michael-jackson-waving-wearing-glasses"Hi Dr. Rob!"

I look up and see a familiar face and smile. I am out shopping and one of my patients has recognized me.

This kind of thing happens pretty often - especially in certain stores. Our town is of moderate size (around 200,000) and so this is somewhat dependent on where I am going, but it can happen any time, any place. When you take care of 4000+ people (and cover for more than twice that number), the odds are in favor of you being recognized at some point.

They are usually somewhat tickled at seeing me in jeans or shorts, and simply say "hi" to me. Most of the time I can get away without dealing with medical questions, although that does happen from time to time. To some extent, the reaction depends on my relationship with the patient, which varies widely:

  • Infrequent visitors - these are patients that I don't recognize because they don't come to my office very often. It is always uncomfortable to me when they say hello, as I have to deal with my poor face-recognition skills. Sometimes I come out and ask them their name, but most of the time I just act like I am as thrilled as they are to see me in public. It is rare that these people ask me anything medical. My response to them is usually, "uhh.....hi!  Good to see you....how have you been doing lately?"
  • Frequent flyers - They may have been sick a lot lately, but generally they are just "high utilizers."  They are willing to take up a lot of time in the office, so they are also likely to do so outside of the office.  They are very likely to ask medical questions.  While I don't want to look like I am trying to avoid them, I am generally trying to get away without too many visits.
  • Really sick patients - These patients are ones where I not only recognize them, but can recite their medication list and what my plan of action is on their current medical situation. These are the patients I will worry about when I am not in the office. I usually am glad to see them as I want an update on how they are doing.  I am more likely to ask them questions.
  • People who I enjoy - There are certain patients I am drawn to.  They are either like me in many ways (for that they get my deepest sympathy), or they are just good to talk with.  I am happy when they come into the office and also when they bump into me at the hardware store.  I would enjoy having these people over to my house for dinner, although I haven't ever crossed that line.
  • Friends who became my patients - I have a number of people who I knew outside of the office who became my patients.  Most likely this is from church, so I see them weekly.  I have no problem with them asking questions, as they are usually very aware of the boundaries in our relationship.  If they need to come in, I will tell them and they are fine with that.
  • People who think they are my friends - These folks know me slightly from outside the office and use that as license to "easy access" to me.  My office staff created the Rob Rule, which states that people who call asking for an appointment with Rob are generally not really my friends, but just trying to act like them.  If I see these people in public, I do my best to duck and cover.  I am likely to get into a prolonged uncomfortable conversation with these folks.
  • Kids I care for - I almost always am happy to see the kids - especially when they run up and hug me.  This is one of the perks of doing pediatrics.  The parents sometimes corner me, but not too often.

apu I was just in the hardware store when the cashier asked me, "are you a doctor?"  When I said my name she became very apologetic, as obviously I am her doctor and she did not recognize me.  The irony of it is that I had no idea she was my patient.  She looked vaguely familiar, but I had to reassure her that there was absolutely no offense taken.

Rural Doctor did a great post about a lady asking her questions in the check-out line.  A small town doctor must have it harder, as there is much more chance of anonymity here where I live.  She has no way to avoid it.  I don't think I could handle that.

Still, there are certain stores where I am nearly guaranteed to see one or more of my patients.  One of the docs I work with refuses to go to certain stores for this reason.  To me it is the price for the job I do.  The good news is that people are generally happy to see me, and when my wife is with me they tell her what a good doctor I am. 

They hope I'll give them a discount on their next visit when they do that.