Viewpoint

Our Policy: The Door Is Open

FROM THE CHIEF MEDICAL EDITOR

Larry E. Patterson, MD

No, I’ll not be discussing United States international trade policy with China. Although that’s an interesting topic, my own open door policy goes back 25 years. It’s an important policy to both my staff and patients, and I was reminded this week of how important it is.

LEFT ALONE ON THE EXAM TABLE

As a private pilot, I’m required to undergo a flight physical every two years. Mine was due, so this week I saw the Aviation Medical Examiner to complete said task. After the initial paperwork and pretesting, I was escorted to an exam room and sat on the edge of the exam table—the kind that has that paper pulled across the length and over the edge (for my protection). The assistant closed the door, and I waited. And waited. I’m not sure how long, maybe 45 minutes, and I’m not sure what people did in the past before smart phones. Fortunately, I used that time reading and responding to e-mails, and looking at funny cat videos on Facebook.

But still, for what became an unnerving amount of time, I was sitting there alone with the door shut. Perhaps I’d been forgotten. Maybe everyone had gone home for the day. It was quite a relief when the doctor finally arrived. He turned out to be a great guy and I’m happy to say I can continue flying.

AN OPEN DOOR OPPORTUNITY

Which brings me back to 1989, when I contracted a consultant, the late Bill Borover, to come and help give me general advice for my startup practice. Among other things, he suggested I leave the exam room doors open all the time, even when I was seeing patients. As time passed it became impractical to keep the doors open during the actual exam for privacy reasons, but we realized it made great sense to leave them open the rest of the time.

Why? From the patient’s standpoint, they don’t feel left alone. They can see workers passing by, and know they haven’t been forgotten. Occasionally all of us get behind, and the guy left behind closed doors will wonder what’s happened.

From the doctor’s standpoint, keeping the exam doors opened helps you from a security standpoint. You have expensive equipment in there, and some folks left alone will be sorely tempted to play with it. Or borrow it. And you don’t have to knock before entering—it’s already open.

Because we’ve done this for 25 years, I forget about this small but vital standard operating procedure. When I visit a doctor who confines me in a closed off room, I always feel I’ve stepped back in time. So tomorrow, keep your patients’ doors open before the exam. It’ll feel odd at first, but soon you and your staff will wonder why you’ve been shutting the door in your patients’ faces to begin with! OM