Let’s talk about managing expectations. You can do this with almost everyone/everything in your life, your goal being to under sell, over deliver.

Some, not all, patients think that when they walk through these hallowed doors, that they’re walking into a place of truth and all-knowing information. They don’t realize the ED is more like a “I’m going to make sure you’re not going to die today or tomorrow, then dispo you as quickly as you came in”-type place. We care about them and their well-being, of course, but we also have a job to do. What helps ease the tension of you NOT figuring out WHY the patient sitting in front of has had intermittent abdominal pain for 1 year that mysteriously disappeared when they came into the ED today, is taking a moment to explain upfront what the goal of the ED is. I’ve worked on trying to develop some of these scripts and, honestly, it helps to frame the visit for the patient and help them know what’s coming. I’ll say something like:

“There is a decent chance, we’re not going to find what’s causing your [insert chief complaint]. That’s a good thing! The ED is fairly limited to finding potentially life-threatening causes of [insert chief complaint]. If we don’t find it, that doesn’t mean nothing is wrong with you, it just means you need tests/studies/imaging that we can’t do here in the ED and is better handled outpatient. If we DO find something that has potential to be dangerous, there is a chance you’ll get admitted to the hospital so we can do some more testing. If we don’t, you can go home and follow with your PMD or we can give you an appointment with one!”

So then, when u come back 2 hours later and everything is normal, you can frame it as GOOD NEWS versus like, hey I don’t really know what’s going on with you. 

You can also do these type of things with wait times! Tell them it may take 4-5 hours to get their CT scan (its not a lie, it might…), so maybe if they get it in 3, they feel like they’re winning. under sell, over deliver. 

This is just something that tacks on maybe 30 seconds on to the initial encounter and may save you minutes of explanations and apologizing at the end. If you don’t do this already, try it out!

June 2024