When a man walks into your office and announces he’s having chest pain, you listen. When an OB patient calls and says she’s in labor, you listen. When a patient calls for an appointment because she just discovered a fixed lump in her breast, you listen. These are the kinds of issues in a medical office that get everyone’s attention – and they should. But what about more subtle messages? Are you listening for those?
Medical office employees are an integral part of the care team. In many cases, front and back office staff spend more time with patients than do the doctors. Because of their close interaction with patients, staff may observe or hear things about and from patients that the doctor never knows about. And sometimes, this information is essential to quality care. Here are three examples. You can likely think of many more that fit into the category of subtle but important.
I can’t afford my medication. A patient might be too embarrassed to tell his or her doctor that they’re taking their prescribed medication sporadically (or not at all) because it’s too expensive. They might, however, mention the high cost of pharmaceuticals in a casual way (and as a hint about what’s going on) to the back office assistant while they’re having their blood pressure checked. The medical assistant could simply commiserate and agree that, indeed, many drugs are outrageously expensive. Alternatively, she might pick up on this clue and ask the patient if they are taking their meds. If the answer is no, the proper response would be, “May I share this information with the doctor before she comes in to see you? We may have samples or discount cards that we can get for you.”
My stress level is through the roof. Patients often have personal issues that they won’t bring up with their doctor because they don’t feel it’s pertinent to their health or don’t want to “waste the doctor’s time.” But a receptionist or medical assistant may learn through casual conversation with a patient that she’s lost her job, separated from her husband, is dealing with elder care issues, or grieving over the death of a close friend or relative. While concerns such as these might not obviously and directly impact a person’s health, they are life stressors worthy of attention. The issue may not warrant anything more than acknowledgment and empathy, but if what’s unfolding in a patient’s personal life is causing them stress to the point that they are neglecting their nutrition, self-medicating with alcohol or drugs, or having significant anxiety or depression, it’s important for the doctor to be made aware. If a staff member hears about these types of stressful situations from patients, an appropriate response would be: “I’m so sorry to hear you’re going through this. May I clue Dr. Smith in on what’s going on? I’m certain he’d want to know.”
I’m thinking about suing you. The occasional patient might come right out and say this, but in most cases the message is more subtle. A staff member might hear something like, “I’m still trying to figure out what went wrong while my mother was in the hospital,” or “I wish someone would have told me before I had this procedure that XYZ could have happened.” The message may also be non-verbal. For example, a patient who had a complication following surgery fails to show up for follow-up office visits. Or, you receive a request for a transfer of records from a patient who has been loyal to the practice for years and who, as far as you know, has no issues with the care they’ve been receiving. If, as a staff member, you get any hint – no matter how indirect – that a patient is considering legal action against a provider or the practice, bring the matter to the attention of the office manager or doctor immediately. It may turn out to be nothing, but it’s better to stay ahead of this sort of issue than to be blindsided by a letter from a lawyer.
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