We all start out as idealistic medical students, downright puppy-like in our devotion to our patients, eagerly bounding to their rescue and spending hours listening to their concerns. Somewhere along the way, we start shutting down, seeing patients as demanding and feeling as if we’re always fighting them off.
I used to do it too; hide behind my layers of staff, complain to the office manager if a patient somehow made it to my voice mail instead of my MAs. I took my turn at call with trepidation, not knowing who might page and what they might want. A few times patients ended up with my personal email in one way or another and one time I returned a call from my cell instead of through the answering service; this direct access to me left me extremely anxious and uncertain. But it seemed normal and natural to react to patients this way.
I think because I’ve had some time away from it, I’m now surprised by how fearful most doctors are of patients. When other physicians hear about my practice — that my patients can all page me at any time, twenty-four hours a day and seven days a week; that my schedule is available online for them to book themselves an appointment whenever they want for whatever they want for as long as they want; that I don’t charge per appointment but just let them come in as often as they need — the other physicians invariably respond with horror, as if I’ve just volunteered to sacrifice myself to the barbarian hordes. They seem to assume my patients will tear me limb from limb and give me no peace.
In reality, even with a three day weekend every weekend, it’s been weeks since I was last paged after hours. And every after hours page has been for something I wanted to hear about: a nasty dog bite, a baby with a high fever, a diabetic with wildly fluctuating blood sugars. I have never once had a patient schedule an appointment that I felt was inappropriate. If anything, I have to badger my patients to come in because they don’t want to bother me. Because by tearing down the wall between my patients and me, I’ve stopped the tug of war. There’s no need for them to always be trying to get me. Because they’ve got me. I’m here for them. I’m available when they need me.
And every single moment that they don’t need me, I’m home with my kids. I don’t have to hide that fact and pretend that I’m sitting in my office, always ready to receive them. Just as I don’t have to keep them from accessing me, I don’t have minimize my time off. Since I’m always available, I’m also always free.
Ultimately, my open relationship with my patients means that I get to be who I am. I never have to hide behind staff or behind a persona. I like it that way and so do my patients.
Robin Dickinson is a family physician who practices in an ideal micropractice model.
Image credit: Shutterstock.com
