The patient

Do not make your patient wait

One of the biggest complaints that patients have about their physician visits is long wait times. We must remember that our patient’s time is just as valuable as our own. We cannot control some problems, such as needing to answer important phone calls or needing to spend a longer amount of time on a particularly ill patient. However, we do have control over other potential causes of running behind.

I recommend not overbooking patient appointments. Some physicians double-book patients in the same time slot just to ensure that their work time is kept busy. However, I am not at all a fan of this practice, which I believe is disrespectful of the patient’s time.

I also do my best in preventing a late patient from causing me to run behind on my schedule; I don’t want this to keep other patients waiting longer than they should have to. In these situations, I will see the late patient toward the end of the clinic, or at least get their laboratory work, refill their medications, and reschedule them to see me as soon as possible.

If you are running behind due to something out of your control, make sure that someone on your staff informs the patient of the delay; if you have a moment, stick your head in the room yourself to give the message. When you eventually enter the room and greet your waiting patient, make sure to apologize and explain why you are running behind. These simple measures let the patients know that you respect them and value their time. If you were tending to a particularly ill patient, this lets them know that you would do the same for them if they were in a similar unfortunate situation.

Smile as you enter the patient’s room

Smiling as you enter the room can help set the stage for the rest of the encounter. A smile as you enter the room lets your patient know that you are glad to be there, that the patient is important, and that you are eager to help. It is not uncommon to have to give bad news to patients who have lupus, such as a new onset of nephritis or worsening of a known manifestation. Initially smiling is important, even when you know that you need to give bad news. If you begin the encounter on a positive note, your patient will feel more comfortable, and this can help decrease any preexisting anxiety. As you enter the part of the conversation where you need to discuss bad test results, then your body language and speech can change appropriately.

Make a visible show of hand washing

One of my most vivid memories of being a patient was when I had an appointment with a surgeon. I clearly heard him wash his hands outside my examination room. Then, when he examined me, I could smell the aroma of soap on his hands. This made a strong impression, making me believe that cleanliness was important to him. I automatically had confidence in him. Hand washing is so important that I have had patients even complain to me of other physicians not doing so before examining them. By overtly exhibiting hand washing, we can automatically increase their trust.

This is not merely an empty performance; our patients have good reason to question our attention to cleanliness. Health care providers have low rates of hand washing before and after contact with patients. Infections continue to be among the top three causes of death in patients who have SLE, and hand washing is an important measure in decreasing the transmission of infections.

Shake hands

After greeting your patient with a smile and washing your hands, shake the patient’s hand. This immediately adds a welcoming gesture to your patient and provides that first human touch to the encounter. Shaking hands allows you to immediately connect nonverbally with the patient and, along with the smile, sets the stage for a positive, open experience. Shaking the patient’s hand at the end of the encounter also helps to “seal the deal” regarding what was discussed and what the plan for management is.

Acknowledge and greet others in the room

I recall the time that I accompanied my grandfather to an appointment with his ophthalmologist. The doctor never acknowledged my presence in the room the entire visit. I was there to help my grandfather understand what the doctor said and to communicate back to our family regarding his condition. I felt uncomfortable during the entire visit as the doctor rushed through the examination. At the end of the encounter, I introduced myself at what seemed to be the first opportune time, and the doctor still barely spoke to me as he rushed out of the room. If he had acknowledged me initially and found out I was the physician grandson, I would have felt more included in the visit and the doctor may have explained things to me more thoroughly in medical terminology so that I could then discuss the findings in layperson’s terms with my grandfather and family. If you acknowledge other people in the examination room, including children, it creates a more positive environment for everyone involved.