the reader does not feel that the dermatologist is being receptive of her concerns. I would encourage anyone in this situation to make their doctor aware that they feel their concerns are being ignored. We sometimes get so focused on the plan we have in our head, that we don’t realized we’ve stopped listening. If the physician is still not willing to listen, then I think it’s not a bad idea to get a second opinion. At the end of the day, the doctor and patient should work together as team with one goal- providing the best care for the patient.

Misunderstanding

The other day, at the office, a receptionist told me a story about her recent emergency room visit. She was having a migraine, and when she came into her room, they asked for a urine sample. She had just used the restroom, and told them that she would be unable to give a sample. They told her they would not be able to give her any medication without the urine sample. She was so angry that she left and went to a different ER.

At the different ER, she was eventually treated and given a prescription for her regular migraine medication. She complained that every time she sees her neurologist, he only gives her seven pills. She understood that insurance would only pay for that amount, but she felt if he wrote for more, then she would just pay out of pocket for the extra. She gets more than seven migraines a month.

I explained to her that in the ER they took her urine to test for pregnancy. A lot of medications cannot be used in pregnancy, and tests such as CT scans can cause radiation and affect a growing fetus. She argued that she told them she was menstruating, to which I replied that sometimes women can have  bleeding that resemble their periods even while being pregnant.

I also explained that when pain is involved, sometimes they need to do drug screening to make sure the patient is not using recreational drugs, or abusing prescription medications. I told her that doctors have become suspicious when patients aren’t willing to give a urine sample because many drug-seekers use this tactic to avoid getting caught and obtain pain medications for recreational habit or to sell.

I then explained that the reason she only gets seven migraine pills is because it is an as needed medication to be taken only when she has a migraine. It is a quick onset medication to be used when the migraine symptoms begin so it will not worsen. If she is having such frequent migraines, it may mean that she needs to be on a daily medication to prevent migraines.

She agreed to see her neurologist, and that’s when I realized so much of the discord between doctors and patients is due to simple misunderstanding. By simply educating patients, we can empower them. So in an attempt to keep the air clear, I’d like to answer any general questions you may have. Send me your questions, and I will post them with my answer. Here’s your chance to “Ask the Doc”

Please keep in mind that I cannot offer medical treatment advice.

The Waiting Room

I read a post on Facebook, where someone was complaining that they were in their doctor’s office and the doctor was seven minutes late for her appointment. Hearing these type of things really frustrate me. I’ve been on my fair end of long wait times, and believe me I know it sucks, but I promise you it’s just as bad on the other side. Chances are if the doctor is late for your appointment, then she is running behind in general, which ultimately means she’s going to be staying way late to finish everything up.

I understand as a patient what the waiting room feels like, and I encourage other doctors to understand too. Sitting in a waiting room can be a very anxiety-provoking experience. You’re concerned about what the doctor is going to say about your test results, or that she’s going to be upset at you for not taking your meds for the past couple days because you ran out. You’re scared that you won’t be able to express yourself or have enough time for all your questions. You may also be worried that you have to go pick up the kids, or make it to the bank, or that time is running out on your meter.

And then on top of all that stress you are sick. Your exhausted and your body hurts. The only thing you want to be doing is laying in bed, and truthfully it’s what your body should be doing. And maybe you’re hungry. God knows what happens to me when I’m “hangry”. I get dizzy, and my head hurts, and I turn into Oscar the Grouch. You need to be home, but instead you are in the office waiting for what feels like hours.

Doctors don’t like keeping patients waiting, but it happens. Maybe the patient before you came in late, or perhaps someone walked in because they were sick. Or maybe someone had a fifteen minute appointment, but it ran a little long because they had a lot of issues. Sometimes it’s a scheduling issue. Someone from another department accidentally double booked, or even worse, the administration requires time slots to be double-booked. Other times we have a serious emergency where we have a patient who needs to be transferred to the ER. We’ll have to fill out transfer paperwork, update the medication and medical history lists, provide emergent treatment, and keep an eye on the patient til EMS arrives. Sometimes it’s a phone call from another doctor or family member about a patient in the hospital. I remember being locked up in my office on a twenty minute phone call like this, and when I came in to see my next patient, she accused me of sitting around on my computer in my office doing nothing.

For my patient readers, I ask you to be understanding with your doctors. It’s not an easy job, and the truth is when you are the patient who has the emergency or special situation we will give you all the time you need. And for my physician readers, we have to respect our patient’s time as well, keep them in the loop so they don’t feel forgotten,and be considerate of what they are feeling as they wait.

Patient Satisfaction

I read an article titled “Patient Satisfaction is Underrated” on the popular medical forum KevinMD.com. It was written by a medical student who was trying to explain to physicians that it is possible to keep patients happy, without caving in to unrealistic or inappropriate demands. Previous to this, an article was written titled “Patient Satisfaction is Overrated”, which explained that patient satisfaction doesn’t produce better outcomes for patients, and that doctors are under a lot of pressure to score high on patient satisfaction surveys, or fear decreased reimbursements.

There were a lot of mixed emotions in the comments section. A lot of disgruntled replies from doctor who have had their fair share of abuse from patients, administrators, and policy makers. Then there were the doctors who were still holding on to idealistic beliefs. Some fell in between, wanting to have those ideals but realizing it wasn’t always practical.

I think maybe I walk in the middle. From a physicians perspective, I cannot deny that constant pressure from my administrators, patients trying to take advantage of me, and simply being overworked, has not made me a little bitter sometimes. But the patient within me still feels like doctors should still believe that providing patient satisfaction is still important and attainable.

As the former article stated, communication is the key. As physicians, we need to be willing to communicate, and not become jaded by prior experiences. We need to find our passions again, remember why we went into medicine, and find happiness in the good work we do, despite what is happening around us. I feel like happy doctors make happy patients.

As patients, we also have a duty to do. We need to see our doctors as human beings and learn how to trust them. We need to recognize that our doctors are not just two letters behind a name, or a signature on a piece of paper. Our doctors are resources with years of training and knowledge who are ready and willing to help us. We have to stop telling our doctors what we WANT because Google said so, and trust the judgement of our doctors to do what we NEED.

I believe we can change the atmosphere between doctors and patients, so that both patients and doctors are satisfied, but we have to be willing to see each other’s side and work together.