Hey Doc! You can borrow my shoes!

Sweeter words were never uttered. I was in the office the other day. It was very busy with a combination of aesthetics patients and obgyn patients. We were bustling along when we found a potential baby in trouble. The ultrasound didn’t look good and imminent delivery was required by c section. This, of course, puts everybody into full on spring into action mode as it should. I realized that I had seriously miscalculated my fashion choice with my wardrobe for the day. High-heeled shoes were not exactly conducive to performing a c section. We quickly and safely got the patient over to labor and delivery so that they could get her ready. I rushed around the office notifying the other patients and directing the staff for a minute. I made a joke at the front desk about my “Sunday Best” attire for c sections and that I did not bring any spare emergency shoes that day to the office. One of the other ob patients sitting in the waiting room hears me and yells out,” Hey doc! You can borrow my shoes! I like being bare foot!” She was dead serious. She was willing to sit there barefoot, pregnant as all get out, in my office until I was done with the c section so she could lend me her sneakers. Ladies and gentlemen hold your horses. Those words were music to my ears. They were kind, loyal, altruistic and just good stuff. This is the kind of happy and kind patient that you dream of. This is the kind of patient that actually thinks enough of you to want to help out in any way that they can. This the patient that comes along just in time to remind you why you are practicing medicine in the first place. You may only get a little sprinkling of them here and there. Enjoy them and appreciate them. You just don’t see that every day.

Of course, I couldn’t take her up on her offer, as amazing as it was. I just couldn’t leave her pregnant, shoeless, and stranded in my office. I thanked her and told her how awesome her offer was and that she was one of my favorite patients ever! I meant every word of it too. She smiled and then left….with her shoes on….and I went clicking down the hall to do my c section.

This patient really is one of my favorite patients, not because she offered me her shoes, but because she is a genuinely nice, kind, grateful patient who seems to understand the value of the care she is given. She seems to appreciate the time that we spend with her. She is also nice to the staff. That is like gold right there. There are way too many patients out there who take some sort of sick pride in treating the staff horribly and then gliding into the exam room without missing a beat and kissing their doctor’s proverbial butt to get what they want. The less astute physician then blithely goes along thinking they have this great patient, without realizing that the staff either cringes in horror or swears under their breath whenever that patient comes to the office. Here is where the communication piece potentially breaks down. I insist that my staff communicate to me immediately if they are treated poorly by a patient.( Yelling, screaming, cursing, etc) I can only fix what I know about. If they continue suffering in silence, there is nothing that I can do. When I am made aware of such behavior, I have an immediate conversation with that patient. I carefully and directly outline the behavioral expectations of respect in our office. I explain to them that I expect each patient to treat the staff and myself with respect and we will do the same. Otherwise, my office may not be the right place for them to seek medical care. I even have a phone script ready for my staff to deal with a belligerent patient. They are allowed to say,” Dr. Katz has given me the authority to terminate this conversation. Should you wish to call back when we can interact in a more civil manner, I would be more than happy to help you.” Then they are allowed to say have a good day and hang up. Yes that’s right. I do not feel that my staff should have to be some sort of whipping post for patents to unleash upon. It is just not right. I will actually dismiss patients for that. I don’t care if they have one of the few great insurance plans left on this earth. There is just no good reason to put up with that. Those couple of intolerable patients can bring down your whole office morale.

There is another species of patient that is difficult to understand. This is the one that somehow has to let you know that you are unnecessary. I see this more often with my ob patients. There are certain ob patients, who really secretly want to have a home birth by a lay midwife before they even come in for their first visit. These are the ones who already resent me and what I represent as soon as they come in to the office….even before we have met. These are the same patients that will shake their finger at me and point out that women have been delivering babies for thousands of years before people like ME came along….complete with raised voice and the whole works. Those are the patients that I just look at them and smile politely…and then I point out that that same thousands of years strong group of women that delivered on their own had a 50 percent mortality rate during childbirth. I encourage them to play those odds to their heart’s content if they desire to. I am not here to get in their way. I also inquire at that moment as to who forced them to come to my office? I politely point out that I do not see any ligature marks from the rope that tied them up and dragged them in and that I did not actively recruit them with a sandwich board and a bell. I remind them that they are free to leave any time. Sometimes, if they are particularly belligerent and out of line, I remind them that my practice will go on even if they leave. This sort of dialogue usually results in one of two things. They either storm out or they sit back down on the table and actually allow me to do my job. Of course, it took me over 20 years to finally summon the cajones to actually have those conversations and to some of you, it might seem a bit drastic, but I don’t regret them. Sometimes they are just necessary. Have a fantastic day everyone!

Dr. Katz

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