We all have sat in the doctor's office, waiting too long to be seen, and thought of what we really would like to say to the doctor and his staff. Face it, not every visit to the doctor goes as smoothly as we would like. For those who know me, you probably are aware that one of my passions has been exploring the provider/patient relationship and the experience patients have when visiting their doctors and sharing what The Patient Bill of Rights entitles the patient to enjoy when being seen by a doctor or unfortunately when we end up in the hospital. Perhaps some may see this as a strange passion, but nevertheless, it is very important.
A number of years ago, actually in the spring semester of 2003, my healthcare administration students and I spent the semester visiting medical practices, observing things like how long patients needed to wait in the waiting room, what kind of experience the patient had in the examination room, the attitude of the doctor, and the attitude of the office support staff. The result of our work was the creation of a poster called I Am a Patient. Based on our observations and based on The Patient Bill of Rights, this poster was offered to hundreds of medical practices throughout the region, and I imagine many of the offices still have it hanging on their wall. I have used that poster as my primary tool to teach my healthcare administration students about provider/patient relations for the past 14 years in the classroom.
So, as an introduction to this new weekly dialogue I hope to have with you, let me relate some of the lessons of the poster. The poster begins with the request by the patient to the doctor to "talk to me in a way I can understand so that I can confirm everything you are saying to me and please ask me if I really understand what you are telling me to make sure I do". The Patient Bill of Rights assures us that when a doctor or other clinician talks to us in the examination room or over the phone that we are being spoken to in a language we understand and that medical jargon that we do not understand is not being used. This right includes having an interpreter in the room if we do not understand English and also asking the doctor to speak to us with common words that make sense to us.
The poster then goes on to convey the message that when we visit a doctor, we are scared and we want the doctor to have some compassion and treat us as a person, not simply as a medical chart on his laptop. It further says to the doctor that when we arrive for the appointment, we do not like to wait for more than 15 minutes in the waiting room, but if we need to wait, someone in the practice should let us know that there is a delay and why. At the same time, we ask that doctors and their support staff provide diversions while we are waiting like this week's People magazine, wifi for our devices, and a television set to watch while we are waiting to be called.
Another request we listed on the poster was that once we are taken into the examination room and the vitals are taken, if the doctor is going to be delayed, someone in the practice should knock on the door every so often to let us know, instead of having the us remain alone in the examination room sometimes for over 45 minutes without any clue as to why it is taking the doctor so long to start the visit.
And then there is the issue of confidentiality. Perhaps, one of the most important expectations a patient is entitled to have is that all information will be kept confidential, and that the doctor will find a way to soundproof examination rooms and separate the desk staff from the waiting room so that a patient cannot hear anything related to another patient. Sadly, this tends to be the most violated right we have as patients. Despite the HIPAA regulations and the forms we all sign, doctors and their support staffs typically do not protect our privacy as well as they should.
The poster next says to the doctor that once the test results are back, the doctor should feel an obligation to contact the patient as immediately as possible with a full explanation of what was found through the blood work or the imaging or the biopsy, and that communication should take place in person or over the phone, and not by a letter that arrives a week later or left on an answering machine. Nothing is more stressful to a patient than having to undergo a test and not knowing the results.
Finally, we want our doctors to show compassion for us and to respect us as patients. We want the doctor to hire compassionate staff that will make us feel that they care about us and that they are working with us. As the poster concludes, "Overall, I would like to feel like a guest of your practice, and be treated by you and your staff as if your practice depends on me, because it does".
So now, 14 years have flown by since we created that poster, and I have been joined by over 15 of my current healthcare administration students in my newest project The Power of the Patient Project. Our mission is to empower the patient through education and information, and we have spent the semester doing presentations of I Am a Patient and other related sessions for patient support groups, in public libraries, at special health and wellness events, and other venues throughout the region. In the weeks ahead, I hope to share information with you to make you a more informed or more proactive patient. Let's take that journey together.
Bob Kieserman is Senior Lecturer in Healthcare Administration at the Arcadia University School of Global Business where he was the Program Director of the Healthcare Administration Program for over 20 years. He is also a practicing medical librarian focusing on consumer health information librarianship. Prior to joining Arcadia, Bob was the CEO of one of the country's leading continuing medical education companies and prior to that served as Assistant to the Deans of the Temple University School of Medicine. He was also a Special Lecturer in Medical Practice Management at Howard University College of Medicine and the Temple University School of Podiatric Medicine. Highly respected by both clinicians and administrators throughout the country, he is the author of four books on medical practice management. Bob's passion is educating patients about their rights and empowering patients to be better consumers of the healthcare delivery system.
To request a copy of I Am a Patient, contact us at PowerofPatient@gmail.com