Thursday, August 23, 2012


I’m hearing stories about wonderful doctors whose offices are less than wonderful, actually reminiscent of the stiff 1950s. My friend Miriam told me,

“Last time I visited my doctor, the receptionist didn’t say a thing to me, just pushed a sign-in sheet across the counter. Soon a woman called me in from the waiting room. Walking ahead of me, she asked how I was—a nice touch, but really, she wasn't even looking at me. And who was she, anyway? A nurse? Another patient? For all I knew, she could’ve been someone who’d wandered in off the street. Am I supposed to ask? Is it up to me to teach manners to grownups? She weighed me, took my temperature, and left the examining room. In a few minutes, Dr. D came in. Now, him I love. Right away he lifted my mood. Afterward, he walked me out, hugged me, and moved on to his next patient. The woman behind the desk said, 'We don't take Medicare anymore. Today's visit is seventy-seven dollars.' She was like a clerk selling me chewing gum, take it or leave it. She handed me a bill with my name on it, misspelled.

“I know Dr. D cares about me. I'm lucky he's my doctor. But his office staff acts like their customers might be burglars. If they were any more negative, they’d assault patients. Wouldn't they enjoy their work more if they were friendly? How can Dr. D not notice how anti-healing his staff’s low morale is?”

Imagine you work in a medical office, dealing with patients who can be out of sorts, demanding, even intimidating. You hear them wail in the examining rooms, and your daily office buzz includes saddening details of their miseries. You spend hours with insurance company phone robots, careening through algorithms in search of the dubious prize, an argument with a live representative. All this can harden you—to patients, to your work, and to your own feelings. Little wonder medical office workers’ morale can decline to the point that they treat their customers coldly.

If a medical office were selling widgets instead of conducting healthcare, the staff might be forgiven its emotional distance with the traditional apology, “Business is business. Don’t take it personally.” But healthcare isn’t about widgets. It’s about people in their deepest pain and need, who are suffering, defenseless, pushed to their edge. If they’re to matter in healthcare, we who work in it need to feel and act from a deeper humanity.

I recommend this more from a medical sense than a moral one. It can’t be emphasized enough that patients need comforting. They need to leave the medical appointment feeling better than when they came in. Toward that end, arguably the most important person on the staff is the receptionist, who sets the visit’s emotional tone. Every member of the staff is potentially a placebo, able to make the patient feel better. An ideal visit is one where the patient is already half-treated before even seeing the doctor.

I could offer suggestions touching on office design, staff behavior, traffic flow, and other features, but every office is different. Instead, I suggest trying this: when business is slow, how about a staff member pretending to be a patient, going through each procedure that a patient would, and afterward writing a paragraph or two about how it felt? When everyone’s done it, you can all go out for pizza and beers (at office expense) and talk about changes you might like to make.


  1. I have been seeing the same thing, Jeff! Older, loved doctors have expressed it also, as to how medicine has changed and it's all about making money as any business. I'm grateful that I was trained before any of this, and when I need a doctor, I look for one from the "old school."

  2. I agree with the article. Some of the nastiness I have experienced from receptionists suggests they really want me to just go away. Few doctors are worth putting up with all that rudeness... Also, a woman 1/3 my age calls me by my first name, or "sweetie" or "honey" and doesn't even introduce herself. Sometimes I ask who they are, or if I am in a bad mood, I just call them darlin' or something, back.