Patients should know more about how to use their Doctors, and Doctors should guide how to use them best. I want to introduce the idea of a Doctor User Guide.
Even dating apps give some guidance or guess to the person you are about to meet, let alone help you with your health problems. It is a relationship that should start with a solid foundation, good communication and expectations for the doctor and the patient. A Human user guide has been around the business world for a while.
A Doctor’s User Guide isn’t just a piece of paper. It’s a tool to foster a constructive and collaborative relationship between doctors and patients. By outlining the expectations and preferences from the outset, a guide is a stride towards more effective and enjoyable healthcare experiences for doctors and patients. It’s about making the healthcare journey less about guesswork and more about working together towards better health and avoiding bumps, misunderstandings and challenging conversations.
For Patients:
A guide helps patients know their doctor better before entering the consultation room. It provides insights into the doctor’s practice preferences, medical approach, and what they expect from their patients. This way, patients can prepare better for appointments, know what questions to ask, and how to follow through with medical advice.
For Doctors:
On the other side, I find in my practice that there is a benefit to having their expectations laid out from the start. This guide allows doctors like me to share their medical philosophy, how they prefer to communicate, and what makes a good patient-doctor relationship. By having these points clarified early on, we doctors can enjoy smoother interactions with our patients, which can lead to better job satisfaction and a more efficient practice.
Shared Benefits for the Doctor Patient Relationship:
Better Communication: The guide opens up a channel for clear and effective communication. It lays the groundwork for open discussions crucial for successful healthcare delivery.
Clear Expectations: By outlining what's expected from both ends, a guide helps in aligning the goals of the doctor and the patient, ensuring they are on the same page regarding the treatment plan.
Increased Satisfaction: When there’s clarity, satisfaction follows. Patients appreciate understanding their doctor’s approach, and doctors value well-informed patients. It allows patients to select doctors that provide services with better informed choice, and it allows doctors to signal their preferences and end up with patients they enjoy working with.
Empowered Patients: A guide educates patients about their doctor’s practice, empowering them to take an active role in their healthcare journey.
Efficient Practice: With clearer expectations, the workflow becomes smoother. This efficiency can lead to a better-managed practice and improved healthcare delivery.
What does a doctor user guide look like?
My DUG is more creative, but I want to be authentic to my patients!
Feel free to use my guide below as a Template and modify it with your answers, or use a more blank template with suggestions.
Introduction
Name: Dr Dan Epstein (Call me Dan; it's OK! Kids call me Dr Dan, which is cute.)
Specialty: General Practice
Medical School & Graduation Year: Monash 2014
A brief personal introduction: I like podcasts, watching the football and riding/running
Medical Philosophy
Approach to Diagnosis and Treatment:
I consider symptoms and your lifestyle, stress levels, and overall well-being. I aim to find the root cause, not just treat the symptoms. I also like to prevent things before they happen, so I will probably ask about preventative health. That is why I like to hold at least 15 minute appointments, with the first appointment with me being 30min, so I have time to get the whole story.
Preferred Treatment Modalities:
I prefer prevention where possible! A mix of lifestyle modifications and medications, where indicated, are my go-to. I refer for Surgery if I think it is indicated but try to avoid invasive risky options if possible. We can together discuss the risks and benefits.
Approach to Alternative Medicine:
I'm open to exploring alternative medicine options as complementary treatments, provided they have a sound evidence base won't cause harm, and are administered responsibly.
Measures of Treatment Success:
Sometimes you can't fix everything. Beyond just alleviating symptoms, I gauge success in terms of improved quality of life, enhanced functionality, and patient satisfaction with their state of health.
Appointments
What to Expect:
Duration of typical appointment: First appointments are 30min, then 15min regular appointments unless the issues are complex or multiple. It is hard to address more than 1 issue per appointment so, if you have a list, consider booking 30min. You wouldn't want an accountant to rush over your tax return, so you don't want me rushing over your health issues!
Structure of the appointment: Tell me up top what all the things you want to discuss are, that helps me manage time. If there is anything urgent or important to you, tell me that first. We will have an initial discussion about your concerns, followed by an examination, and then a discussion on diagnosis and treatment plan.
Expected wait time: I strive to stay on schedule, but unforeseen delays happen in my job, and I can't kick someone out of the room if they are complex or emotional or need my support. So know that if I am running late, I am helping someone, and maybe one day, that person who needs extra time is you! Typically, Data suggests my wait time is mostly under 10 minutes.
Practice Preferences
Preferred Methods of Communication:
I prefer patients book an appointment to discuss most things so I can dedicate time and headspace to it. Small messages can be appropriate to leave with my front desk staff so I can call back between patients. Occasionally I text or email patients' results but don't check my clinic inbox on non-clinic days. If it is urgent, calling the clinic is best.
Availability:
I am in the clinic on Tuesday and Thursday between 8-4. I usually do my paperwork early in the day before seeing patients at 8, but at 4pm I am out the door to go for a ride home! In my non-clinical days, I do research work and write about my interests in behaviour change and decision making. Being a part time doctor can become tricky for avaliability. Some other doctors at my clinic cover my off days and have access to the patient notes.
Why don't I respond to your message?
It is probably because I am busy with a patient. If I don't find time to respond, I will at the end of the day or during my lunch break. But sometimes I miss those to catch up if I am running late. (Don't worry; I still eat)
Preferred Scheduling System:
You can book online or by calling the office. If you need regular appointments, book them 1-2 weeks in advance because I can book out sometimes.
Cancellation Policy:
I want to make sure each appointment is filled with someone needing healthcare. So please call 2 hours before your appointment if you need to reschedule so we can give that slot to a waitlisted patient. Otherwise, I will have to charge our clinic late fee!
Preparing for Your Appointment:
List of current medications and dosages: If I don't know them yet, Please bring along a list or the actual medication bottles.
Medical history and recent test results: If I don't know this already, Any relevant documents from past medical consultations or recent tests can be emailed to our reception. Please do this 2 days before our appointment so I can have time to review it.
Preparing questions and concerns in advance: It helps to jot down any questions or concerns to ensure we cover everything during your visit. It is pretty common for people to forget to ask me something.
Raising Concerns:
My preferred method for discussing sensitive or complex issues: Feel free to bring up any issue during our consultation. I'm here to listen and help. It's my job to talk about all things bodies. This includes stuff you wouldn't bring up at the kitchen table. But in person is best. Telehealth can be hard sometimes with certain problems.
Prescribing Practices
My approach to some medications: Many doctors over-prescribe some medications like antibiotics and pain medications. I try to only presribe these if they are indicated and use guidelines and experience to help me decide these choices. They can have adverse effects. Try to remember that you are coming to me for advice, and sometimes, not requiring medication is a good thing. For example, many patients can feel disappointed if I say they don't need antibiotics. Still, a doctor that provides an honest expert opinion is the type of doctor that you want to make independent decisions with you about your health.
Approach to Generic vs. Brand Name Medication: If it has the same ingredient, you can save money just by buying generic.
Prescription Renewal Policy: Try, if you can, to book the week you are going to run out of medication, not on the day! We often need to check if it is still the correct dose and if the medication is still indicated or do some tests first.
Billing
Billing type: I work at a private clinic, which means Medicare reimburses you for some of the appointment cost, but we charge a fee on top of this. If you have a full pension card within the expiry date, we offer a discount.
Why do we charge on top of the medicare bulk billing rate? This allows us to run a clinic to practice the patient-centred service of medicine at the level we want to provide. If we billed at the medicare rates, we couldn't cover our overheads with 15 minute appointments and would have to have 5-10 minute appointments. I don't feel good complex healthcare can be done in this time and I would burn out practising with 6 patients an hour, have less job satisfaction and make less considered decisions about your care.
Billing Cycle : You will have to pay after your appointment and the clinic rates are displayed on the website.
Payment Methods Accepted: We accept most major card payment options and prefer this to cash.
Financial Assistance Options: We do occasionally make financial exceptions for billing, but this is a case-by-case basis and not ongoing. Please ask our front desk before you book an appointment to discuss your situation and not during or after the appointment. This places unrequired tension in the clinic-patient relationship. However, if you do not have any medicare and you identify as an asylum seeker or refugee, I also work pro-bono at the Asylum seeker refugee hub.
Tips on Being a Good Patient
Being Prepared (see preparing for appointments)
Providing information
Let me know about any new symptoms or changes early. Picking things up early is a key to good outcomes in healthcare.
Scheduling and attending follow-up appointments: It is important we check in on how things are going. Even if things are stable, it is good for me to know. We can work out what timeframe is suitable for a follow up.
Adhering to treatment plans: It is important to try to stick to the plan! If you have a concern about the plan, want to make changes or have trouble sticking to it, let me know! We can discuss it together.
Open Communication:
Sharing any concerns or fears about treatment: My job is to provide you with the information you need to make your own decisions. I will do my best to highlight the options and their benefits and risks. This of course includes your personal beliefs, worries and questions. So please bring them up because if I don't know them I can't address them. We will discuss the best options for you, and I am there to support you through the decision making.
Disclosing all relevant information, even if it seems unimportant: Try to give me all the information you think is relevant, even if you think it is silly. A good understanding of all the information helps me a lot.
Asking for clarification if something is not understood: If I explain something and it is too complicated or doesn't really make sense, tell me! It is important to me that I communicate in a way that works for you. Healthcare things are complicated, and I am always improving how I break down these complex things.
Additional Notes
I am very happy welcoming all diversity of patients, including Indigenous First Nations patients, LGBTQI+ identifying patients and any age or background. One of the best things about my job is meeting and learning all about different people.
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