A great doctor might be what brings you into a clinic but you won’t stay there too long if that clinic and its staff treat you like crap. Once we’re done with this episode, you’ll be able to tell apart the good, bad, and straight-up dysfunctional clinics or hospitals.
Obviously, the skill and location of whatever doctor you see matters the most in your choice for what clinic you join. Every great team needs its stars, but the reality is that in most places, the doctor is one major cog in a grand machine. The mid-level providers, nurses, assistants, staff, schedulers, etc. all should work in harmony. A badly managed practice brings down the best of physicians. On the other hand, a great practice with the most elite supporting cast on earth won’t be able to redeem a god-awful medical diagnosis. You can think of this relationship like Tom Brady’s and Bill Belichick’s New England Patriots. Coach Belichick and his staff put all the pieces together for Brady and his teammates to consistently thread the needle down the field. That’s why you should take note when a given clinic’s staff and professionals communicate well. This is not going to be a discussion about what makes a great doctor—I’m going to need a couple of longer episodes to deal with that topic. However, the purpose of this episode is for you to know if a given medical office or team checks all the right boxes for being able to assist you properly.
Part of the reason why patients can mistrust the medical community is because it’s so easy for anyone to say their clinic is patient-focused, detail-oriented, and competent. If a healthcare facility’s only selling point is being “patient-first” or “patient-centric,” you should question what that clinic has to offer. Hence, in no particular order, I’ll cover all the major red and green flags to watch out for so you can see if a clinic can walk it like they talk it.
You might hit the first possible roadblock before you even get out of the waiting room. Most clinics these days use an electronic medical record system to keep track of all their patients, and in some cases, you end up being just another number in their system. The staff or the doctor might be a little stiff at first because in the wider scheme of things, you could the 60th patient today who’s coming in for aches or pains or covid. You might also be verbally labeled as just a “case” or “client” in an office’s calendar. For some medical businesses, this is the reality but you should notice the clinics with staff who break the mold, call you by name and, for a moment at least, take interest in your day or story. You might also see the doctor having an attitude with patients different from the demeanor for his or her staff. Patients might get attention like they’re Cinderella all dressed-up and the nurse or medical assistant might get a look as if they’re Cinderella before she gets on that pumpkin carriage. You may not even see the same care team member twice over the course of a year. What could also happen is that you won’t be able to get help because no one returns your calls or messages. If you end up in the unfortunate situation of having a treatment plan from your provider go wrong, the worst of the bunch won’t bother to help you further because they want to be as far as possible from their most unsuccessful patient care outcomes. Factors like high turnover, low morale, people just going through the motions, and straight up disrespect at medical clinics can be a sign of toxic culture, but these are usually consequences of deeper issues. Since on this podcast we’re all for being proactive instead of reactive, there’s one cause of mismanaged practices to watch for. An ineffective practice at its core doesn’t let patients tell their whole story. Staff may just cut patients off or express displeasure at the extra work of taking more history. Even worse, critical info about medical history you give to nurses, assistants, or schedulers doesn’t make it to the doctor and other professionals. Your info needs to go all the way up the food chain—as mentioned earlier, strong communication between staff, doctors, and patients influences better results.
Let me say one thing before we get up on the right side of the exam table. With respect to all the red flags we covered, it’s still possible that you can end up at a practice where the doctor and staff are stone-faced and otherwise rude but still work together perfectly and get the job done with your health—such a context does exist, and if your well-being is better as a result, that’s wonderful. That being said, negativity shouldn’t be your main filter for seeing if clinics or hospitals run well. Let’s go through all the important green flags.
A good number of the right things a practice can do will be, of course, opposite from the red flags. For example, your history and important context get properly moved along to all the staff that need to know that info. Routine phone calls get returned in one to two business days. The office makes paperwork as well as pre-/post-visit documentation easy and mostly painless. The staff are genuinely curious about your story and let you do a lot of the talking. The clinic may be willing to accommodate you at the end of the day or early morning even when doing so may be inconvenient for the team. Physician extenders and nurses are empowered to help you but the doctor is still reasonably accessible. Staff learn from their mistakes fast and make things right with you in the case of an error. All of these habits I just rattled off make for a great start but the consistent and effective practices make sure their staff have clear roles. The first scheduler answers clarifying questions about the practice, books you for a time, and passes along your info to the other staff. The front desk and nurse or medical assistants round up the basic history while getting you ready for the main provider. The doctor or physician extender gives you a proper exam, answers more of your questions, recommends a clear plan, then passes you back to the rest of the staff to make sure that plan succeeds.
In a nutshell, medical personnel should care more about your goals as a patient than the goals of the practice or pleasing the doctor. Regardless of all the good and bad incentives of how doctors get paid or how insurance plans work, satisfied patients are what make great clinics and hospitals last. As a result, the best of the best follow those habits. You don’t need clinic staff and doctors to say they’re patient-focused—if these people are willing to go above and beyond to build a relationship with patients at every level in the staff hierarchy, that’s a great place to be.
The care a medical facility gives you (or lack thereof) doesn’t just apply to when you go to the clinic in person or via telemedicine. Your valuable electronic health info deserves proper treatment as well, which is part of why rules like HIPAA exist. Next week I’ll spend time on how medical records should be treated by others and how to handle your healthcare data appropriately. Stay tuned and subscribe to Friendly Neighborhood Patient for healthcare insight. I’ll catch you at the next episode.
