Tuesday, June 28, 2011


My friend Theresa told me she'd just had a visit with her doctor and left confused.

"About medical stuff?"

"No," she said. "Dissonance."

She said she'd been reluctant to go to Dr. D's office but never quite knew why, and now maybe she was learning why. 

"Dr. D's a terrific physician," she said. "He's warm, knowledgeable, tolerant--a great human being. That's why I wondered why I didn't like visiting. Now I realize it's his staff."

She went on. "It came to me today that his office is a factory! Or maybe an insurance bureau, I don't know, but I'd never think of it as a remotely healing place. I check in and soon a woman calls me in from the waiting room. Walking ahead of me to an examining room, she asks how I am. I mean, she isn't even looking at me. And who is she, anyway? A nurse? Drug rep? Another patient? Am I supposed to ask? Is it up to me to teach plain old manners to grownups? She weighs me, takes my temperature, and leaves the room. In a few minutes, Dr. D comes in and right away he lifts my dark mood. Afterward he walks me out to the front desk, hugs me, and goes to see his next patient, I guess. The woman at the desk says, 'We don't take Medicare. Today's visit is seventy-seven dollars.' She's like a clerk selling me a train ticket. She hands me a bill with my name on it, misspelled.

"So here's what's confusing. Dr. D cares about me. I'm lucky he's my doctor. But his office staff acts like they're his competition. If it weren't for his charisma, the place would get closed down as an anti-healing black hole. Now, how can a guy like that not notice that disparity?"

I've had similar experiences. Why do medical offices so often feature an ambience ranging from vapidity to frigidity? When I was a kid, back in the germ days, the style was cleanliness. You knew it was a medical office because you could smell the isopropyl alcohol and eat off the white tile floor. For today's diseases, which stem mainly from lifestyle and aging, the old cold cube doesn't work. Why not opt for qualities that comfort and encourage trust? Look, office staff: "providing" healthcare to "consumers" isn't just another business. Besides, wouldn't you enjoy your work more if you felt friendly and compassionate?  

My suspicion is that Dr. D is aware of the flavor of his office. He likes his employees and finds them efficient. He has no idea, though, that every element of a medical office can be a placebo. The furniture and the lighting are potential placebos, as well as the first word from the receptionist, who as tone-setter is arguably the most important person on the staff. Look, Dr. D: give your staff permission to be the caring people they are, and by the time you see your patients in the examining room, they'll already be half-treated.

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