(c) 2011 Christiana Lambert

(c) 2011 Christiana Lambert

As I’ve said before, I’m not a doctor—and I don’t even play one on TV. When you don’t visit doctors too often, it’s easy not to put much thought into what makes a good medical experience. Once upon a time I was fairly neutral about the whole seeing a doctor thing. Would prefer not to have shots or get prodded, but never responded with too much anxiety—no, I saved that for the dentist’s office where my shoddy tooth-brushing habits would catch up with me back when I was growing up. But other than my having to pay the piper, I couldn’t have been treated better by my dentist and his assistant—I mean, who now would give a young adult a free wisdom tooth extraction for college graduation?

What Doc knew instinctively was how to treat patients as if they mattered—even though he was my father’s friend, all patients really did seem to matter to Doc. Our family loved his care so much that even after we moved to a larger town with more dentists, we drove 40 minutes each way to stay with Doc and his excellent care. When carsickness caused me to throw up—on him—Doc looked little more than irritated and then knew to schedule me for the second family appointment of the day thereafter.

Even though all doctors I encountered were not Doc, I didn’t really think about them that much, but my mother did. She’s the one who later switched me from a doctor with a cold manner and minimal listening and analytical skills—the same doctor who years later would fill in for her doctor during the woman’s maternity leave and procrastinate reading Mom’s treadmill test until he decided results required an emergency flight to a cardiac center. It appears Mom was right about his lack of thoroughness.

Not until I was almost a mother did I understand the awesome responsibility of choosing a doctor for and coordinating care for loved ones. In the last weeks before our twins’ birth, I struggled to decide which pediatric practice would work best for our children. I finally made a choice based on both practical reasoning and a gut feeling. Turns out the kids were in good hands, not only for medical care and developmental tracking, but also for how they were treated from their earliest days. At my son’s 18-month appointment, he picked up a block and beaned the doctor in the head. The doctor just smiled and said, “Hey, that was overhand—that’s quite advanced for his age.”

By now, after overseeing both ordinary and more serious medical care for my kids all the way to adulthood, as well as taking over helping my mother through her final years and sitting in on some care for my in-laws, I am what could be called an “old pro” at it—if in fact I could get paid for all my experiences.

I notice when a doctor is doing more than looking at numbers from a report or relying on obvious symptoms. I can see when a doctor is listening to the story, looking for the subtle. And then, of course, it’s just so obvious when the doctor really enjoys interacting with the patient in the room. I have a doctor who delivered our babies and later performed my hysterectomy—a few years ago I realized that her focused attention in my now routine appointments is almost shocking when I compare her with other doctors I’ve visited. She is so much better at the relationship part of the doctor/patient experience than most.

I learned enough in my MBA classes to realize that most doctors aren’t just practicing medicine, but they are also managing a business. It’s a tough line to walk between keeping a practice running in a timely manner and giving each patient the individual care needed. The way providers get paid makes it imperative for them to be more efficient in delivering care—which can sometimes make a medical encounter seem rushed, especially since much of the payment comes not from the patient but from the insurance company.

That means that doctors are more often “rewarded” financially for the quantity of patients served than for the quality of the encounter with each customer. Any business encounters this classic dilemma when trying to find the right balance between quality and productivity, but service providers—especially those not paid by the true customer—have a bigger dilemma.

Nonetheless, another thing I learned in MBA classes was that simply listening to customers and providing empathy is a pretty inexpensive way to provide quality. Good doctors know this already—my guess is that wanting to do so is one reason Doc and others like him chose to study medicine in the first place.

Here in our own home we are still in search of a solution for the medical condition(s) that led to our daughter’s very disappointing ER visit. However, the doctor she met last week looked at her the whole time he examined her and paid attention to the signs of pain. Will he be able to discover what’s troubling her body? Who knows, but at least she felt heard—which is surprisingly rare for someone who has had enough encounters with medical practitioners in her short life that she could work as a quality control auditor for patient care.

Doctors who treat us as individuals with conditions and/or symptoms versus as a diagnosis code probably stand a better chance of getting the diagnosis right. Good patient care is good medicine for what ails us—even for those times when all that ails us is the fact we have to give up time and money for routine care—but especially for those times when we are in pain and afraid.

Thank you to the doctors out there for whom care is both noun and verb—and for whom the word patient is also an adjective that describes the type of care they provide to us when we visit them as patients.