Why Patients
Don't Buy In Do these pitfalls
exist in your organization? by Susan Keane Baker
What happens when patients don’t "buy in"
to you or your organization? Some patients
leave, requiring you to invest additional
resources:
Time and money needed
to attract patients to take their place.
Extra time spent
with the replacement patients to explain
how your systems work.
Extra time and money
spent creating the systems needed to care
for patients in your organization, e.g.
registration and medical record systems.
Other patients continue with you, but do so
unhappily, and it shows. They have "an attitude"
that makes them more challenging to you and
your colleagues. They take more time, as they
are reluctant to trust what you do or say.
They look for ways to test you, resist you
and annoy you.
Understanding why patients don’t buy in can
help you prevent the non-productive efforts
that must be expended as a result of their
lack of confidence in you. Here are some reasons
why patients don’t buy in:
You
aren’t what they expected. Don’t
refer to yourself as "elite" "premier" or
"best available" unless you can live up to
that name. If you are launching a new service
or philosophy, don’t promote it until you
have tested it. Above all, don’t let your
long-term goal become your patient’s near
term expectation by promising more than you
can possibly deliver.
If you have processes that are unusual for
your area, let patients know about it. When
I was writing my book, I asked everyone, even
complete strangers, about their experiences
in health care settings. A friend told me
about arriving at a physician’s office to
have a consent discussion for a vasectomy.
He and another man were waiting in the reception
area. The other man was called in first. Then
my friend was called, and taken to the physician’s
office, where the physician and the other
man were waiting. The physician proceeded
to have a consent conversation with both patients
simultaneously. It would be an understatement
to say that the patient did not buy in to
this physician. Or to a vasectomy by that
physician, for that matter.
They
are distracted by their own anxieties.
A few years ago, while traveling out of state,
I was in a serious automobile accident. In
the Emergency Department, a physician was
preparing to suture a wound in my head. As
concerned as I was about my injuries, my greatest
feeling of anxiety at that moment came from
the fact that I did not have a sheet covering
my legs. Fortunately for me, they physician
asked me an important question. "Is there
anything I can do to make you more comfortable
before we begin?" I wished for a sheet; he
found one and placed it over me. My concern
about whether or not he was a good doctor
quickly melted away because he took a moment
to find out what my needs and fears were before
he did what he needed to do.
They
are distracted by interruptions and as a result,
can’t listen. While you may be
immune to the needs of your processes and
systems, patients often aren’t. You understand
the need to interrupt a consultation to take
a call from another clinician. Your patient
may not. You understand the need to interrupt
a patient’s registration in order to answer
a colleague’s question. Your patient may not.
You understand the need to have a colleague
take over the care of a patient so that you
can take a break. Your patient may not. At
the very least, minimize the number of interruptions
permitted during a patient’s initial visit
with you. Then, explain why some interruptions
may be essential. "Although I don’t like to
leave my beeper on during a consultation,
when you are here for an evening appointment,
my beeper may go off if I am on call for the
hospital that evening."
You
don’t believe in them, so why should they
believe in themselves? If you are
pessimistic about your patient’s ability to
do well, follow through, etc, your patient
is likely to sense it. Alex Munthe MD was
once asked the secret of medical success.
He replied, "To inspire confidence. The doctor
who possesses this gift can practically raise
the dead."
Someone
on your team has created anxiety about your
operation. When patients don’t
buy in, it’s often easier to try to blame
someone or something else rather than conduct
a self-assessment. Perhaps you remember the
old saying, "Those not present are always
in the wrong." That being said, stay on the
lookout for anxiety triggers. Recently, I
visited the practice of a highly esteemed
physician who holds numerous post-graduate
degrees. A handwritten note taped to his receptionist’s
computer read, "I’ve learned that having a
lot of credentials does not make you a nice
person." The message she was sending is obvious.
The reason that message was allowed to stay
taped to the computer is not.
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