Need advice-- Gaining Trust/Respect from Patients

[primadonna22274]

Sorry Feb it was in response to a dumb post a few back that definitely doesn't fit in with the theme of this thread. Sorry, OP. This gets under my skin.

Now to the OP's question: you've gotten some good advice. Personally I am not a fan of "dumbing it down" but I do very much believe in speaking at the patient's level. If you let the patient talk for a few minutes you will get a very good sense of his/her educational level and be able to tailor your interview accordingly.

Dress comfortably but appropriately. Definitely don't show cleavage or otherwise revealing clothing. You can work on developing a more "mature" voice. A new hairstyle may help. Nothing can substitute for an aura of confidence--don't let them see your insecurities. It gets much better with time and a few white hairs (although I pluck and color those!)

[jdenning]

My MAs are awesome - they prep the patient for me and ask them, "have you seen Janis before? You'll love her because she's thorough and awesome." Then I come in and tell the patient that I'm the PA for Dr. Such and such and there is rarely another question about it after that because we dive into the visit.

There is an art to making it look like you know what you're doing....whether you actually know or not. Take control of the encounter - you drive the visit, not the patient. Always look and sound professional and there won't be any question about your professionalism.

[OneFishTwoFish]

most people know what a PA is. besides, when they checked in, or made the appointment, they were told they would be seeing the PA. or if they weren't, they should be. so maybe educate the front office staff on clarifying with patients who they are seeing.

 

and this might sound like strange advice, but rather than go in saying, "what brings you in today?", look at their chart and KNOW why they're coming to see you. then you go in and say, "hi mr. smith, I see you've been having headaches. let's see what we can do for you".

 

patients feel more confident with their providers if they know they are dealing with someone who has a bead on them from the get-go.

I look through the entire chart before seeing every pt... I only ask that so I can hear what their concerns are in their own words. About a third of the time it's not quite what was written in the chart... But for the reasons you've mentioned, I can adjust how I handle this.

[Simplify]

My MAs are awesome - they prep the patient for me and ask them, "have you seen Janis before? You'll love her because she's thorough and awesome." Then I come in and tell the patient that I'm the PA for Dr. Such and such and there is rarely another question about it after that because we dive into the visit.

There is an art to making it look like you know what you're doing....whether you actually know or not. Take control of the encounter - you drive the visit, not the patient. Always look and sound professional and there won't be any question about your professionalism.

Maybe I am picking at details here, but often I feel like the devil is in the details.  Introducing yourself as the PA FOR Dr. Such and such inherently implies a sense of ownership that the patient will pick up on.  As a profession, we need to advance the idea that we are colleagues, NOT assistants.  I feel that even a subtle shift can go a long way towards furthering this cause.  How about stating, " I am PA. X working WITH Dr. Such and such, or even better, "I am PA X. a clinician working in collaboration w/ Dr. Such and such."  We are already at a disadvantage due to a professional name that is woefully inadequate.  The obligtory followup description of what an actual PA is, however, falls under the pervue of the provder- be smart and purposeful with your language and do us all a favor.

[wjm7]

Maybe I am picking at details here, but often I feel like the devil is in the details.  Introducing yourself as the PA FOR Dr. Such and such inherently implies a sense of ownership that the patient will pick up on.  As a profession, we need to advance the idea that we are colleagues, NOT assistants.  I feel that even a subtle shift can go a long way towards furthering this cause.  How about stating, " I am PA. X working WITH Dr. Such and such, or even better, "I am PA X. a clinician working in collaboration w/ Dr. Such and such."  We are already at a disadvantage due to a professional name that is woefully inadequate.  The obligtory followup description of what an actual PA is, however, falls under the pervue of the provder- be smart and purposeful with your language and do us all a favor.

 

I completely agree.  A very good point.

[AREID]

A lot has to do with how you walk in and talk to the patient. You have to walk in with confidence and at least appear to be in charge of the situation. Maybe try raising/projecting your voice a bit, even acting just a little bit cowboyish if you get me. Good eye contact, a firm handshake, and sit in a way where your body language projects confidence. If there's another person in the room, shake their hand too. You cannot be too friendly with some patients. Sometimes you have to sort of be "the boss", if you get what I'm saying. Some pts yearn for that patriarchal relationship where the "doc/PA" just tells them how it's going to be. Others will appreciate you coming to them as an equal. You have to gauge as you go and adjust.

 

I believe this to be 100% true. I look VERY young. Every patient I would see would ask me how old I was, or if I knew what I was doing. I haven't had that asked of me in one year, and I look the same. But I enter the room completely differently

 

 

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[skyblu]

Maybe I am picking at details here, but often I feel like the devil is in the details.  Introducing yourself as the PA FOR Dr. Such and such inherently implies a sense of ownership that the patient will pick up on.  As a profession, we need to advance the idea that we are colleagues, NOT assistants.  I feel that even a subtle shift can go a long way towards furthering this cause.  How about stating, " I am PA. X working WITH Dr. Such and such, or even better, "I am PA X. a clinician working in collaboration w/ Dr. Such and such."  We are already at a disadvantage due to a professional name that is woefully inadequate.  The obligtory followup description of what an actual PA is, however, falls under the pervue of the provder- be smart and purposeful with your language and do us all a favor.

Absolutely agreed. Nothing irks me more than when one of the attendings tells the patient "Skyblu here is *my* physician'S assistant". Um, no. I am not yours, and I am not "apostrophe S" to anybody.

 

I'm in the ED. Nobody asks too many questions. I walk in authoritatively, with my white coat on, and say, "Hello, my name is (Skyblu), I'm one the physician assistants here, and I'll be your medical provider today. Now tell me, what brings you in to the ER?"

 

I've never had anyone question my role or my authority. I even had a patient who was an old surgeon, retired from our staff, and who initially said, "I don't want to see a PA." I politely explained that was certainly his decision, and the attending would be happy to see him, but I could not say how long the wait would be. I offered, also politely (although inside my head I wanted to wring the arrogant old bastard's neck) whether he would mind if I got things started by taking a quick history so I could at least order labs and get stuff "cooking." I took care of him with the attending, and in the end, the crotchety old man grudgingly told me that we had "opened his eyes as to how much PA's know." 

 

Always wear your white coat, it helps define your role. If you work in an office, I suppose street clothes can be seen as "what the doctor wears". Never wear cutesy scrubs, unless maybe if you work in peds. Wear grown up hair, makeup, and definitely use an adult voice, no up-ending (you know what I mean? When you say sentences that go up in tone at the end? Like everything you say is a question?) Watch an episode of the Kardashians and speak in the exact opposite way they speak. ;)

[OneFishTwoFish]

I believe this to be 100% true. I look VERY young. Every patient I would see would ask me how old I was, or if I knew what I was doing. I haven't had that asked of me in one year, and I look the same. But I enter the room completely differently

 

 

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It makes me feel better in the meantime to know I'm not the only one :) I also get "you don't look old enough to be doing this". Love that one.

[EMEDPA]

You might find in the ED actually that you get LESS of it, because when someone's actually sick they just want someone to help them and they're less concerned with titles.  The guff, if it comes up, usually comes from family members rather than the patient themselves.

or assclown specialists on the phone who "don't talk to PAs".

I agree with many of the above statements. never say assistant, never say " I'm Dr smith's PA".

I am a PA. if someone asks what that is I describe the educational process and my experience without ever using the word assistant. pretty hard to be an assistant when you work alone.

[GetMeOuttaThisMess]

^^^. Plastics on-call in ED and won't talk to PA with regard to a family that wants their angel's simple forehead or chin lac closed so it "doesn't scar". I'm at the point to where they ask "Aren't you too old to be doing this?". ????. I just take the cigarette out of my mouth and tell them that I trained with Dr. Kildare as I poor cheap whiskey over the suture set instruments.

[EMEDPA]

looking older helps as well. I wear my wedding ring at work and have a full beard. I shave the beard off occasionally and then start to get more of the questions about when will I see a doctor, etc.

no gray hair yet but will be ok with it when it arrives. my dad didn't go gray until he was in his 60s.

[EMEDPA]

^^^. Plastics on-call in ED and won't talk to PA with regard to a family that wants their angel's simple forehead or chin lac closed so it "doesn't scar".

I always mention that scar revision a year from now with plastics on an elective basis is an option if they don't like the final result of any repair.

[GetMeOuttaThisMess]

I did as well. It's also why I closed just about every wound possible with a running horizontal mattress. No dehiscence, faster, and easier to get out at time of removal. Yes, it even works well on the face. NEVER had a pt/family complain about the end result. I never did figure out why others wouldn't attempt this type of closure more frequently.

[EMEDPA]

I've never been confused with an MA.

 

It's not your title that makes you who you are: it's who you are that makes you who you are.

in all fairness you are "older" so less likely to get confused with an ma or tech and more likely to be confused with a physician. I see this with most PAs over 50 or those with significant gray hair. in my mid-40s many people think I am 30-35. part of the reason I wear my wedding ring and a full beard.

[GetMeOuttaThisMess]

Gray hair? I'm just glad to have some hair left that can still be gray!

[EMEDPA]

we have an er tech who is only 3 yrs older than I am but he is prematurely gray. sometimes folks think he is the doc...

[UGoLong]

UGoLong, on 08 Dec 2013 - 7:23 PM, said:

I've never been confused with an MA.

 

It's not your title that makes you who you are: it's who you are that makes you who you are.

in all fairness you are "older" so less likely to get confused with an ma or tech and more likely to be confused with a physician. I see this with most PAs over 50 or those with significant gray hair. in my mid-40s many people think I am 30-35. part of the reason I wear my wedding ring and a full beard.

 

***

 

This is a valid point! Still, in our practice, many of our patients are older than I am, so how you act is still important. The white coat, the conservative clothes, a comfortable style of talking with people, and being professional are important. Our new 30 year-old NP is following the same path and doing well.

[EMEDPA]

 

UGoLong, on 08 Dec 2013 - 7:23 PM, said:

This is a valid point! Still, in our practice, many of our patients are older than I am, so how you act is still important. The white coat, the conservative clothes, a comfortable style of talking with people, and being professional are important.

agree with all of this. I wear scrubs and a labcoat, nice leather shoes, good quality pants, etc.

I never understand my colleagues(both doc and pa) who wear jeans or a polo shirt at work. makes you look like a customer service rep at best buy or something. if I was a small town doc and well known to all my pts I might relax the dress code a bit, but only a bit.

[GetMeOuttaThisMess]

It's like the PA who used to post in the AAPA journal or some such who lived in the Outer Banks of the Carolinas. I always pictured him in a labcoat with a tank top, swim trunks, and flip flops in the clinic with his snorkel/fishing pole waiting at the back door. Studies have consistently shown that better dress makes a better impression but a back woods clinic population would probably be just as uncomfortable with this formal

appearance. Ah, the simple days when it was noteworthy that a PA had a relatively independent practice.

[EMEDPA]

I Ah, the simple days when it was noteworthy that a PA had a relatively independent practice.

it's noteworthy today too....many PAs today work as "assistants", present all their pts in clinic or the hospital, and have adopted the mindset that docs are uberbeings who need to ok their every decision and sign all their charts in  realtime before the pt goes home.

[Guest JMPA]

it's noteworthy today too....many PAs today work as "assistants", present all their pts in clinic or the hospital, and have adopted the mindset that docs are uberbeings who need to ok their every decision and sign all their charts in  realtime before the pt goes home.

i second that idea, most believe this false idea that the physician will protect them in a lawsuite case, oh how disappointed they will be when they find the ugly truth that they stand alone. trial day they are ultimately responsible as they physician finds it easier to just replace them and leave them to the lawyers, PAs need to realize that they alone are responsible for thier actions and should not blindly obey orders.

[OneFishTwoFish]

UPDATE: I've had 3 shifts back at my urgent care, and haven't once been asked if I'm old enough to be doing this, "when's the physician coming in?", or "what exactly are you?" I've never gone that long without hearing something like that! I wear my white coat and name tag, I started wearing my glasses, I walk in and shake everyone in the room's hand and look them in the eye when I introduce myself, and I try to sound confident. Small changes make a big difference I guess. Thanks for the advice, everyone! Hope this thread can help others dealing with the same thing!

[ventana]

we have an er tech who is only 3 yrs older than I am but he is prematurely gray. sometimes folks think he is the doc...

Out our age it is not premature to turn gray........ :-)

[delco714]

I'm 24.. only been asked how old I am once..with age references only a few times..and plenty of respect for my title..then again I'm in central Maine, and I work in urology.. giving the patients the sense you're confident goes a long way

[Brainlock]

This is the sort of statement that makes PAs look like cocky, arrogant idiots.  It's just plain laughable.  I'm astounded that someone could think this.  4/4 of medical school in 1/2 the time.  You MUST be kidding.

I am a PA and an MD. I really agree with what is said here! That post really sounded like an embellishment. I can say that my PA training helped me in medical school. But, the didatic coursework

in med school went into MUCH more depth. If Gordon's statements were true, I wouldn't have found it necessary to go to med school years later.