The essence of holistic medicine is to consider the whole — the whole experience the patient has in her life, but also, in microcosm, the whole experience the patient has in the doctor’s office from the moment of arrival. And that is also part of public health — the consideration of the well-being of the entire system. We will not be a healthy society until all our systems are healthy and all our systems foster well-being.
I had an experience yesterday that still has me reeling: I had made an appointment with a holistic doctor who came highly recommended. She is a yoga practitioner and is reputed to be really in touch and connected and good…well she may be great, but I was shut down and dis-empowered by my experience with her office staff before I even got to see her and now I really do not feel I can trust her judgment as a doctor…
The office was in a beautiful building in a chic part of town…I walked in the door holding a wet umbrella (no umbrella stand to be seen) and encountered a lone surly young woman behind the desk. She gave me forms to fill out but no pen. I asked for a pen and she gave me one, but also complained aloud that there had been pens, where were they? I was distracted by her looks – she was wearing a button down blouse two sizes too small, barely covering her ample bosom…not a pleasant sight…I tried to make chit chat – she grunted and told me to go sit in the waiting area. What waiting area? There was one chair behind me…was that the waiting area? Where is the waiting area, I asked – Down the hall – she gestured vaguely and went back to her computer terminal…so I wandered down the hall and found the waiting area, found a place for my stuff and started filling out the forms…to make a long story short, in the time between showing up for the appointment and actually seeing the doctor, I was summoned to a room which I was waved toward not shown, actually shouted for from down the hall, interacted with a sour, unsmiling lab tech, experienced one staffer come up to this tech while I was having blood drawn and say bitchy things about another staff member, shouted for some more, not shown where anything was and then finally waved into the doctor’s office.
Once I was in the office, not even her own office but another doc’s with another doc’s diploma and pictures and stuff in it, I was anxious and stressed-out and feeling raw. It did not help that during the actual exam the doctor could not find a piece of equipment she needed and that as I was paying my bill I witnessed more bickering between staff, mediated by a woman who seemed to be the office manager but who was wearing a see-through lacy undershirt…and this is the office of a holistic practitioner, and a very expensive one at that…hmm…makes me wonder about her level of consciousness, and abilities of observation, and makes me not want to go back there again.
We all know that there are some deep problems with our current US health care system. Presidential candidates run on platforms that they will do something about it one way or another — universal health care, HSA’s, enforced insurance sign-up…but here’s the thing – one of the most important factors in the doctor’s office is not the tech, or the insurance, or the office space itself, although these are of course vital elements. The most important, least considered and lowest paid element is the Receptionist. Granted, I was a medical office manager, and a receptionist for many years, so I may be biased, but I also know how important the reception position is to the well being of the office and the patients and the doctor’s practice.
I was once told by an actual brain surgeon that I played a very important role in the office I worked in since everyone who enters a doctor’s office is afraid, and nervous, and I had the opportunity to put them at ease right away. I took that comment to heart, and worked to make sure that each person I interacted with had as good an experience as possible…granted, some people are difficult, but even with those people I often managed to get them to relax and smile somehow. There are little things – a big smile, a hello, a pen at the ready, information about where the water cooler is located, polite chit-chat, or an apology for being distracted if that is the case…not difficult, and so rewarding. But then, I was highly valued, treated well, and paid well by the doctor I worked with for almost 10 years. She and her manager made it a point to show me respect and eventually friendship, and I returned it in spades.
I understand how expensive it is to rent a nice office, and that tech is expensive, and insurance does not reimburse well – but the unfortunate choice many docs make is to therefore scrimp on staff salaries. Often, staff are paid very low wages and then on top of that they are treated poorly by docs who demand the best of people who have minimal training and who really could not care less about the practice since they are not making enough money to induce them to care. So those docs get what they pay for — taciturn, poorly groomed girls who could really care less about anything but their next (meager)paycheck, and who will not be there long anyway because why should they stay?
And to top it off, at this place there were maybe 3 docs and maybe 4 or 5 women behind the front desk. I guarantee that if I had a chance to evaluate the real work needs and flow of that office, that the practice could run fine with half the staff, paid twice as much — that way they could afford some educated, intelligent, caring individuals who would care for the office and the patients and most of all would actually want to be there.
I am thinking of my new chiropractor – he has a very small staff – his girlfriend manages the practice and they hired a young woman to sit at the reception desk twice a week. This receptionist is absolutely charming — her goal in life is not to be a receptionist, she is a dancer, clearly working this office gig to make some cash. But she is lovely, dresses well (by which I mean everything fits and is neat and clean, I am not talking expensive, that is not my point) and most of all, she is nice. Really friendly and warm and helpful. She is a big part of why I feel comfortable in his office and why I want to go back. I look forward to making appointments, in part because I know this young lady will be delightful and helpful and that I will be taken care of and made to feel good being there.
And neither of these two docs takes my insurance…so in both cases I was/am willing to pay out of pocket for quality and for a holistic, alternative medical approach. Because that fits with my philosophy of care and it is worth a little extra green to get really good care and experience an alternative approach. But while I am enjoying going to this chiropractor and am willing to budget my cash so that I can afford his care, I am seriously in doubt as to whether I will be working with this other doctor again. Oh, I need to see her so I can get my test results and then I will probably say or write much of what I have expressed in this blog post to her, or I won’t depending on the vibe, and then I will likely move on.
The bottom line is – the holistic doc gave me some good information, she seems like a decent enough person, I admire her achievements, and in all fairness she gave me an herbal remedy that feels good and which I will use, but in the end, the thought of allowing her to touch my body again is not palatable. How conscious and enlightened could she really be if she chooses to work in such an unconscious, negative and un-enlightened environment? Even more so if she is not even aware of how bad things are in her own office?
First impressions, the aphorism goes, say a lot – and I must say that based on my experience on both sides of the front desk, the receptionist and other basic support staff are the most important thing a doctor can be spending money on. I would rather be in an inexpensive office space with sufficient technical equipment and have a nice person greet me enthusiastically at the door than be in a beautiful office with all the nicest amenities and encounter a cold, uncaring, rude presence.