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Anxiety and Stress Management

with Patricia A. Farrell, PhD

This blog has been retired. We appreciate all the wisdom and support Dr. Farrell has brought to the WebMD community.

Friday, January 27, 2006

WHITE COAT SYNDROME

The White Coat Syndrome is enough to make many people have second thoughts about a trip to their physician. It’s often something that they fear may happen at the office or, in some cases, it’s the attitude of the office staff and that’s what I noticed today in a major medical center.

Despite the nice decor, I knew there were women who were practically going into panic when they came to this place. A good number of people with blood and needle phobias or just phobias about being placed into small, tightly cramped machines were trying to steel themselves to remain healthy with regular check-ups like this.

I was seated in a very attractively furnished suite waiting for a benign test that I’d had done before and for which I had no anxiety. As I sat there, I saw women of all ages coming in, some with their husbands, some alone. The women at the front desk cheerily handed them clipboards with forms on top and provided pens for completing the forms. Everything seems to be going swimmingly.

Being a half hour early for my appointment, I had a chance to look around and noticed that the large glass doors leading into the suite were painted about one-quarter of the way up with flowers and a white picket fence design that would have, in my mind, been more suited to a kindergarten classroom entrance. I really didn’t like it. In a few minutes I would know why I didn’t like it and something I didn’t like equally as well would happen.

“Lucy,” the woman called out from a side door, clipboard in hand. Lucy was a woman of about 80 who had arthritis and walked slowly as she left her husband’s side to follow the woman’s call. I thought to myself that this wasn’t right. This woman had earned the right to be called not by her first name, but her full name. The woman calling her wasn’t an acquaintance, co-worker or friend. She was someone who was going to lead her to the room where the evaluation would take place.

Within the time I sat there, each woman was called by her first name, whether she were in her 30s or her 80s. Perhaps the staff thought this, like the childish painting on the door, would create a feeling of warmth and friendliness. I didn’t see either that way.

These women were coming to a place which might give them very bad news or good news, but most of them would dread the bad news and not give the good news much thought. They were anxious, but calling them by their first names, to me, didn’t dispel anxiety, but created a sense of a lack of respect for them as women. They were being treated like “girls” and the painting on the door certainly gave that warning to anyone entering here. It should have taken a line from Dante Inferno where it reads “abandon all hope ye who enter here.” The hope, of course, was of being treated like a respected adult. It’s a component of that all-important bedside manner we hear so much about.

Bedside manner begins not at the desk or the bedside. It begins after that first step into any medical waiting room and it is first practiced by the reception staff, nurses, technicians and added to by their air of professionalism.

The next thing to which I objected, and told the technician, was her request that I sign a form which had a blank line indicating “Recommendations.” I was to sign beneath this line and beneath my signature was the physician who had reviewed my form.

I told the technician that this was like signing a blank form and wasn’t legally correct because there were no “recommendations” and the physician hadn’t read my form. She, nicely, informed me that was the doctor wanted and I told her to tell the doctor, nicely, that this was both questionable on ethical grounds and seemed bordering on the illegal to ask me to sign a form that would have recommendations inserted later. It would appear as though I had seen the recommendations and agreed by placing my signature beneath them. Not so.

So, I signed the form and put a large arrow to the margin where I indicated “signed without recommendations on this form.” Wonder how the physician will see that.

Related Topics: Personal Reporter: Answers about High Blood Pressure/White-Coat Syndrome, Making the Most of Doctor Visits

Posted by: Patricia Farrell, PhD at 8:15 pm

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