When I decided to start my own practice, I knew there would be challenges. I have found that one of the hardest things to get right in medicine is learning how to smile even when you don’t want to. I’m sitting here trying to think of a profession where complaints are more commonplace than not. I think restaurants probably get less complaints than a medical office, which can often be difficult on the staff. I really wanted to be customer service oriented in this position, and I still strive to do this with my staff daily, but this is not a place where I believe that “the customer is always right.” I’d just like to take a moment to enlighten you on some of the complaints you have and to address them from a point of view other than your own.
1) Payment is expected at the time of service. Somewhere along the the way years and years ago, people stopped paying for their office visits and merely expected to be billed. Recently, due to insurance changes and higher deductibles, this expectation requires a change. When it used to be as simple as a co-pay to cover your visit, now there is a co-deductible. This is often a much higher amount than ever before because insurance companies are expecting you to pay more for your health than ever before. This is not our fault yet daily we get push-back from people who are aghast when they are asked to pay prior to being seen…or even after. I’ve got news for you. It takes money to run a practice and it takes your money. Without my patients I wouldn’t have a practice but without my patients paying their bills I wouldn’t have the money to run it, either. Think about this…you can’t go into Publix and load up your cart and then get to the front and say, “Oh, just bill me later for all of this.” Medicine is no different. You are purchasing a service just like you would purchase groceries. Of course, if you are having trouble paying for the service I will always do my best to work out something with you. Just don’t get angry when my staff asks for you to pay for your food.
2) Prescriptions must be sent electronically. Believe it or not, I’m not a big fan of the electronic age of medical records. While it appears to be an easier process, and certainly there are less charts to keep up with, it has a lot of hiccoughs. In 2011 the government started requiring electronic prescribing from physicians and practitioners. The flip side of this is that pharmacies are not required to request prescription refills electronically. In fact, most pharmacies are still on an fax system, which is an entirely different world. MOST of the time before you leave our office your prescriptions have already been sent to your pharmacy. There are occasions where I forget, because, yes I’m human and I completely forgot what I said I would do. This is not the majority, however. We get many, many complaints from you that the pharmacy doesn’t have your prescriptions. This turns into a he said, she said argument: we have proof that we sent it, they claim they don’t have it, and the you are the one left in the middle. Unfortunately, however, we experience the large part of the blame for this and you end up yelling at my staff. More than once we will call the pharmacy and ask about the mysteriously lost RX and it is, in fact, there but not yet ready for pick up. Three thoughts on how to handle this so you and I both experience less headaches. 1 – Give us the benefit of the doubt. I realize you need your medicine. I realize that you don’t have any control over the situation and that we do. Yet, give us a chance to help you figure it out before you just start blaming us for not doing our job. The girls are on your side and they want things to be as smooth as possible for you but it is hard to be nice to somebody who is not being nice to you. 2 – Choose a local pharmacy. I’m not going to tell you which pharmacy to use, and sometimes you don’t really have a choice, but I will say this: we never get this phone call from those of you who shop local. When I send my prescriptions to the locally owned pharmacies, the nurses get less patients yelling at them. The prescriptions reach them, the pharmacist has it ready and even knows your name when you go in the door. 3 – Don’t run out of your medications. Yes, this requires you to know when you are due for your refills. I can’t know when you need them. Soon it will be an office policy to not refill medications outside of an office visit. Chances are, if you are out of your medication then you need a return office visit.
3) We can’t always answer the phone. Let me give you a math quiz. I have three full-time and one part-time employee (i.e., not here every day). On Thursday, October 2, the fewest amount of calls that I had into my office at any given time was around 10:30, with 8 in-bound phone calls. (My phone system tracks this and for those of you curious, within the next half hour the number jumped to 30.) At the same time there were a minimum of 5 patients in my office. Now, despite my master’s degree in physics, I can’t make the number of staff multiply to assist the number of patient needs. While I would love to be able to have somebody who could answer every single phone call that comes in, the fact is that we can’t. When a nurse is in a room helping check-in a patient, giving shots, checking labs, etc., she can’t answer the phone. When the front desk is on the phone, checking patients in or out, taking payments, sometimes they can’t get to the phone. I will go ahead and dis-spell two myths: we don’t just sit around waiting for the phone to ring, and, you aren’t our only patient. While we want to be able to take care of everybody, our priority goes to the people who have appointments and then to the phones. Please, please, please, don’t call in and curse because you have to leave a message, and also don’t call in and leave 6 messages in an hour’s time. We do our best to call everybody back and, we like it just as little as you do. Right now I don’t have a solution but, as Shakespeare said, patience is a virtue; assume it if you don’t have it. Give us a break. We really are trying.
When I teach medical or nurse practitioner students, I tell them this: “Just remember that no matter what you do, it’s always your fault.” Patients have an expectation that we are supposed to be perfect and never get anything wrong. I would ask you to look at your own life and realize that our jobs and imperfections are very similar to your own. Together if we work to understand each other better, I have no doubt that things will improve on both sides.
Update July 25, 2015: I’ve had a few responses to this and one comment in rebuttal to mine that I would like to publish in share. When I find it, I promise I will. It was from a well-meaning pharmacy student who made some great points. Stay-tuned!