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I recently went into my hospital shop to buy a thank you card for one of my colleagues who was stepping down as our clinical director.
Now, had I been buying a birthday card there were 23 options available. ‘Get well’ – there were three, less than you’d expect in a hospital. It was outscored by sympathy (four) and ‘new baby’ (five) although this hospital has no maternity unit. But where were the thank-you cards?
There was one measly option available. The same as to wish someone well for moving house. Most people (junior doctors aside) only move every few years. Surely they say ‘thank you’ more often than that?
I then looked at the other hospital shops in the vicinity. The maternity, paediatric and acute hospitals each have their own shops. In all of them, thank you cards galore. But in the place I work, there was only one. The place I work is a mental health hospital. Is this the reason?
I am a psychiatrist who works with adolescents. I rarely have recourse to the Mental Health Act and most of my patients do get better after a period of time. I get a lot of verbal feedback where patients and families thank me. But every year at the time of appraisal, I have only one or two thank-you cards to show. And that’s why I’m not just craving attention – this is evidence, and it needs to be in written form.
In the past I didn’t give the matter much thought, and if I did, I wondered if it was part of being a psychiatrist. But self-doubt has started to rear its head. Is it because I’m not friendly? Is it because I’m not good?
That’s never an easy question to answer, but the evidence suggests I’m alright. I very rarely have patients who DNA their repeat appointments, my secretaries keep demanding more appointments from me for certain clinics because patients demand to see me for their follow up care as well and I haven’t had any complaints in my four-year consultant career.
But liked? I suppose there are other ways of establishing this. I could go all out for ‘likes’ on my Facebook page, but I am naturally very careful to restrict it to close friends and family. I could set up a webpage and encourage patients to log in and leave comments.
But even if that worked, I’d rather have a card. Call me old-fashioned, but it feels like a nice conclusion, a ‘mean all’ and ‘end all’. Perhaps when a patient expresses gratitude, I should be asking them to put it in writing.
So, what would you do? Or perhaps you get hundreds already?
Manohar Pai is a consultant in child and adolescent psychiatry in Aberdeen
A lot of verbal thanks. Cards go to the surgeons!
I have noticed that too in mental health. When I worked in physical, I got way more cards!
I sometimes wonder if some cards are given because people haven't had what feels like an adequate chance to say thanks in person - perhaps some sort of unfinished business. With planned discharges after a series of appointments, I think most of our patients have had the chance to say what needed to be said. Of course, it doesn't make for a good volume of evidence for appraisal!
Maybe patients with mental health disorders experience less in the way of positive emotions like gratitude in the early days of treatment. It takes a long time to recover from each episode of mental ill health. They may have been discharged by the time they can look back and feel truly thankful for the help that they have received.
When I was a junior doctor, thank you cards were quite common. But, after reaching consultant, they have become very rare. Maybe patients think the "huge consultant salaries" that they are told that we get are thanks enough.
Perhaps patients know that appraisal portfolios are electronic and therefore would like to save the consultant the hassle of scanning thank you cards. Adolescents, moreover, would anyway be more comfortable with electronic and cyber stuff.
When I started as a consultant 15 years ago, I shared an office with an older consultant (Mr. B) who used to receive tons of Thank You cards and I could not understand why because I never received any, despite being very nice to my patients. One day I happened to see one of his post-op patients who asked me 'How is Mr. B?' I replied: 'Alright,' and then I queried 'Why are you asking?' The patient replied: 'Mr. B. asked me to see an optician after my cataract operation and then to let him know the outcome by sending him a card or letter. I sent him a Thank you card to let him know that the optician said the eye was settling fine, but I have not had a reply from Mr. B ......'
Perceptive, thoughtful and irritatingly funny. A great piece from a mind that understands more than meets the eye. Thank you Dr Pai. Please keep writing!
Dr. Pai...... When you see the sunshine in the sky, you'll know that is a reflection of yourself! Someone who makes others smile and feel good about themselves, someone who makes people laugh when inside they are crying.. Someone with an amazing ability to turn sad to happy. The lack of cards are not a reflection on you, because if every patient that you cured/helped, gave a card, your office would be full to the brim.... Dr. Pai.... YOU ARE GREAT.,.,.,
Being nice and considerate is what everyone expects of doctors- so when they are nice and considerate, thank you isn't something that patients and relatives feel they have to address. Only when the cards are turned(pun intended) and service isn't what they expect from a noble professional, they feel cheated and are quick to complain. To actually get acknowledged these days by a patient who takes the time out to put pen to paper about their pleasant experience with any hospital staff is therefore a really big deal--- and I would applaud the person for appreciating the good someone has done to them
Really?? Your patients are verbally thanking you.. does it matter? Did you go into the healthcare profession to get thank you cards? if you did, that's your own damn fault. Stop whinging about not getting a written note, appreciate them when they do come through, there are much bigger fish to fry.
As an anaesthetist I received very few thank you cards, and almost all were from colleagues who'd been a patient. I guess the rest of my patients just took me for granted, but the colleagues knew that what I did mattered, which is kind of a compliment of sorts. But then I didn't receive any complaints either, so I guess its swings and roundabouts .. . . .
Just record the verbal thanks/feedback you receive, add to your appraisal. I just send myself a quick email with a brief summary
E.g. Female patient in her 30s told me I'm a good listener.... or similar
The saddest part of your story is the ridiculous appraisal system where nothing counts if it isn't written down, or if you haven't got a certificate to prove it. I'm a retired consultant child and adolescent psychiatrist and can count on one hand the cards I received when in practice; when appraisal came in we used to joke about running workshops on how to solicit eulogies from patients. I still have the mug I was given one Christmas but the helium balloon a family gave me on retiring has long since deflated. Despite that I remember the kids and families I helped and the feedback I got from them at the time. But here's a thought - a GP once told me of one of their patients, in their late twenties, who some years previously had attended our local adolescent unit and said "I hated them and they hated me. Still, it was the best thing that ever happened to me." And don't forget, lots of Dr Shipman's patients loved him!