Be Patient, Doctor

I’ve been told I’m a really good patient. I think it’s partly my desire to please, to make my health professional’s job easier that reminds me to give a succinct history; makes me compliant to treatment. I also know the value of evidence based care and have the good sense to apply it, with guidance, to my own health issues.

I guess wanting approval doesn’t necessarily mean you will be a good patient. A misguided attempt to lighten the doctor’s load could see you give a history full of holes, or leave some complaints unvoiced. It could lead to over-tolerance of side effects and treatment failure, as you don’t want to ‘fail’ your doctor.

Contrary to popular opinion, I think many doctors make excellent patients. Certainly the doctors I have cared for, and their families, have all been wonderful to treat. An appreciation of the doctor’s role, the capabilities and limitations, and knowing the limits of medical knowledge itself, means you may be more accepting of the care you are given. Your expectations may be more realistic.

When I am treating a doctor, especially a fellow GP, I feel self-conscious; highly aware of my shortcomings. I don’t mind though, as I know they are likely to be similar: self-critical, but very forgiving of others. They know what I can offer, and what I can’t.

My physiotherapist tells me that his doctor-patients are more respectful of his time than the average customer. They ring to cancel if they aren’t going to make it. If they miss an appointment, they insist on paying for it anyway.

I think these doctors are being ‘the change they wish to see’ in their own patients. We would do well to insist our own patients treat us with this much courtesy. Going a little off topic now: what makes a good patient?

I appreciate patients who:

– are on time for their appointments (I try to reciprocate by being on time myself)

– if they have multiple concerns, show me the list at the start of the appointment, so we can prioritise. ‘By the way, I’ve been having chest pains’ is not a good thing to tell me at the ‘end’ of our allotted time. We won’t finish for a long time after that! Try to tell me at the start

– know how long their appointment is and that not everything can be sorted out in the one visit. Book multiple appointments, or a double if you have a lot of issues to sort through.

– ring to cancel rather than just not showing up

– offer to pay for appointments they missed or forgot about

– believe that I care about them, know I’m not a Big Pharma shill, I am their doctor who wants the best for them

– know that I have trained for a long time to practice good, evidence based medicine; that I actually do keep up with the latest science, which believe it or not, trumps google university or watching 60 Minutes on telly

– know that it’s my job to give them the best health advice, but it’s their job to prioritise their health and to implement the advice. I can’t solve all their problems for them, even when I wish I could, and

– are willing to pay me for my time (depending on their financial and health situation).

Many private patients don’t realise that by asking me to bulk-bill them, they are asking me to work for about half my normal rate. After a percentage goes on the practice overheads, tax, etc. bulk-billing an appointment leaves me with about $15 in my pocket. I doubt they would ask any other professional to reduce their hourly rate, just for them, because they just had to pay their naturopath $300 and now they’re a bit short of cash, or say to their hairdresser ‘I know you charge $65 for this usually. But how about today you just accept $37 for the same job? Just don’t pay your mortgage or feed your family this month.’

I had one pensioner patient who insisted she pay the full private fee instead of me bulk billing her and claiming the incentive. ‘My health is worth just as much as anyone else’s. Why should you get paid less, just because I’m old and on a pension?’ She asked.

Why, indeed? Needless to say, she’s been a favourite of mine ever since.

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