Ten Commandments of Patient Care
  1.  A patient is the most important person in any medical practice.
  2.  A patient is not dependent upon us . . . we are dependent on him/her.
  3.  A patient is not an interruption of our work . . . he/she is the purpose of it.
  4.  A patient does us a favor when he/she calls . . . we are not doing him/her a favor by caring for him/her.
  5.  A patient is part of our business . . . not an outsider.
  6.  A patient is not a cold statistic . . . he/she is a flesh-and-blood human being with feelings and emotions like our own.
  7.  A patient is not someone to argue or match wits.
  8.  A patient is one who brings us his/her wants . . . it is our job to fill those wants to the best of our ability.
  9.  A patient is deserving of the most courteous and attentive treatment we can give him/her.
  10.  Caring for patients is the reason for our jobs.


1. The first contact between a patient and the healthcare provider is when the patient calls for an
appointment. The phone should be answered by a human being within three to five rings. If voicemail
is absolutely necessary the voicemail should be easy to navigate to receive an appointment efficiently
and assist the caller to reach the doctor when necessary. Doctors are advised to call into their patient
phone lines periodically to experience what the patients experience. Calling your “private” line will
not get you the “patient experience.”
2. Elective appointments to be given within ten working days unless the patient’s schedule necessitates
a later appointment. Urgent appointments to be given within 48 hours. Emergency appointments
within the same day.
3. The registration and wait times in the general waiting area to be under 15 minutes.
4. The Attending doctor and his/her team of nurse practitioners, physician assistants, residents, fellows and medical students are
familiar with the patient's available medical history and condition before
meeting the patient, and maintains attentive eye contact while the patient is presenting his/her
symptoms and past medical history, medications, previous tests, etc.
5. The Attending doctor examines the patient personally in addition to that performed by the team
and not rely on physician extenders or students, interns, residents or fellows.
6. Besides the team, the Attending doctor reviews tests, imaging results and other clinical data and discusses them and the
physical findings directly and thoroughly with the patient/family as well as advises the next steps.
7. The Attending doctors and the team answer all the patient's questions and consider their wishes.
8. The scheduling of future tests or treatment is to be accomplished as efficiently as possible.
9. The Attending doctor reviews these new test results as soon as possible and discusses them with the
patient/family. If the results are not ready when expected, the Attending doctor or his/her
knowledgeable delegate is to call the patient to explain the delay and give as accurate as possible,
an estimate as to when the results will be ready.
10. The Attending doctor discusses treatment options (giving the pros and cons of each option as well as
the risks for each option) and the post-operative care and expectations including but not limited to pain
management. Following the UK acronym: BRAN – B=benefits, R=risks, A=alternatives, N=do nothing.
11. On the day of surgery/treatment, the Attending doctor (NOT a delegate) meets with the patient (before
induction of anesthesia if anesthesia is needed) to triple check and confirm the type of
surgery/treatment, site and side of the surgery/treatment to be performed.
12. As soon as surgery/treatment is finished, the Attending doctor or a delegate who is fully
knowledgeable with the patient's case -- and within the specialty meets with the
family to go over the surgery/treatment. As soon as the patient is awake, the Attending doctor repeats
this process with the patient directly as well as covering the postoperative care.
13. The Attending doctor and/or the team makes rounds on the patient daily in a non-rushed fashion, answering all
questions from the patient or family members. If he/she has to be out of town, a specific doctor can
be delegated to care for the patient, but he/she will have to be completely familiar with the patient's
case, and this doctor's credentials have to be commensurate with those of the original Attending doctor.
14. The evening of the discharge, the Attending doctor or a delegate who is knowledgeable about the
patient’s care and that specialty speaks to the patient or family member by phone to see how things
are and to answer any further questions. The responsible caregiver or a fully knowledgeable delegate is
to call again in another 48 to 72 hours.
15. Phone calls to be returned efficiently and promptly within hours, definitely within the same day.
16. A knowledgeable physician extender or delegate should be conversant in that specialty of medicine as
well as familiar with that patient’s condition.
17. In most instances, any bad news is to be delivered by the Attending doctor. A physician delegate
knowledgeable in that specialty and the patient’s care can deliver the good news or routine results.
18. “A good doctor takes care of the disease; a great doctor takes care of the patient.”


Providing a Compassionate Environment

Provide adequate staffing
Create spaces that work
Promote staff teamwork
Immediate/Same Day/Next Day appointments
Educate staff on TPIU
Provide appropriate cost information to the patients

Providing Compassionate Care

Know your patient
Listen respectfully & attentively without rushing & interrupting
Treat the person, not the disease
Convey information in understandable words
Involve the patient in healthcare decisions
Provide small acts of kindness - a reassuring hand
Show respect to their family

The 6 C’s

Ø Care

Ø Commitment

Ø Communication

Ø Compassion

Ø Competence

Ø Courage

Compassion -- 
a deep awareness
of the suffering of another
coupled with the wish
to relieve it.
Understanding the patient  as a person – 
seeing the person
behind the disease.

Do you practice TPIU?

If so, please let us know.