Yesterday the specialist doctor was personally more appealing than the other two: his soft modulated South African accent seemed educated and reassuring. However he clearly had not read Steve’s records, knew nothing about him except in the most general terms, had reviewed what very few labs he had (all of the most recent and critical were missing). Easily 3/4 of the appointment was spent with him asking questions the answer to which he would have known had he read the chart or even glanced at it before he walked into the room. Towards the end of the appointment he received a text message that his next patient was ready and he began to rush through any questions, referring to a future appointment he wanted us to make in three months time. When we left the room to make said appointment with his staff, we were told there were absolutely no appointments available for at least six months. They declined to discuss this discrepancy with the doctor, saying that his special scheduler would get back to us “sometime.”
This appointment took a little less than an hour. His charge will be at least three times a similar charge at Kartini Clinic for the full two hour (plus) initial new patient appointment. That would be OK, if we only felt that in seeing this doctor we were gaining an informed advocate on our behalf, someone to whom we could turn in an hour of illness and need. But of advocacy there was certainly no trace.
Kartini Clinic does no primary care; we are a referral practice only. This means, in my opinion, that as sub-specialists, Dr Moshtael and I must adhere to a certain standard. Unless the family has declined to allow us to obtain records, or the appointment is made emergently, we absolutely will know about the patient before we see them. One of the main purposes of our Family History Questionnaire, which all parents fill out before we see their child, is to tell the doctor about the course of their illness, the reason for referral, the family’s situation and the genetic load (if any). We always read it before we touch the child. I will not allow one of our doctors to ask “what brings you here today?” We should already know what brings them to us.
Morgan and Shanna have also advocated for this approach among our front office staff. When Steve and I arrived at the doctor’s office yesterday the secretary intoned “name please” although she had the patient roster open on her computer and the time they were to arrive. Morgan has insisted that as we know who our new patient is, many of whom have traveled far to get to us, we must address them with their name right from the start and acknowledge that we have been waiting for them to arrive. It sets a whole different tone.
Now the purpose of this blog is not to say “we do everything right and everyone else does a worse job”—neither of which are always true– but rather to open the discussion about what it feels like to be a patient. No matter who we are, we are all patients at one time or another. So share your experiences with us and help us know how we, at Kartini Clinic, can improve our touch as we strive to help families feel as if they had someone in their corner when they needed it.
