Searching For The Elusive ‘Perfect’ Patient

   Ever so often we have the rare pleasure of attending to a “perfect” patient. As there is a “melting pot” of personalities in the world, this extraordinary patient may have a different definition from one healthcare provider to the next.

   In my short time working as a student doctor, I have fortunately had the pleasure of working with my share of pleasant patients. Some of these patients have showered me with intriguing conversation, courtesy and even small tokens of appreciation such as baked goods. After a long day’s work, it is these patients who make the demanding nature of working in the medical profession rewarding.

   From my experience, patients’ interests in their own well-being ranges from non-adherent to the over-informed. Either end of this spectrum creates a challenge for appropriate treatment. The patient who falls in between these two extremes is considered “perfect.”

   The patient who does not trust or respect the doctor enough to try out the care plan may have delayed healing or non-healing. These types of patients are difficult because it seems like all of your care and concern is being wasted. These patients are providing a disservice to themselves because doctors begin to form preconceptions that the patient will not listen to them.

   Doctors may more readily refer these patients to their fellow peers, creating a discontinuity in care. In addition, there may be a tendency for doctors to spend less time at the “difficult” patient’s bedside and they may inadvertently schedule their follow-up appointments further apart. However, it is not uncommon for many of these patients to be regular “no-shows.”

   There is a thin line between not caring and misunderstanding a patient’s circumstances. It is essential that the individual caring for the patient communicates effectively and ensures that the patient or the patient’s caretaker understands in entirety the progression of treatment. This may involve seeking an interpreter, avoiding the use of medical jargon or physically writing down the plan.

   The “middle-of-the-road” patient is the easiest to treat. These patients are kind to everyone involved in their health treatment plan. They are organized and answer your questions without hesitation. Even if they had a miscue in following the treatment suggestions word for word, they will often confess to their mishaps. In addition, they ask informative questions and show a genuine interest in their well-being. Many of these patients are appreciative of your services and cognizant of your time.

   From my experience, the best patients exhibit patience. These patients are kind from the initial greeting until the final goodbye, despite the wait. Doctors show great interests in these patients, know them by name and anxiously await their appointments. Doctors will go “that extra mile” for these individuals. They may be more inclined to exhaust all treatment options for the aforementioned patients. This symbiotic relationship benefits both the patient and doctor.

   On the far end of the scale are those patients who are too informed. At times, these patients come off as defensive. Before you can enter the room and take a seat, these patients are shoving Web MD printouts in your face. These patients tend to ask a lot of questions but do not necessarily listen to your answer. They have convinced themselves before even speaking to you or going through a physical exam that they are suffering from the ailment that they have diagnosed themselves. It is difficult to get your point of view across to them.

   In addition, stereotypically, doctors make the worst patients. Being on the opposite end of the table is a difficult position. I have observed that patients who work in the healthcare field are constantly monitoring their care. There is nothing wrong with this approach but there are times when others may identify an aspect of your health that you overlooked. It is appropriate to give practitioners a fair chance at your care.

   Just as in any other profession, there are going to be both bad and good days as a podiatrist. The myriad of patients you see during the day will often determine if you leave work feeling rewarded or ready to retire.

   It takes time to realize that you cannot please everyone and develop appropriate coping skills so you can best serve the widest variety of patients possible. Once you master these principles, you will have the admiration of every party involved by being able to remain poised in any situation.

Ms. Ryans is a fourth-year student at the Temple University School of Podiatric Medicine and is in the class of 2010.

Dr. McCord recently retired from practice at the Centralia Medical Center in Centralia, Wash.