I was never too good at opening lines. "Hey baby, you come here often?" "What's your sign, beautiful?" No, that's not me. Perhaps that is why I didn't date much. Now, however, I must be good at opening lines. My job depends on my ability to talk to my patients and get them to talk to me. Sometimes it goes well, other times it doesn't. For example, sometimes I walk into a room with a person looking ill and out of habit I ask them "how are you doing?" Obviously not well, since they are in my office, right? But out of habit, they usually respond, "Fine, how are you?"
Sometimes it is the patient who initiates. Last week I had several patients say to me, "Doc, you look more stressed out than I am." I really didn't feel that stressed on that day. It made me very self conscious about what non-verbal message I was sending. I try to avoid saying things like, "You look tired today!" I may say it, but only after I have talked to them for a bit.
I have also had patients comment on my weight, which has gone up and down. One lady was somewhat rude and said, "My word, Doctor, you look pregnant!" I was so taken back by her forwardness that I had a hard time gathering myself for the conversation. I suppose people feel that I put them on the scale, so I am fair game. I have more than once had some people say that I look like I have gained weight only to have a subsequent room tell me that I must be losing. I try to take it in stride as best as I can.
One of my favorite things people say to me is: "Don't come near me, Doc. You don't want to catch what I have!" I give them a quizzical look and say, "It's really somewhat normal for a doctor to be around sick people." Why would you come to the doctor and then have them stay away? I guess they are being polite, but it is somewhat humorous when that say it.
Another common encounter is with the impatient patient. They are checking their watch and wondering what took me so long. If they confront me as to what took me so long, I usually try to disarm them and say something like, "Well, I was really trying to avoid seeing you. My nurses kept harassing me, however, and I had to give in and see you." I do this if I know the patient well enough. Otherwise I will say, "You got in the slow check-out line in the supermarket. It just happens some days - we can't predict how much time each visit will take, but regardless, I will always give you the time you need." They seem happy with that answer.
In general, however, I try to enter with a compliment. If it is a baby I am seeing, I will say something like, "hey there cutie!", or "Hey beautiful!" I also like to say "Hi there, skinny" to the particularly chubby baby. For adults, I will try to find something to compliment. My elderly ladies are very pleased when I compliment what they are wearing. In general, my African-American elderly ladies still believe you should dress up to come to the doctor. I like that.
Some patients have built their world around their medical condition. To them, their way of getting attention is to highlight their problems. To these people, I am always finding something good to dote on before they can complain. If I can give them some attention for reasons other than their sickness, perhaps some day they will come in without complaints. That is my dream for them (albeit far off).
I get about 90% of my information for decision-making from my discussion with my patients. History is always more important than physical. Saying the right things at the start will make that job much easier.
Besides, I don't really want my patients to "come here often." My goal is to keep them out.