By nature, I’m a pleaser. I want people to be happy, be comfortable and have their needs met. This is especially true with my patients. I never want anyone to leave the office feeling that a concern was not heard or a problem was not addressed.
An old family friend, who is also a family medicine physician, once told me that he would be happy to refer all of his adolescent patients to me. “I don’t like what those patients bring with them, “ he said. When I looked at him, puzzled, he replied, “Their parents!”
There are many instances where it isn’t enough to meet the patient’s needs. We must also deal with family members and their expectations.
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This is most apparent with adolescent patients. Mothers most often accompany their teenage daughters to their gynecology visits, and their goals are frequently different from their daughters’. This sometimes puts the provider in a precarious position.
Last week, I was running late during my afternoon office hours. I had a very ill pregnant patient who needed immediate inpatient care. The arrangements and transfer to the hospital took quite a bit of time.
When I entered the next patient’s exam room, I apologized to both her and her mother for their long wait. It was obvious that the patient’s mother was very agitated, but I tried to smooth her ruffled feathers. The appointment continued to spiral downward as the patient’s mother told me she had diagnosed her daughter’s problem and had also made a treatment plan.
After listening to the patient’s complaints, I gently explained that I thought the issue was something different and outlined a treatment plan. The mother got very angry and stormed out of the exam room, yelling that I wasn’t listening to her.
Stunned and somewhat shaken, I apologized to the patient, who in turn apologized for her mother’s behavior. She agreed to my plan of care and left the office. Her mother called my office manager to complain about me a few days later. She was mostly upset about the wait, but also felt I was undermining her authority with her daughter when I disagreed with her diagnosis and plan.
As difficult as it was for me to disagree with the patient’s mother, it is my job to look at the entire clinical picture and make a diagnosis and plan based on the facts. Although I believe that providing good care often involves patient or family input and preferences, I won’t go against my knowledge and instincts simply to make a parent happy.
Robyn Carlisle, MSN, CNM, WHNP, works as a full-scope midwife at University Doctors and Kennedy University Hospital in Sewell, N.J.
