Your Most Important Asset – Your Reputation

Kenneth P. Schultheis, DO, FACEP
Chief Medical Officer

I have always maintained that a person's most important assets are their reputation and their health, and of these reputation is foremost! As physicians the manner in which we relate to patients, their family and friends should be our first priority. If we are unkind, disrespectful, rude, abrupt, uncaring, whether or not we have "met the standard of care" we have failed in our obligation to the patient.

The manner in which we relate to patients and those who accompany them absolutely affects outcomes. As a physician, if we do not inspire patient confidence, the likelihood is that the patient will either not comply with the recommended treatment or will seek out a second opinion. In either instance the satisfactory resolution of their medical condition will, at a minimum, be delayed.

Additionally, it is important in a clinical setting that we look like a doctor. If a medical professional looks like a "slob", then they will be perceived as a "slob", which understandably brings into question their credibility. Blue jeans, sweat suits, shorts or dirty sneakers are not part of the image patients expect in their physician. Although these items may be acceptable in a casual, out of office setting, society has a perception of what we physicians ought to look like, and an unkempt appearance, poor hygiene or inappropriate attire just doesn't cut it. Proper grooming, a clean appearance and professional attire go a long way in building patient confidence.

Patients should have the sense that you truly have their interests foremost. If you are perceived as uncaring or insensitive, they will consider other options for their future medical needs; and a community's loyalty toward a physician and hospital are critical to a successful hospital based emergency department practice. The following are some suggestions to consider in your emergency department practice.

• Always greet patients in a caring manner and be sure to introduce yourself. "Hi, I'm Dr. Schultheis, and how may I help you?" Also refer to them as Mr., Mrs., or Miss, and not by their first name, unless they are family or a close personal acquaintance. For children first names are generally appropriate.
• It is also important to touch the patient. Whether you hold their hand or otherwise touch them in a supportive manner, such reassurance will go a long way to help relieve any anxiety.
• Keep patients and family informed regarding pending laboratory, x-ray or other needed studies; and be sure to discuss the results of these studies, avoiding medical jargon where possible. Patients, not having medical backgrounds, generally have difficulty understanding words such as carbuncle, cellulitis, pleural effusion, and acute coronary syndrome. Patients certainly understand the following descriptive wording, such as abscess, skin infection, fluid buildup in the lungs and heart attack.
• Be sure to include family and friends in discussions regarding recommend treatment. They will assist the patient in complying with your recommendations, and can be your ally in assuring that any needed medical follow up is undertaken.
• Keep the patient's personal physician in the loop. Always consider calling the patient's physician, as their understanding of the patient's medical history can be very helpful. It's also reassuring to patients knowing that their doctor played a role in their care.
• Do not forget to inquire as to whether or not the patient needs medication for pain. Remember most patients come to the emergency department because of pain. Too often they don't receive the pain relief they deserve.
• Also, before discharge ask the patient or those accompanying the patient if they have any questions. Occasionally you will be provided information that may surprise you, such as, "What happened to my doctor; he told me he was going to meet me here."
• And always - Document! Document! Document! The medical record should thoroughly document the patient encounter, and also reflect that you truly have the patient's interests foremost. If you are ever challenged in the legal arena, the medical record can be a supportive and significant ally in your defense.

In summary, as medical professionals the manner in which we relate to patients should be our first priority!