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through the looking (or sometimes bulletproof) glass

This blog post was included in Grand Rounds: Customer Service in Healthcare hosted by Debra Gordon at “A Medical Writer’s Musings on Medicine, Health Care and the Writing Life.”

This blog post was included in Chronic Babe Carnival #10: How Do You Deal With The Medical Establishment?

People with chronic illnesses spend a lot of time in doctor’s offices. Or, to be more accurate, we spend a lot of time in their waiting rooms. We sit there reading ancient issues of People Magazine. (If we’re lucky, that is. More often, we’re stuck idly flipping through a magazine about some weird or obscure topic like moths, wondering why on earth the office would choose to subscribe to THAT magazine given the hundreds of options out there… ) But the magazines are the least of our worries.

I’d guess that almost every one of us has a horror story or two to share about interactions with the staff. They double book appointments then make us wait for hours upon hours. They don’t tell us how much paperwork we have to fill out until we arrive, then say we have to wait now because we missed our appointment time while we were filling it out… and after all that they then proceed lose it. Don’t even get me started on incorrectly billed visits that lead to hours wasted arguing with insurance companies. Getting a copy of your medical record is a royal pain: you have to request a copy on the specific day that the staff member is around, and then come back the next week to collect it. There was a lot of truth to that Seinfeld episode in which Elaine is trying to get a look at her medical record…

Still, how many of us have seen life from the other side of the counter? I’ve worked as the triage greeter in an Emergency Room and, repeatedly, as the person who discusses research studies with you and acquires your consent. Let me tell you something, it isn’t too pretty on the other side either. There are mountains upon mountains of paperwork. Despite your best efforts at an organizational filing system, things somehow end up in the wrong places. Scheduling is a nightmare – people are never available when you need them to be. Most of the staff are overworked and underpaid. In some emergency rooms, they’re stuck behind a bulletproof glass just so that they are safe at work.

We are frustrated people, and I don’t think we’re out of line to be. We deal with an awful lot of pain, endless medications, exhaustion, eating restrictions, and people who don’t understand what we’re going through. We need to take out our frustration on someone, and they often bear the brunt of it because… well, because they’re the contact people… they give us the bad news that we’re number 50 in the queue … or that the paperwork we spent an hour filling out last time has been lost and must be filled out again …  that the next available appointment isn’t for another 6 months… and so on. How many times per day do they deliver bad news? More times than I’d like to disappoint people, I’m sure. I think I’d feel terrible. And their frustration shows when they start getting snippy at us.

The thing is though, we spend so much time getting frustrated about their failures that we rarely thank them for the favors they do manage to grant us. I’ve seen them use up their personal text messaging (SMS) allowance to communicate with me because I can’t take calls during class times. I’ve seen them call and argue and shout and plead with scan labs to please, please squeeze in an appointment for me. I found out from the lady running my scan once that the secretary at my doctor’s office had called every day for the past month to see if an appointment had been cancelled in order to get me an earlier one. She never told me that, she just called and informed me “an appointment has opened up” … and let’s not forget when they squeeze us in because, as hard as we tried, we were too sick to make it to our scheduled appointment the week before.

Think about the demands that we make … please be open more hours, please have more staff on hand, please magically fit us in… are they reasonable? Not always. Doctors have lives too – and most of them have their own illnesses, we just don’t know about them. Even if they could hire more doctors and more staff to be open longer, can we really afford for our healthcare costs to go up even further? We want them to upgrade their systems so we can book online like the dentist’s office (or some other clinic) let’s us do, but more efficient systems require money – and appointment slots cancelled in order to train staff. It takes time for those things to be implemented. I agree that they’re fantastic, and I think most clinics intend to implement them – when it’s possible. And as for fitting us in… no doubt we are definitely in need of an appointment ASAP… but it’s easy to forget that the people who are scheduled for that appointment slot we want might have been waiting for months just like we’ve been asked to. We get irritated when someone is squeezed in ahead of us, but forget that we were irritating someone else when they managed to squeeze us in last week. All those patients that are ahead of us on the list might be just as much in need, but it’s easy to forget that. They’re just theoretical. We don’t have names or faces to make them real. Meanwhile we can feel our own pains and want them to just stop already.

A lot of times our frustration IS well placed, but I think it’s only fair to thank them when they help us out. (If we even know that they’ve done that for us). So the next time you’re having a frustrating experience with the staff at your clinic or hospital, remember: they’re only human.

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10 Responses

  1. I’ve found that a thank you really does go a long way. My office almost seems surprised when I appreciate my gratitude, which is very telling about the other patients they deal with, I think. Must be difficult a lot of the time.

  2. I ALWAYS try to be polite to the lower level workers. I’ve worked customer service in the little I’ve worked and people are not nice enough in general!

  3. I am probably going to nursing school after I get my bachelor’s degree, so I will definitely get to see what happens behind the scenes. I read a lot of doctor’s and nurse’s blogs and I see the frustration that they have to go through. But at the same time, when I am in pain and sick it is hard to realize they are people too with their own lives and other things to deal with.

  4. @Diana – isn’t it amazing what people are willing to do if you take the time for a simple thank you? gotta admit though – it’s hard when youre really ill and in a lot of pain to think about things like that

    @Annie – “people are not nice enough in general” SO TRUE

    @Melanie – i totally agree. and that’s awesome about nursing school! 🙂

  5. This post was featured as part of Grand Rounds: TOPIC: Customer Service in Healthcare.

    http://debragordon.blogspot.com/2010/06/grand-rounds-topic-customer-service-in.html#comment-form

    Want to hear about customer service from the patient perspective? Then hop over to the Life of a Grad Student with Lupus. This is not a hearts-and-roses kind of blog, but that one that hits hard where it hurts–and one that any clinician in the field should be reading to get a sense of how what you say and do impacts your patients.

  6. A friend of mine forwarded this link on to me – thank you. I manage a medical office in Vancouver, Canada, so I know our medical system is slightly different. However while I have spent more time behind the counter in the last year I have spent a significant amount of time on the other side.
    A part of me wants to make every patient who ever complains live on the other side of the desk, just for a day to realize it is not easy. To know that we do make mistakes as we are human and we aren’t gods or even demi-gods and as such I don’t control much of anything, so you are ultimately yelling at the wrong person. I do not set the schedule and even if I did, I would not choose to work from 8-8 to accommodate everyone’s schedule, so do not ask for a 8pm appointment on a Saturday and then get mad when I tell you we do not work those hours. I cannot prevent the anesthesiologists from going on holidays the day before you were booked for surgery thus cancelling the whole day. I can’t make anything happen any faster and nor will I make it go any slower even though you may yell at me, though some days I wish I could. I am not your wife, husband, mother or father, I cannot make sure you do anything I ask you to do, you are an adult, I will not chase you to get a test done.

    However, I know the feeling on the other side, the frustration and exhaustion – tired of waiting, poking and being treated by other staff inconsiderately. I know the desire to be short with a receptionist or lab tech. Therefore, I try to keep this in mind when parents yell and holler. Though I will say you normally get one shot in my books, and then you are flagged.

    • Thank you for all that you do to help us get the appointments, lab work, prescriptions, etc that we need. … and thank you for taking the time to read my post. Please thank your friend as well, i’m honored that something i wrote was considered worthy of being forwarded on.

  7. […] through the looking (or sometimes bulletproof) glass June 2010 7 comments 4 […]

  8. […] through the looking (or sometimes bulletproof) glass June 2010 7 comments 4 […]

  9. […] to hear about customer service from the patient perspective? Then hop over to the Life of a Grad Student with Lupus. This is not a hearts-and-roses kind of blog, but that one that hits hard where it hurts–and […]

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