Summary: Patients fire doctors all the time, that’s nothing new. But why do patients “stick around” after a bad experience?Christopher Springmann: I'm Christopher Springmann and you're listening to Body Language. "What can I help you with today?" That's the first question that Dr. Danielle Ofri, our next guest, asks of every patient. It makes sense but the responses she sometimes receives will shock you. They are instructive, especially if you're committed to being an effective patient who gets real value and satisfaction from that all-important doctor relationship. You wrote a fascinating article for the New York Times entitled, Giving the Doctor a Second Chance, which was very generous on the part of a patient who announced to you, "You know, doctor, I almost didn't come back today. I was ready to choose another doctor, but I decided to give you a second chance." I have a fairly good idea as to how I would respond to that. I would certainly try biting my tongue. How did you respond to that? What was it, challenge? Dr. Danielle Ofi, MD: It was quite the shocker. You know I said good morning, how are you, how can I help you, my usual pleasant overture. I knew I'd seen this patient once before about a year ago, and quick glance at the notes suggested it was a relatively healthy patient. There wasn't anything big going on. So I was kind of shocked when she said this, because usually that kind of thing comes when you've had a major clash, a big disagreement on treatment. And I didn't see anything in the chart to indicate that. CS: From the patient's standpoint, the conversation didn't get any better. She said, "Someone said you were a good doctor, but I was not impressed. You know, Dr. Ofri, my previous doctor, even though he was just a resident in training, was much better than you." What are we dealing with here in terms of unrealized expectations? And frankly, I guess the larger issue is who trains people? In this case, who trained this woman to be a patient? DO: Well nobody does, but she came in. Clearly, she had an experience with me that was much less than what she was expecting, and certainly much worse than what she had with her prior doctor, even though that doctor was only a doctor in training, and I'm one of the senior physicians. So I was quite shocked, a little bit hurt. It really stung, I will say that. And I kind of had this moment of freezing, what on earth had I done? Had I yelled at her? I didn't know and again, I quickly looked at the chart and I couldn't see anything. CS: What her unfulfilled expectations? DO: Well I didn't know. She kind of looked at me and you know and I said that you know— and I felt so bad. I didn't even remember the visit, one of you know hundreds and thousands of healthy patients that I see. CS: Oh. And that didn't make her happy did it? DO: So I had to say could you tell me what happened. And then she was like oh it figures; you don't even remember. CS: Ah, ha, ha, ha. DO: God, what have I done? So I finally asked her. I had to really kind of you know lay it on the line. "I honestly don't remember. Could you please tell me?" CS: Well at least you were honest. And if I can digress for a moment, physicians who are honest and candid with patients, especially about their mistakes and apologize, have not only a fairly good response from patients but are much less apt to be sued if there's a problem. But let's move on here. So what happened? DO: So, looking stonily at the wall said, you know, "You didn't do a physical exam." I hadn't done a physical exam at our last visit. CS: So her expectation was that that was part of the deal. DO: Which I think is a completely reasonable expectation and that normally is. And there are occasions when we don't do it, but by and large most medical visits have a physical exam. And I guess I had done the history, and I guess I figured out what was going on and I either forgot or blanked out or didn't think I—I didn't even remember what transpired. CS: Well I think the
