Last week, our post, "I Hate Doctors" generated some interesting response. It also helped us put a different, and we think, valuable slant on a piece in today's Well — the New York Times health blog. Entitled "Six Ways to Be a Better Patient", the post is a shortened version of a longer post by "Dr. Rob" in his blog Musings of a Distractable Mind. Dr. Rob and his blog demonstrate perfectly why I have a job.
In order to be a better patient, Rule Number One, according to Dr. Rob, is The Doctor Can't Do It Himself. He goes on to write this:
The best doctor can do very little with patients who ignore
instructions. Sometimes noncompliance is partly due to physicians not
explaining things well, but medical compliance is ultimately in the
hands of the patient.
I am mystified as to why some patients will ignore nearly everything
I say and yet continue coming in for regular appointments. It is
frustrating, causing some physicians to get angry with these patients
(and even discharge them). I figure it is the patient’s dollar that is
being spent, not mine.
The reason patients do not comply, Dr. Rob, is that they're human beings. Human beings have a lot of reasons for doing what they do (or not doing it) and guess what? They're not always rational, particularly when they're sick. Especially if they're very sick.
Doctors will line up to rail against evil pharma sales reps, greedy drug companies and inappropriate DTC advertising. Yet, for whatever reason, an incredibly important, difficult conversation with your doctor, one that has a profound effect on your health, takes place in an office, according to Dr. Rob, that is a rushed madhouse, pretty much always on the brink of anarchy. I'm not exaggerating here — a few more quotes from the post:
- I have over three thousand patients.
- My staff has a very demanding job. Remember that you are not their
only responsibility – you may be the 100th job for the day . . .A staff member is generally more valuable to
me than a single patient, and I need to show my staff that they are
valued by me.
- A doctor’s office is always on the brink of chaos – with an incredible
amount of information coming in and going out, a large number of phone
calls, insurance company headaches, and personnel situations that can
throw the best system flat on its face. People forget that there are
hundreds of other patients with thousands of test results the office is
This is exactly why relationship marketing has a role, and why it works. This is not the kind of environment where it's easy to ask questions or get help, and it's certainly not the kind of environment that's going to follow up with a patient who's borderline noncompliant, or help him stay on his meds. There isn't time, and there isn't money. None of this, by the way, is Dr. Rob's fault, necessarily,
In the real world, the world we all live in, the only resource a patient has after leaving the doctor's office is us. In a perfect world, of course, we wouldn't be needed. But until then, RM is a harried doctor's best friend.