Friday, November 17, 2017

Dr. Peter Gallogly: lessons for patients and healthcare workers

Dr. Peter Gallogly was thrust into viral internet space overnight.  He was recorded yelling at a woman in the waiting room of Gainesville After Hours Clinic, a healthcare facility in a community that serves a predominantly underinsured population. The story led to a hostile online response that didn’t know the whole story. Analysis of what happened in Dr. Gallogly’s clinic can teach us all how to be better with patients and healthcare providers.

Dealing with difficult customers in any field is a challenge. In healthcare, customer (or more aptly, patient) service presents unique situations. The person is usually seeking relief from an illness, awaiting a diagnosis, are in need of daily care in a hospital or healthcare setting, or are dealing with an emergent situation. These circumstances can leave a patient vulnerable and reactive. It is understandable. It is their problem, and it is deeply personal.

The healthcare worker has small room for error. More than most industries, they have to walk a narrow line with regards to staying within the guidelines of the professional licensure state board regulations, national associations’ professional rules, their facilities protocols, policies, and procedures rules, insurance companies’ rules and regulations, and the governmental laws.

The collision of protocol and a patient’s need for attention can lead to a perfect storm.  This is what has happened to Physician Peter Gallogly. There is one more factor to fold in—a selectively edited video that presented only the patient’s side of the story. An angry professional and a video recorder turn temporary attention seekers into viral video stars.  

The patient and viral video star, Jessica Stipe posted the video on Facebook and wrote on the post:

“The (doctor) was mad I wanted my co-pay back and was unhappy with having to wait so long and proceeded to cuss me out, my daughter recorded it because they were so rude. When he saw it was being recorded he snatched my baby’s phone and shoved her when she tried to get it back. … Never go there for medical care.”

What Ms. Stipe failed to mention, was the events leading up to the viral video.  Dr. Gallogly released the following statement explaining the series of events, and an apology for his unprofessionalism.
“Ms. Stipe had been increasingly belligerent and abusive to the office staff, cursing them and threatening them with violence because she was unwell and had been waiting to be seen by me for more than an hour. 
Ms. Stipe demanded her copayment returned. I went to the front desk only after Ms. Stipe received her refund, she refused to leave the office and continued her abusive behavior towards the staff. Despite repeated requests from office staff, she repeatedly demanded to see me instead of leaving. 
When I walked into the waiting room Ms. Stipe and Ms. Wearrien cursed and threatened me as they had done with the office staff previously. The front desk then called the police. At the very end of the events, I most regrettably lost my temper and spoke to the two women in a most unprofessional manner. I make no excuse for my unacceptable behavior.”
Witness statements are consistent with Gallogly’s story, and the police report also backs his claims.
What can we learn from this?  Patients need to understand that today’s walk-in clinics frequently are overstressed facilities, with more and more patients seeking immediate care, high-quality care, and affordable care.  Fast, good and cheap are very difficult to achieve simultaneously in any profession, and in healthcare delivery must strive to reach this narrow intersection.
Physicians and staff dedicated to patient care are under immense stress to see more people in less time, minimizing costs while being complete.  Again, an amazingly thin line to walk.  Patients need to understand that.
And while their medical status is deeply personal to them and demands immediate priority, they need to understand that the waiting room is full of people that feel exactly the same way.  It is never easy to digest that one’s health problems might have to wait, and the potential for tempers to flare and voices to raise increase dramatically in the tense atmosphere. Patients need to understand their position in that stressed system.
Physicians and staff need to be cognizant of the patient’s perceptions. It is their problem, it is real, it is immediate.  To have to wait for care can seem like an eternity. Listening and empathy go a long way, and are critical to developing rapport and eventually trust. When there’s trust there’s understanding, and they realize their position in the bigger situation within the clinic.
It is easy to Monday-morning-quarterback Gallogly’s response. Without understanding the reality of the threats and the imminent danger to him and his staff, it is hard judge the appropriateness of the response.  He did exactly the right thing in asserting himself in defense of his staff and the safety of others on site. By his own admission he clearly crossed a line in the magnitude of his reaction.
The bottom line is that the situation was a powder keg.  Insert an irate patient making threats and an overworked physician in a stressed clinic, and it is easy to understand how this could happen.
That’s why we can all learn from this unfortunate experience. Clinics like Gainesville After Hours and physicians like Dr. Gallogly have important roles in our communities. Some understanding, empathy and clear communication on behalf of both patients and medical staff can help diffuse potentially difficult situations.
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