A patient’s call to set an appointment is the first contact between the patient and the healthcare provider or doctor’s office. A human being should answer the call within three to five rings. If voicemail is absolutely necessary, the outgoing message should be clear and provide easy to follow instructions on how to book an appointment and reach the doctor when necessary.
Patient’s appointments are comprised of three Categories:
Elective: to be given within ten working days — unless the patient’s schedule necessitates a later appointment.
Urgent: to be booked within 48 hours.
Emergency: to be set for the same day.
The registration and wait times in the general waiting area should be under 15 minutes.
The Care
Prior to meeting with a patient, the attending doctor and his/her team of nurse practitioners, physician assistants, residents, fellows and medical students familiarize themselves with the patient’s available medical history and condition.
During the meeting attentive eye contact is maintained while the patient is presenting his/her symptoms and past medical history, medications, previous tests, etc.
The attending doctor examines the patient personally — in addition to the exam performed by his/her team — and does not rely on physician extenders or students, interns, residents or fellows.
In addition to the team, the attending doctor reviews tests, imaging results, and other clinical data and discusses them along with the physical findings directly and thoroughly with the patient/family, and advises on the next steps.
If test results are not ready when expected, the attending doctor or his/her knowledgeable delegate calls the patient to explain the delay and give an estimate — as accurate as possible — as to when the results will be ready.
The attending doctor discusses treatment options (clearly articulating each option’s pros and cons, as well as associated risks) and expectations, including but not limited to pain management.
The attending doctor and the team answer all the patient’s questions and consider their wishes.
The scheduling of future tests or treatment is to be accomplished as efficiently as possible
On the day of surgery/treatment, the attending doctor (NOT a delegate) meets with the patient (prior to induction of anesthesia, if needed) to triple check and confirm the type of surgery/treatment, site and side of the surgery/treatment to be performed.
Upon completion of surgery/treatment, the attending doctor or a delegate — who is fully knowledgeable with the patient’s case and within the specialty — meets with the family or support person to go over the surgery/treatment. Once the patient is awake, the attending doctor repeats this process with the patient directly and covers the postoperative care.
The attending doctor and/or the team makes rounds on the patient daily in a non-rushed fashion, addressing all questions and concerns the patient or family members may have. If the attending doctor 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.
The day of the discharge, the attending doctor or a delegate with specialty and patient care knowledge speaks to the patient and/or support person by phone to ascertain the patient’s condition and answer any further questions. The responsible caregiver or a fully knowledgeable delegate is to call again within 48 to 72 hours.
The Follow-Up
Phone calls are to be returned efficiently and promptly within hours, and definitely within the same day.
A knowledgeable physician extender or delegate should be conversant in that specialty of medicine as well as familiar with that patient’s condition.
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.
“A good doctor takes care of the disease; a great doctor takes care of the patient.”
One of our goals is to align today’s healthcare with this vision. If this resonates with you, please donate to our cause.
