Tips for an Emergency Room Physician

(The following is taken from a document that I just wrote and sealed into an envelope to mail to one of the local hospitals, after an adventure that we had this afternoon)

Tips for an Emergency Room Physician: How to Come Across as Arrogant

An example scenario:

Patient is 15. Has severe lower abdominal pain. Is accompanied by his father.

You’ve done an initial exam. You suspect a stomach virus that’s going around. You’ve ordered a urine sample, blood tests, an X-ray. After reviewing the test results, you conclude that it is indeed a stomach virus. You communicate this to the patient and his father.

So far so good. The patient and his father are satisfied with your care. Here’s your chance to come across as arrogant.

The father asks, “Any chance of appendicitis?”

Let your mouth drop open as if this question is unfathomable. Smirk. Roll your eyes and/or put the sound of rolling your eyes into your voice. In your reply, include the words “When it’s stomach pain, everyone thinks it’s appendicitis.” This creates a picture of the father's belonging to a large population of the ignorant.

You’ll know you have succeeded in coming across as arrogant if the father comments, “Don’t jump on me.” (Because that will mean that he feels that you jumped on him.)

A suggested response to the father: “I’m not jumping on you. I’m just trying to explain.”

Suppose that the father continues, “Do you want feedback on how you’re coming across?” Assure him that you do, but let your face and tone of voice communicate that you don’t, that you’re just humoring him and falling back on those hazy memories of instruction in bedside manner.

Important notes! Actions that could interfere with your coming across as arrogant:

Take into account that emergency room visits are rare for most people, and even their routine and uninformed questions are sincere inquiries.

Take into account that a father might feel an obligation to ask a question not only for his child's sake, not only for his own peace of mind, but also for the sake of his wife, who insisted that he ask that question, particularly because as a child, she nearly died from a ruptured appendix.

Take into account that your natural inclination for answering a question may not communicate the attitude that you intend.

Take into account that there’s a sign on the wall of the examining room encouraging visitors to speak up if they have any questions or concerns. A misguided person might classify a perception of being treated rudely as a concern.

Good luck, Doctor!