You are currently browsing the tag archive for the ‘Bedside Manner’ tag.

(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.


(c) 2011 Sherman Lambert

Might an empathetic bedside manner trump news delivered, softening blows because the patient feels heard?

Visit one, not requested by us but strongly suggested by the medical staff, started off in what is a typical way in our family: they got my daughter’s name wrong. Hey, I realize I named her a unique name, but after sixteen years at a practice, why is it so few of the staff get her name right? Is it possible they have a habit of not reading with attention?

Then the staff member proceeded to ask us why we were there—and then argue with us about our answers. We did not ask to come back so soon, but were told it was necessary for a specific reason—which had not been recorded the same way in the visit notes. Before we left without doing anything medically, three staff members were in the exam area, none willing to agree with the reason we said we were there while turning the conversation to what my daughter was not doing right—through information that had never been discussed at the previous appointment.

First of all they discounted what they had done and then turned the finger of blame on us. We were supposed to feel appeased with platitudes that it wasn’t a waste of time because they got to check out something else. Believe me, it isn’t whether they think something is a waste of time that matters—it’s what we, the patients—customers, if you will—think.

And maybe we would have felt the visit had not wasted our time if they had even offered one sincere apology for the miscommunication. Perhaps they really do think we got it all wrong, but this is not the first time we have encountered such confusion at this practice after we had the apparent misfortune to see two different providers at two visits—either office politics or medical philosophy discrepancies are involved or the staff does not write good notes in the charts—or all of the above.

In fact, with all my years of watching over my mother’s and my kids’ care, I can tell you that this is not an area I get wrong often, if at all. I know when the appointments are and I know why they say we are supposed to be there. The more I deal with medical appointments and procedures, the more I realize that good patient care is about more than the medical aspect—it’s also about good listening and record-keeping.

So I can tell you that my daughter was very unhappy to go to an appointment elsewhere an hour later. Since we haven’t figured out who should be her primary care doctor now that she is nineteen, when she has an urgent general concern when she is at home, she still has to go the pediatric practice where she’s been seen her entire life.

First of all, they called her by her given name. Then the PA asked questions that showed she had read the most recent sections of her medical chart. And, get this, she didn’t question how she said she felt, but discussed it with an empathetic tone. Of course, then she sent me out after a few questions so she could treat my daughter like the adult she is. By the time the appointment had ended, this PA had suggested something that could explain so much about all these constant physical problems that have been so hard on my daughter’s emotional well-being. Not a one of the specialists had ever mentioned such a possibility but so often they didn’t appear to have read her medical history and/or did not listen enough to our explanations to ask such thorough questions.

The daughter who entered that practice ready to shutdown on the next medical person who discounted her experiences left peaceful, despite hearing that there might be an explanation for her health problems that would mean even more medical treatment.

I am convinced she calmed down all because she felt she had encountered a provider who tried to understand all she had experienced, by simply reading good notes and asking related questions to draw out more possible information as well as by listening to the answers.

In other words, she felt heard. And that may make all the difference in getting a good enough diagnosis so that true healing may begin.

Recent Comments

Enter your email address to subscribe to this blog and receive notifications of new posts by email.

Join 304 other followers

Blogging AtoZ Challenge 2012