What To Do When A New Patient Is Disconnecting Before You Can Connect

The other day I was scheduled to see two new patients at the end of the day. The first new patient was more complicated than anticipated, and I spent extra time to ensure all her orders were in and that she knew where to receive her treatment. As I was walking out with that patient, a family member of my last new patient was starting to wheel her out of the exam room.

It was that “I had enough” look on that last new patient’s face. Let us call her Rose. Immediately I knew. They were going to walk out without being seen by the doctor – me.

There was an immediate sense of panic that ran through me, as if an electric wave just darted across on my chest. While still in awe, I took a quick pause. I was calm.

There was no judgment, just curiosity.

“Can I help you?” I asked.

“I’m going to leave, I don’t feel well,” replied Rose.

What crossed my mind at that time was to make sure she was medically stable. Was she referring to not feeling well physically that she had to leave – was it necessary to send her to the emergency department? Or was she tired of waiting to be seen?

Rose continued, “I waited for too long. I was told to be here forty-five minutes early to fill out paperwork.” At the time of this conversation, it was eight minutes past her appointment time.

“Your appointment time is at 3 pm. I am right about to see you. Would you like to go back (into the exam room)? Thank you for your patience!” I said, as gently as I could be.

Rose agreed and her sister turned the wheelchair back toward the exam room where they just left. Without wasting a second, I walked toward the back of my office, grabbed my medical assistant to help me take care of the previous patient. Then I swiftly entered the exam room where Rose was.

I sat down where I could see Rose and her sister directly. Focusing on how I could help Rose, I smiled and explained that we usually ask new patients to come 40-45 minutes early so that they will have all the paperwork completed before their appointment time. Then I started with asking how she was feeling.

“If I were feeling well, I wouldn’t be here,” Rose answered.

“Tell me what’s going on,” I asked.

At that moment, I sensed a shift. A shift in the room’s aura. It went from cold and isolated to warm and present. There was a sense of bonding, with both parties reaching out.

Rose went on to share with me how she had been feeling. I was looking at her attentively, listening to what she was telling me. We shared some funny moments. I explained to her what I thought was the problem and what the possible causes of the problem were. I offered a detailed treatment plan. There was time to pause. There was time to listen – all focusing on Rose. I wanted to make sure she knew that she had my full attention, and that I understood her feelings and her complaints.

At the end of our encounter, Rose thanked me for spending the time to explain things to her. As she was being wheeled out of the exam room, Rose’s face spelled gratitude and hope.

Making a connection with your patient is vital to a healthy doctor-patient relationship. You are at a disadvantage when your patient is disconnecting before you can even start the connection. This does not mean you cannot build a bridge to connect; it will just take more effort.

When a patient is walking out on you, do not panic. Pause and let yourself calm down. Be curious about the situation. The patient made the appointment and came – why leaving now?

Be flexible how you do things, especially in the unpredictable world of clinical medicine. Normally, I would have finished the previous patient’s chart before going to see the last patient. That was an unusual situation and I made the judgment call of focusing on Rose first.

Always smile. A smile helps relax you and the other person. A smile lets the guard down. A smile indicates the person is welcome here. A smile is a sign that you desire connection with the other person.

Focus on the patient. Think about how you can serve the patient. When you are focusing on that, your words and your non-verbal gestures will show that you care.

Let the patient know that you are paying attention. Let the patient feel that they are understood. That is the most important part of the connection. It is also the moment when the patient believes that you are there for them. When this happens, everything else is much easier. It is easier to have a discussion. It is easier to talk about a challenging situation.