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I am terrified of needles

imageLike every other organisation that requires you to sign up there is a ritual when patients aka customers visit their doctor’s practice for the first time. In most places where I’ve worked people are sent away from the counter with a clipboard and a bic biro. The data collected is mostly for administrative and billing purposes. This information is later entered onto the computer database by a receptionist, oddly enough minus a lot of the information that the doctor might find useful, such as  the patient’s allergies, their height and weight and their family history.  But far more important are other omissions: Why this practice? Why now? What are the person’s hopes and expectations? The practice’s are always clearly articulated on every sign post:

There is a charge for non-attenders. The doctor reserves the right to cancel your appointment if you are more than 20 minutes late. Payment must be made in full after the consultation. This practice charges a ‘gap’ payment of $50 per consultation. Abusive language and behaviour will not be tolerated. We aren’t open on bank holidays etc.

Nowhere is it apparent that the practice is interested in the patient’s ideas and concerns. We are left to discover these in time. Sometimes we do, but only if we are moved to seek that information:

I hear you are good with young children. My parents are your patients. Your practice is close to my office. I need regular prescriptions for opiates. I prefer a male doctor. You seem to have a nice office. Your receptionist is my neighbour. I am terrified of needles etc.

And what of the hopes and expectations:

I need you to believe I am in pain.I want you to help us cope with mum’s dementia. I need to be reassured about my symptoms. I am a hypochondriac but want you to be interested in me anyway. I want a scan of my abdomen. I have been injured at work and want compensation to help pay my debts. etc

It might be so much easier to make progress in the subsequent consultations if we sought this information, acknowledged receipt and made this a backdrop to the subsequent meetings. It is so rare, and so gratifying when the organisation, institution, company, supplier or practice appears to care from the moment you enter their portals.

Picture by Cavale Doom

Comments

  1. Derrick kuan says:

    Very interesting idea Moyez. We don’t systematically collect this sort of information. Maybe we should. It’s amazing how so many of the problems we see in general practice arise from not understanding a patient’s perspective. It sometimes betrays or can be perceived as a lack of respect.

  2. I suspect we can develop a better registration form that could be a useful as a prompt to gently probe such issues. Might put something up soon. Thanks Derek.

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