The A-Team

Issue: BCMJ, Vol. 60, No. 2, March 2018, page(s) 77 Editorials
Jeevyn K. Chahal, MD

My MOA: “Good morning, Dr Chahal’s office.”

Patient: “I need in today!”

MOA: “What’s happening?”

Patient: “I’m having back pain.”

MOA: “Is it urgent? How long have you had it?”

Patient: “Yes, it is urgent. I’ve had it for 5 years, and I need in now!”

My MOA asks the patient their name and takes a look at their chart. She realizes that they’ve no-showed the last three times for the same issue. She sighs and finds a spot to fit the patient in, yet again.

I am a solo family practitioner in a private practice with one full-time MOA and one part-time MOA. If you watched TV in the 1980s you may be familiar with The A-Team. My full-time MOA is like the B.A. Baracus of the team. She takes the brunt of the abuse from patients. But I pity the fool who crosses her. She is hard-nosed and serious about her job, but just a big softy underneath it all. My part-time MOA is like “Howling Mad” Murdock. He is quirky, loud, and brings an element of entertainment to the office. I guess I’m the John “Hannibal” Smith of the group. I’m always assessing the situation, creating the plan, and keeping the peace.

We face many frustrating scenarios at the clinic. Often our patients will walk in off the street and demand to be seen immediately for non-urgent issues when it’s quite apparent that the waiting room is full. We have pharmacies asking us for refills of prescriptions that I’ve never written or refills when the patient has neglected to book a follow-up appointment on a timely basis. Patients want to be seen at lunchtime, in the evening, or on weekends as they don’t want to take time away from their busy schedules to come in. Patients don’t return calls, even after we’ve left three messages, but they expect me to take their calls immediately while I’m seeing booked patients. Patients will not only not show up for appointments at our clinic, they will also not show up for specialists’ appointments. There are times when patients will complain to me about the service they’ve received from my staff. Or worse yet, patients will complain about my staff on online MD-rating sites.

I always assess each situation immediately and address the concerns, trying to support both the patient and my MOAs. And yes, we do see patients who walk in off the street, we do refill prescriptions when patients run out and don’t have an appointment, we do give patients yet another chance when they’ve broken the no-show rules, but we also try to educate patients and encourage them to become more responsible for their health. We, as a team, do a lot of debriefing of “the battle” at the end of the day. We provide honest feedback in a supportive manner, and there is often some laughter.

It all sounds pretty harsh—working in a medical clinic—but there are a lot of perks as well. We have many appreciative, kind, and interesting patients who make it all worthwhile. We see the cuddly babies, the energetic kids, the hardworking adults, and the lovely seniors. We see patients of all ethnicities and socioeconomic statuses. We get a lot of cards, chocolates, tea, wine, and most importantly, hugs, thanks, and good outcomes for our efforts.  

We are always learning and evolving. I reassess the general well-being of my staff and my patients on a daily basis. Recently, and just as importantly, I have also been assessing my own well-being. We are now opening up same-day appointments in the morning as well as in the afternoon. I am doing more home visits for patients who are elderly or incapacitated. My MOAs and I are calling a lot more patients with results to ease their minds and to save them time from having to come in. We are becoming a well-oiled machine. We are listening to the needs of our patients, as they are an important part of the team as well.

We are the A-Team. Each of has the same goal, which is to provide compassionate, timely, and knowledgeable care for our patients, and to have a good time while we’re doing it. There are many days that I look at our team and think to myself, “I love it when a plan comes together.”