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    Here’s how physicians can combat patient gripes

    Let’s face it, we’re all experiencing the mixed blessings of longevity—not only are patients living longer, but physicians are also practicing medicine longer, postponing their retirement until the kids (or grandkids) are out of school and on their feet. This means for primary care doctors, including family practice physicians like me, and internists, the added blessing (or sometimes curse) of having long-term relationships with patients. Some of my practice includes extended families where I care for the parents, kids, and grandparents—what a challenge! Of course, there are wrinkles in these long-term relationships, but generally, they can be ironed out if addressed.

     

    FURTHER READING: 5 ways to improve physician mental health

     

    I was recently inspired by another article in Medical Economics (by author Rose Krivich, “Top 11 gripes physicians have with patients"), and curiously, have a solution for each legitimate gripe, based on decades of sorting through the combatants in this health-care disaster we’re engaged in on a daily basis.

    In no particular order, here we go:

     (1) No shows

    Yes, people do miss appointments, and it is both annoying and financially a disaster for the doctor if this happens often. But, there are extenuating circumstances, and a good office manager can sort through the “Dog ate my homework” stories we all hear (the funniest being “I’m too sick to get out of bed”), and with some kindness and intelligence, help resolve issues of absence. Car accident? That’s a given. We routinely let the patient have the benefit of the doubt. “Stuff happens,” to approximately quote Forrest Gump, and kindness and common sense dictate some laxity is reasonable. But we do have to stay in business, so having a 24-hour cancellation policy in effect and reinforcing this at every point in the appointment process not only generates necessary income but minimizes holes in the schedule.

     

    HOT TOPIC: It's about time PCPs say enough is enough

     

    (2) Noncompliance

    Always an issue, but look on it as more of a challenge. Is the patient secretly uncomfortable with the treatment approach? Often use of a long-term drug such as a statin for hyperlipidemia is prescribed routinely, but the patient may manifest his resistance by simply losing or ignoring the prescription. It may be frustrating for the physician, but this is a fixable problem—maybe the drug is too expensive? Look for alternatives. Have lifestyle changes, diet and exercise been explored? We can be creative, especially if these are big issues, like heart disease, that need a concrete, durable solution.

    (3) Free tests?

    Yes, everyone wants a bargain, and especially these days, when it seems like an adversarial relationship between the doctor and the insurance company has blossomed, there are many mixed messages. Does the patient get a once-a-year free (no copay) healthcare exam? Is lab work included? And if so, (drum roll) which lab tests are really covered? This is not a time when we can legitimately take out our collective frustration on the patient. They are generally not equipped to decipher the fine print gobbledygook that governs culpability when it comes to testing. A simple explanation that the office will attempt to bill for the visit and testing as preventative care, but there may be some patient responsibility is both honest and accurate. In the long run, aren’t we partners in our patients’ health, not opponents?

    Next: 'Last time I looked, we were all human'

    Stephen Patt, MD
    Stephen Patt, MD is a semi-retired family medicine physician who lives with his beloved wife Lisa and wonder dog Sally Salt in the wilds ...

    2 Comments

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    • [email protected]
      Your blog held my interest right to the very end, which is not always an easy thing to do!! A debt of gratitude is in order for the decent blog. It was extremely helpful for me. Continue sharing such thoughts later on too. This was really what I was searching for, and I am happy to come here!
    • UBM User
      Thank you for reasonable and sensible responses to these issues. Too often I see doctors grousing about their patients and refusing to see their role in the problem nor seeing it from the patients' point of view. I suspect a big part of the problem is doctors' getting squeezed between sicker patients (can't afford to come in until the problems get big) and crappier reimbursement. Some of these doctors need a break and should take a vacation and think about why they're in medicine and stop being in practices they hate. They don't have to accept delivering crappy service and being in a crappy job.

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