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Dealing with Doctors - August 30, 2014

In our modern age, it is unfortunately rather common for people to experience difficult customer service interactions. Most of us can share several stories about rude and upsetting conversations with store clerks or call center staff. It's simply part of life. However when you experience an unpleasant interaction with healthcare staff related to your medical care it can be a particularly awful experience.

When I worked as a Human Resources professional for a hospital, one of my job responsibilities was conducting training programs for hospital staff. One class that was offered was titled "You Said What?" The class was designed to remind hospital staff to remember the importance of having empathy for patients and their family members and to be sensitive in their word choices when speaking to them. Healthcare professionals are no different from any other workers, they sometimes get caught up in the routine nature of their work. They are exposed to traumatic and upsetting news day after day, so it is only natural that they sometimes become a bit desensitized to it.

In this class, I shared some real life examples to illustrate the importance of appropriate word choices. When I had surgery for the first time I distinctly remember when the nurse woke me up in the recovery room. As I woke, I was groggy and in pain and suddenly remembered where I was and that I'd just had surgery. The nurse nonchalantly said to me, "I'm so glad you woke up the last two patients didn't wake up!" Then she walked away to attend to something else. I later learned that the other two patients had not actually died, like I assumed, but simply had difficulty with the anesthesia wearing off. I'll never forget the feeling of fear and panic that ran through my body as I thought there were corpses next to me in the recovery room. Another example came from a friend of mine. She had complications during her son's birth and had an emergency c-section. When she woke up in the recovery room she immediately asked the nurse how her baby was doing. The nurse told her that he "looked like a seal". The child had a minor birth defect that caused his arms to turn out. In both of these cases the information the staff shared with the patient was technically accurate but very insensitive to how the patient might interpret it.

What can you do when the healthcare professionals in your life could improve their bedside manner? In my opinion, there are different levels of offense and violation in these matters and therefore different ways to handle each incidence. After you get over the initial shock or upset, the first thing to consider is how often and in what context will you likely encounter this individual throughout your care. If you are undergoing treatment for a major health issue you will encounter many people throughout the course of your care. You will probably find that you don't have the time or energy to take action after every single difficult encounter. A strategy of just letting it go and moving on can be very useful in some cases. How you decide is to consider the amount of regular interaction you will likely have with this person and the degree to which their remarks upset you. If this is a nurse who will be administering your treatments weekly for several months versus a technician who may administer a simple test once or possibly twice I recommend handling it differently.

First, if this is a situation where the person has said something demeaning, prejudiced or is a violation of confidentiality then it does not matter who they are or how often you might interact with them. In those cases the way to handle it is quite simple. Immediately ask to speak with a supervisor or higher level manager and file a formal complaint. Speak up right away and ask to have a different person assigned to your case. There is simply no justification for violating HIPAA confidentiality laws or making abusive or discriminatory statements or comments. In the rare cases when this happens there really is nothing else to do but to swiftly take action to stop it.

However in most cases the problem is not as dramatic and is merely upsetting such as the examples I used in the training class. The individual involved may be doing his/her job well generally but may have just had a momentary lapse in judgment and chosen their words poorly. This does not make the comments acceptable, but it's important to remember that healthcare staff are human like everyone else. The best thing to do, if it is someone you may interact with regularly, is to gently point out to the person how their words landed. This could happen the same day or the next time you see them. Explaining how their word choice caused you fear or embarrassment or anxiety can quickly help them understand the mistake. Most of the time when it is brought to his/her attention they will immediately apologize. Most people aren't intending to be offensive and appreciate the feedback. If you don't feel comfortable talking to the offender directly then asking to speak with a supervisor, office manager, or their peer may be easier. You may also want to include it in the comments of a survey. The key is to frame it in the context of helpful feedback rather than an angry complaint. It will be more effective this way and you may want to reserve your complaints for other problems you encounter with your care.

The thing to keep in mind is that often what is expressed by the healthcare professional is simply stating a fact or something obvious to them. Since healthcare professionals often see people with debilitating conditions or life threatening issues they usually discuss these things matter-of-factly. I'll never forget the time that a surgeon talked to me after doing a procedure to drain fluid from my husband's abdomen. He bluntly asked if my husband was "in hospice care yet". This shocked and upset me because he was still undergoing regular treatment. At the time I thought he was being insensitive and rude but now I realize he was asking a reasonable question based on my husband's physical condition at the time. So before expending energy to file a complaint about someone's word choices, I recommend taking a little time to consider if it was truly inappropriate or rude or was it simply something that was difficult for you to hear regardless of how it was delivered.

Generally, people who choose to work in healthcare do so because they are caring, kind individuals who want to help people. The way they interact with patients may sometimes be flawed. It's important to realize you can and should speak up when this happens but I caution you do so only when it serves your well being. There will be times when it is best to let it go and other times where you speak up. Do your best to choose the path that works for you.