Physicians Should Strive for Transparent Communications

A recent visit to my ophthalmologist reminded me that patients learn much more about a practice when things go wrong. At least that's what I believe.

My previous visits have been a model of smooth operations. I have been seen on time and moved smoothly through the process. Last week was very different.

The visit began normally. It was quick and easy to register. I was escorted to an exam room on time and a technician efficiently checked my current prescription as well as my vision. She also performed several other tasks and then put drops in my eyes to dilate them. I was sent back to the waiting room for the drops to take effect - so far so good.

I don't think I was told how long I'd be in the waiting room. My memory from previous exams was that it would be awhile, but not a long wait. After more than 30 minutes, I went back to the front desk.

Despite the fact that there were three people there, it was several minutes before anyone made eye contact with me. I took that as a sure sign that they knew there was a problem. Finally, I had an opportunity to say I was concerned that I'd been forgotten.

After another few minutes, the young lady said that the doctor was "now" in the office, which made me wonder where he had been since it was about 11 a.m. and the waiting room was chock full. She announced that I was the next exam patient in the queue. Apparently there were a lot of rechecks in the office that day and they were the priority. This was probably a good strategy, assuming that the rechecks could be cleared more quickly than the full exams. At the same time, I did not like the idea that I was running more than an hour behind while the office was catching up on the rechecks.

I sat another 20 minutes. The helpful assistant noticed me when she came to get another patient and said, "Have they not gotten you yet?" I assured her nothing had happened.

A few minutes later, someone did take me back to a room with no comment about the delay. I mentioned the delay and there was no response. I suspect the move to a room was a placating tactic, because I sat there another 10 minutes.

When the doctor came in, I asked if my eyes were still sufficiently dilated. He acted as though he thought I was making a joke, but he clearly knew I was not a happy camper.

After he checked me out, he began a lengthy monologue about whether or not I needed a special test that he likes to have me do each year. Since this test requires going to another department and some more waiting time, it was clear to me that he was trying to get me on my way as quickly as possible. He finally convinced himself that since nothing had changed in eight years, I could skip the test this year.

I went to the counter to pay my bill. Unlike previous visits, no one suggested or offered sunglasses and I had to remind them that I needed a script for new glasses.

All in all, especially given the usually smooth operations, it was abundantly clear that there was a big problem that day. Rather than be transparent with me, everyone in the practice did their best to ignore it.

No one warned me about the delay or offered me options. No one kept me informed as the situation developed. No one apologized. In the face of my escalating, albeit polite, frustration, they all ignored the elephant in the room.

I will not abandon the practice over this one encounter, but my opinion of the physician is significantly damaged. If he cannot directly address something as relatively minor as a scheduling snafu, how can I trust him to be honest with me if something really serious goes wrong?