There are still certain absolutes when it comes to your care that you need—and have every right—to expect; no exceptions, no excuses.
Health care reform, with all the radical changes that are just around the corner, is causing bedlam. I love that word. With little effort, we can imagine politicians and big medicine stakeholders from all sides going crazy with schemes, proposals and projections and everyone going mad: bedlam. But while it’s one thing to have insanity on the big health care stage, do you have chaos in your doctor’s office? Let’s go into the trenches where medical care actually happens and discuss something that’s as relevant today as it was during the polio era: your relationship with your doctor. How are you and your doc getting along lately? More specifically, do you still enjoy a true partnership with your physician—a mutually respectful alliance that you can count on when it matters?
Based on patient satisfaction surveys in our area, most of you are still mostly satisfied with your primary care physician. But you can be sure your doctor is feeling the pressure of reform. Physicians, more and more, must comply with an array of new regulations that are becoming intolerable. Many are designed to create massive amounts of data that can be analyzed and ultimately used to measure doctors’ performance and efficiency. This means your doc is spending a lot more time on the electronic record of your visit and less time on the visit itself. Doctors are under pressure like never before. That’s why it’s never been more important to create and preserve a personal relationship with your doctor. Without an involved and responsive doctor, your care is likely to suffer.
If you recall times when you were upset or frustrated with a medical experience, you’ll probably find that the problem wasn’t an error in medical judgment. It probably wasn’t a missed diagnosis or a slip of the scalpel in the operating room. Most of the time, the problem centered on your doctor’s lack of response. Your phone call wasn’t returned promptly. Lab test results weren’t reported to you. The subtle spot on your mammogram wasn’t explained. You couldn’t get an appointment. Your medication wasn’t refilled. The list goes on and on.
While it may be convenient to blame medical politics for frustrations like this, it doesn’t really fly. This is about you and your provider. There are still certain absolutes when it comes to your care that you need—and have every right—to expect; no exceptions, no excuses.
Let’s start with the most obvious: Your doctor must be responsive. If you call with a simple question about that new medication or for some advice about a minor problem, you should get a call back. Today. Not tomorrow; not next Thursday. We’re not trying to be overly demanding here, we just want a simple call back. If the doctor’s assistant relays a message like, “I checked with Dr. S and she said it’s fine to take those two meds together,” that’s perfectly acceptable. But for anything more complex, it’s not unreasonable to expect that your doctor will pick up the phone. You’re not asking for a 20-minute dialogue, right? All you want is a brief chat to be sure you’re on the right track.
The second absolute is even more basic: Your doctor will see you when you need care. When you call with a high fever or an ache in your lower abdomen or a swollen big toe, you need to be seen. Today. Not tomorrow; not next Thursday. Of course, this can be a strain on your doctor’s office and it can be inconvenient. But every office and every doctor has to assure that their patients have same-day care when needed.
The last absolute is simple but critical: You must be informed of the results of every test. It’s surprising how many doctors’ offices still work on the “If you don’t hear back, you’re fine” policy. Unfortunately, every malpractice lawyer is very familiar with examples of that disastrous strategy: The scan shows a “spot,” the report gets lost, the physician doesn’t know the result, the patient never hears back…bad news. Every patient needs a doctor to report back on every test, every time.
Health care reform is coming. Patients and doctors both need to be prepared. This is a perfect time to give your doctor-patient relationship a checkup.
Dr. James DeVore has been a full-time family physician in Santa Rosa since 1980. He’s medical director of St. Joseph Health’s Annadel Medical Group.
