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09/18/2017 James E. Koon, DPM
Millennial Expectations
For some time now, patients have been researching their doctors on the Internet. I am consistently told by new patients that they chose me based on my Internet reviews. Word of mouth referrals are still a mainstay of my practice. I have never advertised.
My experience has been that all patients’ expectations are rising. Everyone wants everything giving to them and they all want their insurance to pay for it. Many come in with pre- conceived ideas of what they have because “Dr. Internet” has seeded their minds. Many come in wanting Jublia or Lyrica because of advertising. Very, very few patients have no idea or concern of declining reimbursements to us or the burden of running a practice/complying with CMS/dealing with insurance companies. Some patients do recognize that we don’t make the money we used to but most still think we are all rich.
Patient respect for doctors has declined significantly in the past decade and we doctors are responsible for some of that. I know many of you will argue the point, but showing up on the hospital floor wearing jeans and a Polo and no smock is unprofessional. Keeping a cluttered office is unimpressive. Papers taped all over your cabinets and reception windows makes your office look cheap. Dirty carpets, torn upholstery on your chairs, dirty AC vent registers, dusty exam lights, dirty windows, etc. give off a poor impression.
Being a money grubbing whore is the worst impression maker there is. I have countless patients that have come to me who have been in other offices where they felt they were being raped every visit. This impression is the worst for Podiatry and for Medicine in general. Those who engage this activity cannot be reconciled. They are who they are and we all have them in our towns and we all know who they are. There is nothing you can do about that. It has been that way forever and it will be that way forever. Those practitioners could not care less about anyone else. They are in it for the money.
My dad, a former GP, told me early on that if you make patient care decisions based on money you are making the wrong decisions for your patients. I recognize the need to make money but there is a great and vast difference between conducting yourself as a business vs being a professional. Patients can see BS when it is presented to them. They know when they are being taken advantage of. It tarnishes their perception of physicians.
What patients want is to get better. They want to be rid of pain. They want a doctor who is compassionate and caring. It isn’t hard. Be honest, be caring, be professional. Not everyone is going to get better and that’s a fact. But you must try to help them with sympathy and empathy. I have been told by other doctors that have seen my treatment failed patients that the patient still loves me despite my not getting them better. No one sues a doctor they love.
Unfortunately in these days of internet reviews it is more important than ever to conduct yourself professionally. A bad review on the internet can be a very, very hurtful thing as many sites share reviews making one bad review one that shows up on multiple review sites. Patients MUST be made aware from the outset that they will be held responsible for libelous remarks on the internet. We have it in our new patient form (that they must sign) that we will defend ourselves vigorously for any libel submitted on the internet and that we will pursue damages as a result of any made.
I don’t get along with every patient. No one does. When I recognize I am not in a productive doctor-patient relationship I inform the patient of my feelings and recommend they seek ongoing care from another practitioner. In my opinion, that is the defensive position to exercise. I rarely send out dismissal letters because I don’t need to. I tell them nicely to their face and they get it.
Everyone expects great care in America and fortunately most give it. It’s why we went into Medicine. It is a most rewarding field to be in for me and one that gets better every year. Over time, we all learn to work smarter, not harder. Do the right thing always and you will have very little to be concerned about.
James E. Koon, DPM, Winter Haven, FL
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