Howzat?

I like my job.  I like my coworkers.  I like the overwhelming majority of the patients.  Most of them are reasonable, pleasant, decent people but there are always a few who keep things...um...interesting.

Recently we had a new patient come in.  I handed him the paperwork and explained what was necessary.  He looked at me like I was from Mars.  Yes, he spoke English.  Yes, he seemed to be of normal intelligence.  Occasionally, some of the language on the forms throws people so I am perfectly happy to explain terms that are unfamiliar or do my best to clarify questions if needed.  There was none of that with this guy.  He just wanted nothing to do with the forms other than to put his name and address on them.  The thought occurred to me that perhaps he was unable to read but he seemed to be able to make out other things that would indicate he could read.  He just didn't want to be bothered. 

He came up tot he desk three times to protest the need for the forms.  I gave the standard responses about the doctors needing the health information so they could give him the best possible care to him.  I asked if he needed help with the forms.  Nope, he just didn't want to do them.  The exam should give all the information the doctors needed.  By this time I was getting busy at the front desk with other patients so I asked our records girls to continue with the gentleman.  She had the same problem with the man but she has the patience of Job and such a sweet nature she can coax the most stubborn patients.

Later on I told her I admire how well she handles the obstinate folks because it just annoys the crap out of me when people argue about something as simple as filling out a form.  Records girl just smiled sweetly and said in the most gentle tone pretending to address a mulish patient, "I have three like you at home.  You can't beat me down anymore than they have so let's just get on with it shall we, you twit?"  Ah yes, we all need to find a way to cope. 

The next perplexing patient was one who came in late last week.  I had never seen her in the two years I work in that office.  She marched in the door without an appointment and let me know the doctor doesn't charge her full price because she's a hardship case.  Ok, well, office policy is we need copies of tax returns each year to justify continuing hardship arrangements and you haven't been here in two years so it's full price until hardship is re-established.  She protested she is in the same job she was in two years ago when she was given the hardship rates.   Mind you I did notice the shiny new car she was driving, the designer wallet pulled from the VERY expensive purse, and the Iphone clutched in her hands with freshly lacquered 2 inch nails.  Her two year old was wearing a ridiculously expensive brand of sneakers and mention was made of going out to a pricey local restaurant after the appointment as well as a recent vacation to Cancun.  Oh, and she didn't bat an eyelash at handing over a debit card to buy nearly $100 worth of orthotic pillows.  Though I am no math whiz this is not adding up in a logical manner.  That's hardship?

Then we have the patients who just have no time.  Today brought the lady who was being re-evaluated and wasn't sure she had the extra 15 minutes for that.  Uh, you made the appointment.  If it became apparent that it wasn't going to work perhaps you could have called to reschedule.  We are VERY flexible about that.  We don't charge for late cancellations and it is rare we can't get you in the very next day if today doesn't work.  She was in such a dither at being held up when she came to check out she wanted to use my desk phone to order takeout because as she reasoned, if she waited to get within cell range she'd have to wait some more for the food but if she called from the office she wouldn't have to wait. Her level of tension over the time is pretty standard.  One time she was so cranked up I told her she had to take three deep breaths before I'd send her back to the doc.  She thought I was kidding.  I was not.  Whenever someone enters in a tizzy and tells me about all the other people they have to take care of and responsibilities pressing on them  I just let them rant away.  Once they get it all out I tell them this is their time to take care of themselves, no one else, and to take a deep breath with me right there at the desk before they proceed.  I get some weird looks but then they comply and they smile and are surprised to find they actually feel better.  This lady, nope.  She is just on full throttle every waking moment.  No time for the frivolity of a deep breath?  Sugar, you're going to have a stroke before you're 50 if you don't lighten up.

Finally,  we have the ones who demand special accommodation such as the guy who wants to be on a special schedule for reminder calls.  Front desk staff do reminder calls the day before the appointment.  I specifically choose whatever time of day is slowest in the schedule as the time I do the calls.  This character wants instead to be called the same day as his appointment but only about three hours in advance.  Really?  (Mind you we do strive to give personal attention, I keep track of several categories of preferences for a lot of our patients, who likes/dislikes receipts, who likes which exam room/doctor, remembering names and asking about other things patients remark on in conversation like vacations or other family happenings, other routines that comfort the anxious folks while they are IN the office.  Heck, I even had one somewhat infirm elderly patient who had given me explicit permission to retrieve a wallet from a pocket in a walker because fumbling around for it and in it was truly a difficulty for him.) Call you three hours before your appointment...you've got to be kidding.  You're a grown man with intelligence and education and no disability.  Sure, I've got phones ringing, people showing up unannounced, others arguing about forms, others with appointments who think the times are mere suggestions, patients needing to be checked in and out, and patient flow to be kept at a proper pace but sure, I'll drop it all just to give you a jingle at precisely three hours before your appointment.  Get real.

Now if you'll excuse me.  I'm going to go take some deep breaths.