"The Doctors don't know how to help you."

[Standardethics]

That statement was uttered by the medical receptionist in my primary care physician's office. In my primary care physician's office, there are two workers. One might be a medical assistant of some type, (and the old thread "medical assistant in the office" is very important); she says that she is. The other is not. She is a receptionist. Said receptionist has told me, "The doctors do not know how to help you." What does she know that I do not. This sounds like a terminal pronouncement.

It is hard not to carry the blame for this because the receptionist is given full sanction by the physician to discuss matters in depth with patients. I well know that her level of education is minimal. I also know that she thinks she "knows" me, as that's the way things are around here. So, why have I ever engaged with her on important matters? Illness. Fear. Frustration. Knowing that she does, in fact, hold tremendous power: to get records sent expediently, to coordinate care, to get me an appointment sooner than later.

She's read all my records. She has interpreted lab test results. All sanctioned. But this latest really cracks it. Should I, or any patient, assume that this hopeless attitude on the part of all physicians involved in care, is true? (I'm sure that I can). So, then why would I want to continue to be a patient in any part of this system, which is extensive, where all records are shared through electronic transmission, and where (all) the physicians don't know how to help me? I don't.

It's quite bad enough that medical assistants here do, in fact, come in with zero training, are referred to as "nurses," believe they function as two and four-year R.N.s, and, are missing the key component that makes the difference between good care and bad care, and that's the lack of self-questioning. When any health care system supports empowering receptionists, (a tremendously important job - key first-contact and exacting skill sets), to act as nurses per se, that's a big problem.

[JustKeepSmiling, ADN, BSN, RN]

A receptionist at your PCP's office said the doctors do not know how to help you? You, the patient?

[OrganizedChaos, LVN]

Wow. I'd get a new PCP like, yesterday. If she in no way has any medical training then she shouldn't act like it.

I'm sorry you're going through this.

I hope things get better.

[nursel56]

You are correct when you point out that office personnel are frequently in the role of "gatekeeper". If you and the doctors this person was referring to have a good rapport and this person seems to be interfering with that then you should by all means mention it to them.

An effective relationship between a provider and ancillary staff augments good practice. It should never be such a source of frustration. Sometimes a provider relays a message to unlicensed staff so he or she doesn't have to deal with something, in which case you would need to sort out the truth as the receptionist or medical assistant may simply be doing what they believe is a legitimate part of their job.

Honest and clear communication with your provider is essential, and part of that is trusting the office staff. "The doctors don't know how to help you" is such a statement that can be interpreted in several ways. Sorry you're going through such a difficult time.

[Standardethics]

That is correct.

[Standardethics]

The crux of the problem is that the reception believes her job to include counseling, interpreting and speculating on laboratory reports, and making such comments. She meant exactly what she said. I am sorry that your response seems to be that of an apologist. No physician should entrust receptionists to the degree represented here.

I once wrote a paper on the impact of front office staff on the quality of patient care - ranging from obstructionist, and downright dangerous, to advancing, not only provider-patient/patient-provider relationships, but the very integration of health care.

R.N.s are highly trained professionals. I have worked hard, with some success, to enlist R.N.s in medical offices, and will continue to advocate for certification of medical assistants and the limiting of information passed on to patients via receptionists. Meanwhile, the receptionist, who has the inside track on how I am perceived as a patient, has made it impossible for me to believe that I can get a fair review within this system. The degree to which that is true, cannot be exaggerated. The previous primary care physician, upon first visit meeting, (with me smiling and eager to have a fresh start), within the first paragraph, said, "You know, people just don't like you." That was, of course, the first and last visit.

But I do not wish to detract from the more serious matters dealt with in allnurses, and will leave it that nurses need to take a stand when they are aware of practices that bring ill health and a heck of a lot of headaches to patients, and, to themselves.

[elkpark]

The crux of the problem is that the reception believes her job to include counseling, interpreting and speculating on laboratory reports, and making such comments. She meant exactly what she said. I am sorry that your response seems to be that of an apologist. No physician should entrust receptionists to the degree represented here.

I once wrote a paper on the impact of front office staff on the quality of patient care - ranging from obstructionist, and downright dangerous, to advancing, not only provider-patient/patient-provider relationships, but the very integration of health care.

R.N.s are highly trained professionals. I have worked hard, with some success, to enlist R.N.s in medical offices, and will continue to advocate for certification of medical assistants and the limiting of information passed on to patients via receptionists. Meanwhile, the receptionist, who has the inside track on how I am perceived as a patient, has made it impossible for me to believe that I can get a fair review within this system. The degree to which that is true, cannot be exaggerated. The previous primary care physician, upon first visit meeting, (with me smiling and eager to have a fresh start), within the first paragraph, said, "You know, people just don't like you." That was, of course, the first and last visit.

But I do not wish to detract from the more serious matters dealt with in allnurses, and will leave it that nurses need to take a stand when they are aware of practices that bring ill health and a heck of a lot of headaches to patients, and, to themselves.

Not sure what kind of responses you're looking for here. Yes, that's a lousy situation. I would speak directly to my physician and express my displeasure about the interaction with the receptionist, and, if my concerns were not promptly addressed, I'd be looking for another physician. (Problem solved.)

[TriciaJ, RN]

I'm with elkpark on this one. You really should let your doctor know what's going on. Receptionist interpreting lab results and counseling patients? I hope he keeps his liability premiums paid up. If he can't or won't address the situation appropriately, then you need to start shopping for another provider.

I agree that front office staff have a huge impact on the patient's experience of a medical practice. I once urged my mother to change doctors before his office staff killed someone.

[Standardethics]

The entire system here functions that way. It's not a matter of finding another physician when the entire system is involved; that is, all the practitioners. I'm glad your mother had you to support her to leave a practice before the office staff killed her.

[groovetta]

I left my PCP for this same problem. I discussed it with him at one point. I finally just got fed up with his front office staff and changed doctors. Very first visit with my new PCP, it was noted that my WBC count had been elevated for years and soon was given a leukemia diagnosis. Frustration with front office staff saved my life. It all boiled down to he was too cheap to hire any full-time staff or real nurses.

Really the staff you mention are only regurgitating what they've heard their providers tell patients, not realizing, without nursing education, not every situation is the same.

[Standardethics]

Yes. I have no doubt that they are regurgitating - but what they're regurgitating is probably the truth of how the patient is perceived by the physician. There is no direct mechanism for legal action against front office staff, unless one can afford a private attorney and all the stress involved.

I am sorry you have leukemia. Must say, that that's a bit anxiety-provoking. I would guess that the elevation, in your case, was somewhat substantial. Again - there are no options here to get away from the system.

[psu_213, BSN, RN]

She's read all my records. She has interpreted lab test results.

I have an even bigger issue with this than the receptionist telling you "the doctors don't know what to do with you." If she is looking at "all" your records, my guess is she is looking at all the records of other patients. Some people have information in their medical records that this receptionist may find "juicy," and may think it is a good idea to share those details with her friends. Yes, it is unfair of me to judge the receptionist not having even met her. However, I find it pretty inappropriate that she has full access to all patient records whenever she wants them--and I'd inform the PCP of this--and inform him/her that I am no longer a patron of his/her practice.