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When Time Constraints Harm Your Patient Relationships


Wondering how to deal with sticky staff and patient situations? Ask The Civility CEO. She'll answer all your questions about conflict in your practice.

Dear Sue,

I recently joined a busy family practice that operates on a volume-based incentive business model. I want to get to know my patients, but our practice manager is constantly on my case about not seeing enough people in a day. How can I develop strong patient relationships while working within the time constraints I am repeatedly reminded about?

Editor's Note: Working in a medical practice means dealing with a variety of people. To help you, we've asked The Civility CEO® to answer your questions. Facing a tricky problem in your practice? E-mail your  conundrums here. Your anonymity is guaranteed.

Frenzied Physician

Dear Frenzied Physician,

Talk about a double-edged dilemma! While it's imperative that you build rapport with patients, it's equally vital to honor your commitment to the practice to stay on time and on target. Here's an approach that may help you accomplish both of those tasks.

Come up with six standardized social-centric questions to ask patients, and incorporate one or two of those questions into your conversation at each visit. Examples of social-centric questions are, "How long have you lived in this area?" and, "What hobbies do you enjoy?"

While you may think these questions sound trite, they will actually help you learn more about your patients and ultimately save you time. Discovering details about someone's hobby, for example, may provide clues about his or her general state of wellness. Your treatment plan for a long-distance runner who presents with acute shortness of breath will be entirely different than that for a bingo buff.

Jot down interesting tidbits about patients to briefly refer to at subsequent visits. People appreciate it when we remember details about their lives, and being prepared with good questions and solid notes will help you cultivate your connections. Over time you can add quick queries like, "By the way, how did your ball team do in that tournament?" or, "Which college did you decide on?" Your patients will love you for it.

When it comes to the management of your practice, keep in mind that while you're dealing with physical conditions, your manager is dealing with fiscal conditions. Like it or not, you're on a collaborative mission to enhance the financial well-being of the practice. It has quotas to meet and you have a professional responsibility to help it meet those goals. Your (and everyone else's) livelihood, depends on it.

Finding a way to work with your practice manager is critical, and mutually respectful communication is a good place to begin. Request a meeting to clear the air and start anew, especially if your manager's complaints are continual. You could also ask other partners, PAs, or nurses in the practice for suggestions that will help you stick to the schedule and still satisfy your desire to acquaint yourself with patients.

Realistically, time is money when it comes to medicine. Whatever you do, don't flatline your relationships over the bottom line of the business.

Dear Sue,

We work with a doctor who is always late. His behavior is negatively impacting the morale and efficiency in our office. Patients are complaining to our staff, and our staff is complaining to us. What can we do?

Punctual Partners

Dear Punctual Partners,

I suspect you would agree with English humorist E.V. Lucas, who said, "I have noticed that the people who are late are often so much jollier than the people who have to wait for them." Mr. Lucas may have been a humorist, but there's nothing funny about chronic tardiness.

People who are habitually late are usually that way because we allow - and sometimes enable - their behavior. No matter how frustrated we are when they fly into the room spewing their "Sorry I'm late!" spiel, we often reply with, "That's OK." Medical emergencies aside, it's not OK!

You need to have a serious talk with the dawdling doctor about how his behavior is affecting your patients and the practice. Here is a five-step strategy:

1. Schedule a meeting that allows ample time to discuss your concerns (keep in mind that he'll probably be late).

2. Focus on discussing facts, not feelings.

3. Find out from your colleague how he would like you to deal with his delays. For example, you could ask, "When your patients complain that you're always late, how would you like us to direct the staff to reply?" Giving him some say in the process will (hopefully) make him more accountable.

4. Declare your expectations and outline the changes you are prepared to institute. For instance, you might say, "Every time you're late for a meeting the rest of us wait for you. This is a waste of time. From now on we will start and end meetings on time, whether or not you are present. We expect you to make every effort to be in attendance. Will you agree to do so?"

5. Follow through.

Please don't delay! There's no time like the present for this crucial conversation.

Sue Jacques, The Civility CEO®, is a veteran forensic medical investigator turned corporate civility consultant, keynote speaker, and author. Jacques helps people and practices gain confidence, earn respect, and prosper through professionalism by creating courteous corporate cultures.

This article originally appeared in the February 2015 issue of Physicians Practice.

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