I was musing about how I screen doctors, to whom I refer and with whom I enjoy working. What makes me pick up the phone and call Dr. A and not Dr. F? There are basic reasons; do not call a dermatologist to do brain surgery, make sure the doc speaks the patient’s language, it helps to be skilled in that particular disease and, of course, they actually call me back.
However, thinking about how I choose a doctor, it occurs to me that the attributes of skill, communication and results, are the entry qualifications, but they are not enough. They make a Dr. B, not a doctor A. A primary reason I refer patients to specific physicians is “Carpe Diem.” Seize the Day. Or perhaps the cumbersome, “Comprehenderent Patiente,” Seize the Patient.
Its my day off, 7:05am, I am in the kitchen, in my underwear, drinking a cup of coffee, trying to ignore the dog who is excited about the prospect of a walk, when my cell phone rings. It is Dr. RS. It is his day off too and he is standing in his kitchen, drinking a cup of coffee and ignoring his dog. I suppress the underwear image. He wants to discuss a mutual case that is bugging him, a young man with cancer to whom we have both given care for years. We go over the problem, come to a solution and at the end of the conversation, and this is key, he says, “Do you want me to handle it? I will call him.”
Even in the early pre-coffee fog, Dr. RS. is taking responsibility, taking control, and seizing care of the patient. None of the “I will mail a prescription to the patient so he can set up the test, “ or “have him call my office for an appointment,” let alone, “Why don’t you call him?” Dr. RS. is taking the patient under his wing to make certain medical care is done soon and done right.
This is key to the best doctors; they see every patient as their personal responsibility. Patients perceive this kind of care, as “how would you treat your mother?” It is much more. It is guaranteeing that every connection is made, every question answered and that whatever happens, whether the medical problem is in that doctor’s specialty or not, the doc confirms that treatment is given without the patient having to stumble, confused, from office to office, hoping to find the right care. Such “close-the-loop” doctors use their medical expertise and understanding of the healthcare system, to “walk” the patient through until medical issues are addressed and a plan is actualized.
One of the most astonishing office calls we receive is from new patients who have been told to “find an oncologist.” The patient has a mass or a pain or a bizarre blood test and some “physician” says, “well, you might have cancer” (or even “you do have cancer”), so “go find a cancer doc.” You have to be kidding! This seems to me like if your house was burning, you call 911 and they send you a list of firemen.
This contrasts with one of the most professional calls we receive, every day, when a primary doctor or surgeon calls our office, insists on talking to one of us directly and says, “I am here in the office with Ms. Smith. When can you see her?”
This is not an easy thing for patients to measure, but I think patients can get a sense early, if they are aware of its importance. Does the doc or office get back to you? Do they help set up tests? Do you worry for weeks after a critical test is performed, because they have not told you the result? Do they listen and communicate? Do they seem to connect and care? Do you feel lost, adrift, or does the doctor captain your journey?
The key to the great physicians is not just compassion, caring about their fellow man. The key is passion, investment in their patients, going not the extra mile, but the basic step of making sure each patient gets complete and connected care. It is what patients should desire, each patient expect and each patient needs.