Over coffee each morning, I quickly skim the headlines on my laptop before heading to work. It is Washington winter, it is dark outside, and the headlines in health care news are grim. Health care workers are burned out. Doctors are working hard all day and coming home to find scathing reviews on online rating sites. Some have their compensation tied to the results of patient surveys. Patients are trusting Google searches over their doctor’s advice. Doctors are leaving their practices. Should I leave too? I could become a dog-walker. Dogs cannot write online reviews.
I thought I loved my job, but these daily reminders of how terrible it is to be a doctor make me want to climb back in bed and wait for the sun to rise. “This forced morning person ritual is for the birds anyway,” I tell myself. Instead, I will pour more coffee, flip on my “happy light,” and try to find a reason why I should not leave today. Yesterday I stayed because I remembered that I get paid to do this.
Today I am not leaving clinical practice because my patients appreciate what I do.
I know this because they have told me in person. They say things like, “You saved my life,” when all I did was take out a herniated disc. Others say, “You saved my life,” and they actually were on death’s door when we met. Sometimes they are grateful enough to write a note or bring me elk meat, salmon, or chocolates. The chocolates are my favorite. I keep a drawer in my desk just for warm fuzzies: notes and gifts from my patients. On top of my desk is a rock carving that a patient made to show me how much better his hands were working after surgery. When I have had a rough day in the hospital or worked with a more challenging patient in the clinic, I take a deep breath through my nose and look through some of the notes. It is therapeutic.
Sure, I have had a negative review, and it stings. I was stunned when a person using a cartoonish pseudonym wrote some outrageous comments about me on Google. It probably served me right for Googling myself. Egomaniac!
A few years ago, I was faced with the news that, although I believed myself to be quite the sensitive doctor, I was one percent less sensitive than I needed to be. I scored 84 percent on the key question on my Press-Ganey patient surveys and needed to score 85 percent. Anyone in my organization scoring less than 85 percent was required to attend a three-hour session on patient experience. Being time-obsessed, I was outraged that I had to spend three precious hours on training that was clearly geared toward those other boors who don’t know how to communicate with their patients. I went. The doctors leading the session had some clever hacks for getting more out of a patient visit. I made peace with Press-Ganey since it is not going away. Looking at the data they collect, my actual patients leave some nice feedback. I have become at least one percent more sensitive.
Today, I will ask my patients if they are glad that they had surgery. Most will say, “Yes,” if I am doing my job right. I will spend some time with the ones who are not sure and listen to their concerns. This is what I would have liked for Ms. Cartoon Name if she had come to me. Often we can solve simple misunderstandings face-to-face, like explaining that the term “cerebrovascular accident” is not an accident at all.
Today I will stay.
Barbara Lazio is a neurosurgeon.
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