The letter from Dr. Peter Salgo in the NY Times (see my post of March 24) generated eight thoughtful letters in yesterday’s edition.
A letter from James Conner, a medical student living in Cambridge, MA, had this to say:
“My medical-school class is brimming with bright, compassionate young minds with diverse backgrounds and ideals. What we lack is a unified identity of ourselves as humble future public servants distinctly removed from market pressures.
This is exemplified by the emerging popularity of combined M.B.A.-medical programs, as well as admissions policies that seem to focus on hard numbers first and personal qualities second.
From admissions to curriculum design, medical schools must appreciate their place in restoring the human nature of the doctor-patient relationship.”
Princeton Professor Uwe Reinhardt, one of the more thoughtful leaders in health policy and payment, challenged anyone to find a memo or other directive to physicians telling them to limit their office visits. He is right – while physicians feel that they must do so in order to maintain (not increase – maintain) income, the issue is flattening the increase in health care costs. The solution is being efficient, and that means efficient in your back office and support areas. Physicians need to be spending time with patients. If they feel rushed, and patients feel rushed, the visit becomes inefficient and ineffective for everyone concerned.
1. Place clipboards outfront with a form, offering patients the option to write down all of their questions and complaints, so that they won’t forget something, or they don’t bring it up until the supposed end of the visit.
2. Sit down when you’re talking to your patients.
3. When you ask “is there anything else you’d like to talk about today” – sit and count to 10 before ending the visit.
4. Prepare and offer brochure and other information to your patients. You should be the source of accurate health information
5. If you know the patient, your visits are going to be more effective and efficient, because everything isn’t new. You assistants can ask some of the “what has changed” questions.
6. Next time you go to a dentist, pay attention to what they do. Their staff, whether dental assistants or hygienists, get a lot of history before the dentist comes in.
7. “Warm up” your exam rooms. Wallpaper, paintings, dim the lights a bit, use indirect lighting, and softer colors to calm everyone down – your patient, your staff, and you. Clean – even sterile – doesn’t have to be boring.