A Medical Economics Web Exclusive

How do you come across?

Good communication is the best way to prevent conflict from spreading like a bad cold, says this doctor.

By John R. Egerton, MD
Family Practitioner/Friendswood, TX

In a medical office, where personality differences and the difficulties of serving a sometimes demanding public can easily strain tempers, it pays to be aware of how contagious a bad mood can be.

One day, after I asked my nurse where the needle holder was, she glared at me as if I’d accused her of something grossly immoral. She’d been rather cool all day, I’d noticed.

Just what I needed, I thought–a nurse in a foul mood, when everything else was already going wrong. I’d spent the weekend searching in vain for misplaced documents needed to prepare my income tax return. My father had been admitted to the hospital, and we didn’t know how seriously ill he was. A leaky toilet had flooded the bathroom and soaked the bedroom carpet. My car was in the shop.

At first I tried to ignore the nurse’s chilly demeanor, attributing it to the stress of a busy Monday, but finally I said, "Is something wrong?"

"There obviously is. Will you tell me what?"

"Sorry?" I said.

"You’ve been snapping at me all day. What have I done wrong?"

Me snapping? I’d been irritated by her mood and my own problems. Maybe I hadn’t been my usual cheerful self. But I didn’t think I’d been snapping.

I apologized, explaining that I was distracted by things that had nothing to do with her. She made sympathetic noises and quickly thawed.

Until then, I hadn’t realized how much others–maybe employees in particular–could be affected by subtle changes in my mood. The sense that an employer or colleague is displeased can upset the delicate balance of a work relationship. When things get off kilter, it’s important to speak up.

Another time, I noted with irritation that one of our receptionists was putting in several hours of overtime each month, yet during the day, she had time to chat with her co-workers. When I pointed this out to the office manager, she said, "But part of her job is to close the books at the end of the day. Every time you run late, she has to stay until all the patients have been seen."

Now, instead of getting annoyed when I see the receptionist chatting, I try to finish the afternoon on time and discourage unnecessary walk-ins. It pays to communicate–specifically.

Shortly after a new receptionist started in our office, my nurse and I both became frazzled. The new staffer was scheduling as many as three patients an hour for complete physicals requiring blood tests, ECGs, and other services beyond the scope of a regular office call. We couldn’t keep up, and the waiting room was backing up with grumbling patients.

"Please spread out the physicals so I never get more than one each hour," I told the receptionist.

"Okay," she said. "No problem."

But days later, I still faced back-to-back annual exams.

"Look," I reiterated, "You mustn’t book me for all these physicals."

"But I’m not," the receptionist said, pointing to the scheduling book.

It turned out that patients didn’t always specify "full physical." Sometimes they requested a check up, blood pressure check, diabetes check, or insurance exam. The receptionist had no idea how much time each would take; I’d never clarified that.

Now, I have her ask for more specifics when patients call for appointments, and book any kind of "check" or "exam" as a full physical.

Gender differences can influence perceptions, too. As I, the only male in our office, eloquently commented at our regular meeting yesterday, "in an office like this with a bunch of women all working together, I think it’s amazing that we get along so well."

I can’t figure out why my nurse is scowling today; I don’t think I’ve been snapping. I’d better talk to her later.

John Egerton. How do you come across?.

Medical Economics

2002;10.