DEAR MISS MANNERS: Part of my job is to educate patients about caring for their own health. This country is experiencing a shortage of health care resources, and too many people use the ER as a family doctor, surrogate parent or hotel.
I make every effort to appreciate each person's circumstances and not condescend to anyone. However, listening to complaints about waiting too long for care -- when the patient's actions have often led to their condition and they take no responsibility for this or for using the ER inappropriately -- is a burden.
Regardless, we must be polite. The last thing we want is for anyone to feel unwelcome and not seek our help in an emergency. Of course, patients in doubt should come in to be seen. However, patients who have a cold or toothache would find continuity of care and less waiting time seeing a family doctor or at a walk-in clinic, freeing up the ER staff for critical patients.
Would you please suggest how these messages can be phrased in the most effective way?
1. Everyone is responsible for his or her own health. One cannot expect the doctor to override an unhealthy lifestyle.
2. The doctor prescribes treatment solely for the patient's benefit. Patients who don't follow their treatment can expect to stay sick.
3. The ER is for emergencies. Nonemergency patients are asked to be patient and to use their family doctor whenever possible. We'll help them find a doctor if needed.
4. Seeking treatment early on, before a problem gets serious, is always preferred, and does not make the patient a wimp.
5. Patients should ask questions until they understand what is going on. I'd rather spend five minutes on that today, instead of having them get worse later.
6. If an antibiotic is inappropriate, please don't think I'm uncaring. We have big problems caused by giving them when they're not necessary. I will give you other forms of treatment that will be more effective.
7. Car accident patients need not worry about appearing unclean. However, before coming in for a toothache (lasting all week) please make yourself presentable.