medical manners Archives - Page 4 of 6 - Professional Courtesy, LLC

Seek Patient Permission

January 30, 2014 by procourtesy

Seek Patient Permission

It is not unusual for physicians to be shadowed by all sorts of people. Sometimes, college students will seek out summer jobs in a physician’s office to see if they want to consider a career in medicine or even, nursing. Med students will follow physicians for a period of time to gain some practical experience in their field or specialty. And certainly, in teaching hospitals, it is very common for a group of students and physicians to round on patients.

However, regardless of who is following or shadowing the physician, there are some important considerations to be observed.

Be sure and seek the patient’s permission before bringing an unexpected person into the patient exam room.
Introduce those who are following the physician and let the patient know who they are, and why they are there.
Seek patient permission before allowing a student or intern to do a procedure on a patient.
Respect the patients right to decline having someone else in the room during their exam or do a procedure on them.
Train the people following the physician in patient privacy guidelines.
Limit the number people allowed to follow the physician at any one time.

Always remember to put yourself in the patients position. If you were in the same situation would you want to be exposed to crowd? Being naked in a crowd can be a humbling experience for anyone.

What to do When Your Patient Dies

January 23, 2014 by procourtesy

What to Do When Your Patient Dies

Over the years, many people have shared with me their disappointment at the lack of acknowledgment from their physician when their loved one died. Especially, when their loved one had been a long time patient of the physician. In fact, many people have shared that they switched physicians because of what they perceived as a slight.

When people go to a physician for many years, especially the family physician, it is not unusual to feel a real bond with that physician and staff. Think about it, medical people are involved in some of the most intimate times in a person’s life. They are there when babies are born, when your kids get raised, when loved ones are diagnosed with terrible illnesses and yes, when people die. So, it makes sense to me that when a patient dies, some acknowledgment should be made by the physician and or his or her staff to the family.

I also think hospitals should have protocols in place to acknowledge the death of patients in their facilities. Many hospitals send congratulations on the births that take place in their delivery units, why would you not note something on the opposite end of that spectrum.

At a time when health care seems less and less personal to patients some simple, but thoughtful gestures of concern and sympathy can let patients know that you really care about them and their families.

Here are some things a medical practice could consider:

Have a policy in place as to how you are going to acknowledge the death of one of your patients.
Sending a hand written note from the physician and staff would be greatly appreciated.
A token floral arrangement is another option.
Send a representative from your office to the calling at the funeral home.
Follow up with a phone call after a short period of time to the surviving family member if they are your patient.

Hospitals could send a personalized letter of condolence to the family…no generic form letters for this situation.

Reach out and let your patients know that you care. I guarantee they will appreciate it.

Let me know what your office or hospital does. I am very interested to know.

A footnote: I have had several dogs over the past years and when any of them died we got a heartfelt sympathy note from our Vet…I think people deserve the same from their physicians.

Reach Out and Touch Your Patients

December 4, 2013 by procourtesy

More and more, I hear business people say that they don’t like to touch people, shake hands or to be touched by others due to the risk of getting germs. This is a very sad commentary, as far as I am concerned. But even sadder, to me, was to hear nurses say they don’t like to touch their patients because they feel they are unclean or they don’t want to risk getting their germs.

While I appreciate not wanting to get someone’s germs that may cause an illness, I think to take the “no touch” approach with your patients is risky and very damaging to developing a mutually respectful relationship.

Nurses and physicians are certainly taught techniques on hand washing, maintaining sterile fields, dealing with patients who are infectious by using isolation procedures and various other ways to protect themselves and avoid spreading diseases to other people. So why the resistance to touch your patients?

I think it is multifaceted with some of it brought on by how high-tech medicine has become. Healthcare workers are now booting up their computers to enter data and the answers to the questions they ask their patients, often, before they even shake their hand or make eye contact with them. Physicians are now able to do every test imaginable to diagnose patients that it seems rather easy to forget about actually putting your hands on the patient. I have even had people tell me they received a complete physical without ever having taken any clothes off. This is unimaginable to me. If physicians aren’t actually looking at someone’s body, I would guess they are missing some things.

We know from studies that babies who are not touched fail to thrive and some, even die. The human touch is a big part of diagnosing and healing. Imagine the elderly patient who lives alone and has no one to hug them. Touching people and being touched is essential to life. We all seek touch from those we love. Why not make sure it is part of the equation when caring for patients.

So, here are some tips to ensure you make some sort of physical contact with your patients:

Upon entering a patient’s room in the hospital or the office exam room, extend your hand to meet them before you go to the computer to start asking questions.
If handshaking is not possible, touch the patient on the shoulder, or arm. This is a comforting gesture when consoling them or delivering bad news…something they will appreciate.

Spend a few moments talking directly to the patient. Note the color of their eyes to make sure you are making appropriate eye contact.
Introduce yourself and let them know what you do and who you are; nurse, tech, P.A., etc.
While entering data in your computer, look at the patient while asking the question and then look at the keyboard when entering their answers. Reassure the patient that you are listening to them.
Shake hands or extend another touch upon leaving the exam room. Your touch will be noted.

If you still don’t want to touch your patients, maybe you should reevaluate why you went into medicine. Compassion is important in caring for the sick.

And for those business people who don’t like to shake hands…to refuse to shake hands with someone is a huge insult. Shaking hands is the universally accepted way to touch others in almost, every country in the world. So, reach out and touch someone, then go use your antibacterial wipes

Calling Patients to the Exam Room Politely

November 14, 2013 by procourtesy

Calling Patients to the Exam Room Politely

I am often taken aback when I am in a physician’s office waiting area and hear the staff call back their patients to the exam rooms. Many times there is this abrupt voice that comes from a half opened door announcing loudly, HARRY! Nothing else is said and the poor patient gathers themselves up following the nurse or medical assistant down the hall to their designated exam room in silence…no smile, no warm greeting or introduction. Then, if you are lucky, you get to stop in the hall to get weighed on the community scale. One office that I was in recently, even took blood pressures in the hall before directing the patient to the actual exam room. Not too private, at a time when there is so much emphasis on HIPAA privacy guidelines.

I appreciate that practices may want to cut down on expenses by having one or two communal scales instead of one in every room, but getting weighed in public can be pretty humbling. Surely, there is a better way to do this. Gathering patient information should be done in the privacy of the exam room with a closed door, not in the hall leading to the exam rooms.

So, here are some suggestions on how to call a patient back to the exam room politely:

To assure you can be seen,walk out into the waiting area as close to the patient as possible to call them back.
Smile and greet the patient warmly.
Address the patient formally by Mr. Mrs. or Ms. (this is not a privacy violation)
Direct the patient as to what room they will be going to. For instance, “third door on the right or room 6.”
Don’t ask any medical questions in the hall where answers can be over heard by others.
Don’t weigh people in the hall unless the scales are set up for privacy. And take into consideration as to how coats, purses and other extra clothing will get in the way of an accurate weight.
Consider taking blood pressures in the exam room, only
To identify patients in the waiting area try having the receptionist put a sticky note on the front of the chart using some sort of identifying comment as to who is who. For instance, “red sweater or blue coat.” This then allows you to walk right up to the patient and let them know you are ready to take them back to the exam room.
Be prepared to assist older patients or patients who have limitations or obvious injuries back to the room by taking their coats or other personal items.
Once the patient is in the room, close the door and keep them apprised of their waiting time.
Keep conversations in the hall to a minimum so patients don’t over hear private or inappropriate information.

Trying all of these simple suggestions will leave a much better impression on your patients.

Navigating A Modern Medical Practice

August 6, 2013 by procourtesy

Navigating A Modern Medical Practice
The contemporary practice of medicine has taken a major shift for physicians and patients alike. The reasons for this are multifaceted: managed care, expenses, insurance, technology…the list goes on and on. Certainly, physicians and hospitals are finding it challenging and feeling a lack of control as they adjust to the rapid changes in the practice of medicine. And so, patients must make adjustments as well, in order to feel they have control over their health care

Historically, progress has two sides to it. We usually have great benefits, but we often lose something that is unique to the old way of doing things. Medicine is no different. The solo practice where a patient and the “ole family doctor” have a close one–on-one relationship is becoming rare. However, this does not mean a patient cannot have a meaningful and effective relationship with their physician in a large group and get excellent medical care. It does mean that the patient may have to shift their thinking and adjust their approach. Patients who take more responsibility for their health and learn to work the system and their physician’s practice effectively can reduce the poor communication that is a common complaint today.

Some tips to navigate a modern medical system are:

Be proactive before you get sick, if possible.
Know the routine of your physician’s office.
Try to see the same physician at every appointment to enhance continuity of care and to establish a relationship.
Learn the names of the medical staff you deal with, in person, and when you place a call.
Learn when to place a call to the office. Avoid Monday mornings at 9 am, before lunch and minutes before the office closes.
Ask for, and keep copies of your own health record and that of your family members.
Plan ahead for prescription refills. Don’t wait until week-ends or the last minute.
Learn how to navigate the telephone system by asking for the extension number of the nurse and how to get a “live” person.
Understand their protocol for emergencies.
Find out what hospital your physician goes to? Many medical groups split the hospitals for efficiency. Your physician may not make rounds or have privileges in your preferred hospital.
Know the people who are providing your care. If the staff or physician does not let you know who they are, introduce yourself and ask their name and title/ position.
Turn off your cell phone! Taking calls during your appointment is rude and disruptive.
Understand your physician’s protocol for receiving test results. Some offices only call patients with negative test results. If in doubt about the expectations or if you are anxious about a test results, call.
Call ahead and see if your physician is running behind if timely appointments are a concern. Ask again when you arrive and check periodically if your wait is getting lengthy.
Be familiar with the privacy guidelines and be sure to document the family members who are privy to your medical information.
Consider taking a family member or trusted friend to your appointments. If you are elderly or have serious medical issues another person can act as an advocate and help prevent errors in information transmission.
Take notes or ask if you can record the conversation for other family members.
Note when making an appointment if it is essential to arrive 15 minutes ahead of your appointment time to fill out paper work.
Understand that courtesy is infectious on all sides and very important. Make sure you are considerate. If you encounter rudeness from a staff member or physician, respond kindly. It will often diffuse the behavior. We all have a bad day, but if it is one individual, and the behavior is persistent, let the physician know. They can’t fix a problem if they don’t know about it.
Change practices if the personalities and attitudes of a particular office are something you can’t live with. Be sure to let the office know why you left.
Document serious glitches. For instance, if you call multiple times and no one returns your calls, let management know. Your time is valuable and waiting for long periods of time without a response can hold up progress.

Sooner or later we all become consumers of the medical system, even physicians. Staying informed and up to date will help with the frustrations that plague the modern practice of medicine. Dr. Welby, as we knew him, may be passé, but there are many fine caregivers who have replaced him. On the surface, their style, accompanied by advanced technology may make things seem very different, but the ultimate goal of most physicians is to care for people and make them better.

Seek Patient Permission

What to do When Your Patient Dies

Reach Out and Touch Your Patients

Calling Patients to the Exam Room Politely

Navigating A Modern Medical Practice

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