Masashi Rotte - Perfect Phrases for Healthcare Professionals: Hundreds of Ready-to-Use Phrases

The authors would like to thank the following individuals for their insights on communication between patients and healthcare professionals: Naisohn Arfai, M.D.; Yuan Liu; Rex Mathew, M.D.; Robert Perkel, M.D.; Joanna Rotte, Ph.D.; Steven Selbst, M.D.; Margaret Strosser; Michael Weinstein, M.D.; Mark Zwanger, M.D.; and Mischa Mirin, M.D.

People have many different motivations for entering the field of healthcare. These motivations might range from an altruistic drive to help others to a desire to work in a job that is intellectually challenging. Still, we must remember that we are in a service industrywe get paid because we provide services to our patients, and they have a right to expect quality care from us.

There are myriad reasons that patients become upset about their care. More often than not, we have provided good care for our patients but factors beyond our control, such as insurance issues, wait times, or unrealistic patient expectations, obscure our hard work.

There are many steps in a medical encounter that force patients to wait for things to happen. In a typical outpatient office visit, patients can show up on time for an appointment but not see their provider for over an hour. Furthermore, wait times can vary widely, depending on the location of the office (urban versus suburban, academic medicine versus community medicine) and even the day of the week.

Patients can become quickly frustrated if they feel that they are waiting for no good reason. Whenever possible, let patients know upfront how long they should expect to wait and why they are waiting. This communication can be accomplished by something as simple as placing a sign in a waiting area or treatment room with expected wait times for office visits or procedures. If something does go wrong, such as a lab test being misplaced, explain this to the patient, apologize, and do your best to rectify the situation as quickly as possible.

Patients can also become angered when they see staff joking with each other, checking e-mail, or making personal phone calls. Patients seeing these behaviors may feel that they are being ignored and being made to wait unnecessarily. If you are on break or need to take care of some personal business, do it away from patient care areas so as to not appear indifferent to patient needs.

Mr. Smith is a patient who has come to the Emergency Department (ED) with ankle pain after a fall. He is upsetand complaining to the nurses and doctors because he has waited three hours to be seen.

When you enter a room to interview or examine a patient, be sure to introduce yourself and to explain your role in the patients care. If the patient has other people in the room with him or her, be sure to identify their relationships to the patient.

Hello. Im Dr. Gordon. Im a doctor in the Emergency Department and Ill be responsible for your care here today. [To a woman sitting with the patient.] Are you here with Mr. Smith?

Apologize for their wait. If you were the patient, you wouldnt want to wait either.

Im very sorry that you had to wait so long to be seen. We have not forgotten about you, but we are very busy today. We always make sure that each patients problems are fully evaluated, and some problems take longer than others.

Acknowledge that you understand that the patient is upset, and then try to address his or her concerns. In addition, if your exam room allows it, sit down when you speak to patients. Studies have shown that when physicians interview their patients while sitting down and at eye level, patients overestimate the amount of time the physician was in the room with them.

I can see that you are upset about having to wait to be seen. You are right to expect to be treated quickly when you come to our hospital. Here is what I can try to do to get your x-rays done as soon as possible.

Emphasize to patients that you will do what is needed to take care of their medical problem.

Im here to help you now and Ill spend as much time with you as you need.

Try to give patients periodic updates on the status of their care.

I just spoke with the radiology technician, and she is sending your films to the radiologist right now. We will try to get you out of here as soon as possible.

Mrs. Lee is waiting to see her dermatologist in the exam room of an outpatient office. She is having a follow-up visit after a skin biopsy. She is mad that her dermatologist hasnt been in to see her yet.

Letting patients know why they are waiting can often calm them down. If they realize that there are reasonable, or sometimes unavoidable, delays in their care, they may be more accepting of a wait.

Im sorry that you have had to wait, but let me tell you the things we have been doing while you were waiting. I have reviewed your chart and the blood tests you had since our last visit. We also had to call the pathology lab because they had not sent over your results yet. In addition, my office staff had to contact your insurance company to verify your coverage. We have gotten all those things squared away, so now Im here to focus on you.

Mr. Ford recently had a cardiac catheterization for chest pain. His cardiologist sent him to the ED because he hasswelling and pain in his groin where the catheter had been inserted into his femoral artery. He needs to have an ultrasound of his groin to make sure that he doesnt have an abscess or pseudoaneurysm. Unfortunately, its a weekend night, and there is no ultrasound technician available until the morning.

If there is going to be a delay in some part of the patients diagnostic or treatment plan, let him or her know about it up front, and explain the reason.

I just want you to know up front that we wont have an ultrasound technician here to do this test until the morning. I know its a real hassle for you to have to wait this long, but I think this is a very important test.

If we explain the importance of tests or procedures, patients are often more accepting of delays.

There can be some serious causes of your symptoms, such as clots or damage to blood vessels. I want to make sure that we get the right diagnosis for your pain and swelling. Unfortunately, I cant make any decisions about your treatment plan until I get these test results.

Let the patient know what you can get done while he or she is waiting.

What I can do is call the radiology department so you are first on the list for testing tomorrow. While you are here overnight, we will give you all of the pain medicines you need and monitor you closely.

Mr. Hurwitz has presented to the Internal Medicine clinic at University Hospital to be evaluated for hypertension. He is complaining to the attending physician because a medical student and then a resident have interviewed and examined him.

According to the Association of American Medical Colleges, there were more than 1,000 teaching hospitals in the United States in 2009. Patients seen at teaching hospitals are cared for by medical students and residents.

Im tired of seeing you trainees. I want to see the real doctor. I dont want to have to keep repeating my medical history to the nurse and then the medical student and now some resident.

Patients can become aggravated by having to undergo repeat interviews and physical exams. Nevertheless, performing a history and physical exam on numerous patients is essential to developing clinical skills. Let patients know that at a teaching hospital, they will see people at all levels of medical training.

Im sorry you have had to repeat your medical history so many times. This is a teaching hospital, and that means that we have medical students and residents here, but we all work together. Sometimes, being seen by more than one person can help jog your memory or tease out some important details. I also want to emphasize that as the senior physician, I supervise all of your care.