Sunday, May 1, 2022

How Do Patients Choose Doctors?

My last blog post contrasted the experience of being an employed physician with being a private practice doctor. I expressed that at this stage of my career that I much preferred being employed to running a medical practice. (This means that I can now spend all of my time just being a doctor!) But there are desirable features of private practice medicine that simply do not exist in the medical megalopolis where I now work. Not surprisingly, the vibe is different in a gargantuan organization that employs tens of thousands of caregivers, staff and support personnel who serve millions of patients domestically and overseas. 

It is simply not possible to recreate the intimacy that I enjoyed in my prior small practice with my patients and my own staff.  Here’s an example that will illustrate my point effectively.

Telephone Directory

Here's how I found my doctor!

For as long as I’ve been practicing medicine, I’ve queried every new patient who came to see on how they ended up with me.  Yes, there were a handful who found me in the phone book (readers under the age of 40 are encouraged to google this item) and some who simply wandered into the office with digestive issues.  But most of them had a more personal reason that led them to my office.  I would routinely hear remarks from patients similar to these:

My dad loved how you fixed up his stomach for him and told me to come here.

I got your name from my neighbor who raved about you when she was in the hospital.

I looked up your reviews and wanted to see you.

I am not citing the above examples in a boastful or self-promotional manner.  Indeed, nearly every doctor has similar vignettes and examples of patient loyalty.  When a patient has made a conscious and deliberate decision to see a particular doctor, this automatically advances the doctor-patient relationship. Every restaurant or tradesmen or consultant or retailer appreciates a word of mouth referral.

In my current job, I do see some patients who were referred to me by other patients, but this is much less common.  Typically, patients or their primary care professionals call a centralized scheduler who scans the sea of gastroenterologists and plugs the patient into an available appointment slot.   Of course, there is no difference in the quality of my work, but the vibe is not the same.  When I ask these patients how exactly they came to see me, often they reply ‘I don’t know.’

Remember (or imagine) going to the local hardware store in search of a particular tool?  You would be greeted by a friendly associate or maybe even the owner to assist you.  He might even know you by name.  While one could purchase the same item in a big box store, the experience is not the same.

When an organization is dealing with zillions of patients, guess who prevails in the Intimacy vs Efficiency contest?



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