Patient Engagement

The Patient Patient

I got to the clinic 15 minutes before my 1:00 appointment, and my expectations were realistic: I knew I would wait to get in to see the doctor.  After all, it’s not called a “waiting room” for nothing.  So I came prepared to spend some time, read some magazines, keep on top of email.  However, what I did not anticipate was a waiting room packed with people and simmering with energetic frustration.  Some of these patients were still unseen at 12:45, despite their 8:00 appointment.  They were angry and tired, as were their family members and translators.

The chaotic scene was not aided by the staff response.  Two administrators sat behind the counter, fielding a constant parade of irritated questions and complaints.  As I sat and watched the dynamics, I thought that these staff members had no real sense, training or concept of customer service.  If only they’d come from behind that protective shell of a desk, entered the room periodically, apologised for the delay, and acknowledged the inconvenience for people who had been waiting hours, without a word or explanation, they could have mitigated the tensions flaring.

I waited for 4 hours and 45 minutes.  And while I pride myself on being a patient patient, I was exhausted from the tedium of the delay, the palpable tensions in the room, and my own escalating thoughts and fears about what the doctor might say – once I saw her.  Finally, I was ushered into an examination room, where I waited a bit longer.  When the doctor walked into the room, tense and tired, she never made eye contact.  She looked down at my file instead of at me, and said her first and only words: “read the chart.”

And that’s when I pushed back at the dispiriting wait, the collective frustrations, the lack of acknowledgement and common courtesy.  But I didn’t lash out.  Respectfully, in a normal tone of voice, I said “No, I won’t read the eye chart.  First you have to introduce yourself, you have to look at me, I have to introduce myself, we have to actually see each other.  This is my first appointment of many, and we can’t start this way. I know you’ve had a stressful, horrible day – I’ve been in that waiting room all afternoon, and clearly something has gone very wrong.  And I also work in healthcare, so I’m sympathetic to the pressures you face.  But we must create some kind of relationship, a partnership between us as patient and clinician, for this to work.  Trust me, I don’t want to be your friend – I don’t want to go shopping with you or gossip about our kids.  But I need to feel that we have some kind of real connection.  So let’s start over.

My name is Judith John.  I’ve just been operated on to remove a blood clot which resulted from a hemorrhaging brain tumour. One of the outcomes is damage to the optic nerves, so I have double vision.  I can see two of you, but please, just give me just your one name.”

The doctor was visibly taken aback by my comments.  But she responded, and with an apology and a smile, she offered her name, and her handshake.  We started over.

– Judith John, May 2014

One thought on “The Patient Patient

  • While living the US I too had occasion to visit an Opthalmologist and like you found a waiting room full of anxious people waiting … and waiting … The difference was that at about 20 minute intervals, the receptionist did come out from behind the desk to give us (a) the reason the doctor was late (an emergency surgery following an industrial accident in which a young woman’s eye had been pierced by a hot metal objects); and (b) his estimated time of arrival, described by what he was doing – he has started the surgery … he is almost finished … he is finished (and thinks the young woman’s eyesight will be near normal) … he is on his way … he will be here in five minutes. In doing it this way, we all felt part of the heroic journey that was unfolding and felt as happy as we imagined he and the young woman would with the outcome! When he came in, he came right into the waiting room first thing … he said, “I’m SO sorry to have kept you all waiting. I know Janet [the receptionist] told you what the delay was about, but I want you to know now, that I am going to ask you wait even longer if you can. I don’t want to compromise your care just to catch up, so I will take exactly as long with each of you I need to. I won’t rush. I have asked Janet to bring some juice and cookies in for you. If you can stay, I promise I will see you today. If you can’t, please enjoy some juice and cookies and Janet will help you find another appointment within a week. Is that all right? Does anyone have any questions? OK – let’s get started … Mr. Jones … would you come with me please?” And with that he and Mr. Jones breezed out – and the juice and cookies came in! Wow! None of us left, all of us were seen, all of us felt not only part of this heroic drama we “witnessed” but we also felt valued and cared for. There are some terrible, unforgivable aspects of the American healthcare system – we saw those too – but at least this physician and this clinic had the patient in mind as they went about their day – and it felt good.

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