Whether our patients are content with our work greatly depends on their expectation prior to the treatment.
While we should always do our best to deliver high quality work, modulating -and many times lowering- their expectations can further maximize your patient’s satisfaction ratings. Here are 4 ways how you can do that.
Presenting cases is one of the most important skills in medicine. Mastering this skill will greatly improve your work as a doctor and enhance your career. When you give good presentations, your attending will
- know you understood the patient
- trust your judgement and
- give you more responsibilities.
Doctors, who know how to present a patient will be perceived as professional by their colleagues and bosses. Here are 7 key points.
“Hey Daniel, greetings from Jack [our attending, name changed]: Don’t ever put in a pneumocath in a patient’s chest again, your patient suffered a pneumothorax”.
That’s how I was greeted to my late shift after I had put a chest tube in a patient the day before, which obviously hadn’t work out as we had hoped.
As it turned out, the patient had a pneumothorax before I even saw him. But either way, I wasn’t all that happy about this kind of feedback in front of all my colleagues. Obviously someone was happy I had caused a complication.
During a recent night shift I was called to a patient who obviously was acutely ill. She had been transferred from the ICU to the ward today. Further workup showed she didn’t have urinary tract infection (UTI) as suspected, but: necrotizing fasciitis.
Every time you end your shift, you’ll be criticised. Your colleagues and bosses try to understand why you did what you did.
That’s why they will question why you
- initiated this diagnostic procedure
- started that therapeutic regimen
- established this diagnosis
- or didn’t do all of the above.
That’s OK: Three doctors, four opinions. However, many doctors take that form of criticism personal and react defensive. Here are my four steps to handling criticism, so you profit from it:
When you start off as a doctor you depend on the nurses. Oh man, some of them saved my butt several times, I can tell you. There were times when they suggested adequate therapies when I had no clue what to do next. It depends almost entirely on you, whether they help you out or make your life a living hell.
Here is what I learned during my first years in residency. More.
“Do you have any more questions..?” Every good doctor patient conversation ends with this question. But what if you don’t have an answer yet? At the beginning of my career I found myself rushing out the patient’s room because I didn’t want to answer any more questions.
Photo courtesy of IStockphoto.com
Last week I received this voicemail from the principal’s secretary of my son’s elementary school: “Hello, this is the elementary school. Your son Jonas … [ten second pause] … unfortunately …[ten second pause] has on his head [twenty second pause] a little bruise after colliding with a classmate playing soccer….”
Photo courtesy of JONAS
If you want your patient to follow your medical advice, you need her to feel respected by you. There are easy-to implement things we can do reach that goal.
Photo courtesy of IStockphoto.com
- Start with a smile.
Create a positive atmosphere. That doesn’t always work but surely has never harmed anyone.
- Introduce yourself.Mumbling your name at the beginning won’t do it. Even if you speak loud and clearly the patient probably won’t remember it. That is why you also have to wear a name tag, so the patient doesn’t have to ask you again.
- Listen, when the patient talks.That sounds easy, but trust me, it’s not. There are many things wandering through my mind: what I have to do, who has to be called. The patient notices that. You should look in his eyes, take notes and really listen.
- Do not sit in the patient’s bed.We have a long shift, we are up on our legs all day. So to relax, we can sit down in the patient’s bed while listening, right? No!!! First of all: It’s unhygienic, but that’s not the point. For a certain time the patient has lost his home and his privacy.
Here in the hospital every ten minutes somebody enters without knocking to measure something. All he has left of personal property IS THIS BED!
Respect this and don’t just sit down there. Take a chair. BTW: It doesn’t make it any better, if you ask prior to that, because many patients can’t say no to a doctor.
- Kick out visitors (politely) before you start examining a patient. There shouldn’t be anybody else is in the room besides: medical personell and bed neighbors. Don’t ask the patient if they can stay, because that would make him the bad guy. Some visitors can’t understand why they are kicked out. In that case you should be the bad guy, not the patient.
- Get the patient’s permission to lift up the blanket, shirt, night gown etc. before the examination. Whenever I do that most patients are surprised to be asked, because they are used to doctors just doing that without asking.
- Use draping techniques. While you examine the patient only uncover body parts that are examined right now. Most hospitals provide night gowns, which can be untied or unbottoned easily.
- Explain the long wait: If the patient had to wait for a long time provide an explanation for that. Tell her that now your whole focus and concentration is on them.
- Explain the next steps: Before leaving the patients room you should explain what you found out and what is going to happen next. Ask whether she has any questions.
- Leave the room as you found it. Remove all garbage, bring the bed back to the position you found it in, and make sure the patient can reach her personal belongings.
Question: What gives you the feeling to not be respected by a doctor? Leave a comment below!
When I implant a central venous catheter, the patient’s face is covered with drapings. Many patients who are conscious during this kind of intervention are very nervous. I can only imagine that it’s not much fun to have your face underneath a blanket, it’s 40°C, dark and you are waiting for some guy to put a needle in your neck. There are definitely things more fun to do, I imagine.