Blog | Friday, October 11, 2019

The doctor walked straight past and didn't even acknowledge us

One aspect of medicine that anyone who reads my work knows I'm most passionate about is keeping excellent communication at the core of health care. It's a vastly under taught skill, and although medical schools are certainly getting a lot better at teaching the fundamentals than they were a few years ago, there's still nowhere enough reinforcement throughout ones medical career. It's therefore easy for all of us to slip into bad habits. Don't get me wrong, physicians do a difficult job, and it's probably only a tiny minority that are really bad communicators. However, each one of us (yes, everyone) can always do with constant reminders and be on a learning curve to make ourselves better.

I'm going to relate one story in particular that happened to me not so long ago. I was back in England and my mom had been scheduled for an elective surgery. I made sure that I would be home for it (thankfully it wasn't anything major) and the whole family went into the hospital in the morning. We spoke to the surgeon and he went through the procedure and took consent. He told us the surgery would be later in the day. So we waited. And then the afternoon came and we continued to wait. 2 o’clock. 3 o’clock. 4 o’clock. No word, and my mom was not eating (NPO). We asked a couple of times if there was any news about the timing, and the nurses just apologized to us and said they would let us know as soon as they heard something from the OR (in England we call it an “Operating Theatre”).

Finally close to 5 o’clock the surgeon came through the waiting room and went to speak with the charge nurse. He then strolled straight past us, all of 10 feet away, gave us a glance as we stared at him, and just carried on. The charge nurse came out and said that unfortunately due to some staffing issues, the OR was closing, and they couldn't do the surgery on that day. She expressed a genuine apology, but we were of course very disappointed (this was the NHS, with its long wait lists, and the surgery ended up being delayed for over a month). Anyway, what actually disappointed us the most—more so my mom—was the behavior of the surgeon. My mom's life would be in his hands and we had placed our trust in him. Yet he walked past several times during the day and finally at the end he traversed us without even acknowledging us, despite knowing full well we had been waiting the whole day.

I wasn't really as upset as my mom (I'm really not easily offended, and know how busy health care is), but more just shook my head because I know slights like this happen every day in medicine, even on this side of the Atlantic. How much effort would it have taken for that surgeon to stop, turn around, say sorry (for factors which were probably beyond his control) and at least respectfully acknowledge my mom? Probably all of 20 seconds. Even within a socialized National Healthcare Service, with much less of a customer service mentality than the USA, it's still the respectful thing to do. Whether health care professionals like it or not, we are held to a higher standard of courtesy by the general public than the plumber or grocery cashier.

One of the most frequent requests that is thrown any physician's way during our long and hectic work days is: “The patient has a few questions” or “The patient's family is here and would like to speak with you.” I know that for lots of doctors, this can be perceived as something of a drag, causing an instant rolling of their eyes. Certainly we may occasionally have a few difficult patients and families, but the majority of the time this isn't the case. Every physician should actually see these requests as a natural part of the job, and not anything extra. Because it's the part of the job that is truly remembered and leaves a lasting mark. It's not about clicking boxes on a computer, ordering and reviewing tests, meeting targets, or writing medical notes. That's the extra part. All doctors should see themselves as the “Communicator-in-Chief” and the face of medical care, not just the physician-scientist. No matter how suboptimal our health care system, bloated our administration, or how behind with time we feel— nothing comes before communicating with our patients. Imagine yourself in that position of feeling vulnerable, or sitting at the beside of the person you love most in the world. How much you'd appreciate that good communication.

So if you're a doctor, do not underestimate the power of just having a minute of extra conversation with a patient and family member. Stick your head in a room as you walk past, stand there for 20 seconds and ask if everything's okay. When you see a family all sitting in a room, go in, say hello and introduce yourself as the doctor in charge. These little sincere things can blow your patients' and families' minds away, because it's still so rare, and will instantly put you ahead of 95% of other doctors in their minds.

Suneel Dhand is an internal medicine physician, author and speaker. He is the founder of DocSpeak Communications and co-founder at DocsDox. He blogs at his self-titled site, where this post first appeared.