The Appointment 

So now is the day of the appointment, the patient has arrived and they're waiting in reception. A couple of things can go wrong in this moment. The biggest being that the reception staff may not know who you are may not have access to your diary or you could've been silly enough not to keep your diary up-to-date. Suddenly this information gets conveyed to the patient by the reception staff they then frantically trying to find out who you are or contact you to make sure you're coming. The reception may be in a building which you don't work in very often. The patient may have turned up 15 minutes early. You may not have arrived yet. There can be some confusion in this moment which the patient may not be kept shielded from. You can't control how the reception staff react, but you can decrease the chances that they will have something to react to. Physios in mental health often work across large areas and there may be buildings within a trust which we use and don't access very often. Temporary or new reception staff may have no idea who you are so it can be important to let the reception team know in advance that you are coming and what time to expect you. Do everything you can to make sure that when your patient arrives in reception they and you are expected.

 

It is tiny failures like this, which can have a large knock-on effect on the effectiveness of your appointment. The great majority of patients will just shrug off an event like this, but you'll find your patient groups which are more prone to anxious thoughts and negative emotions and will be unduly affected by a situation like this.

 

Your patient is now waiting in reception, the reception team have let you know, so you walk down to the waiting room to collect them. When you get there please don't stick your head out in the door and shout the patient name like it's roll call in the Victorian secondary school. Enter the waiting area and have a look. It may be that the patient you're expecting to see looks up, sees you, and you make eye contact. What I would do now is immediately smile, then while still smiling say hello or whatever greeting is your preference, then introduce yourself (if this is the first time you've met them) and invite them to come in all well still smiling. To talk while smiling at the same time, is a useful skill for helping put people at ease and letting people know that you are pleased to see them. I remember listening to radio 2 presenter explain that she had been taught to smile when introducing herself and the programme she was presenting even though this was on radio and no one could see her.

 

If when you walk into the waiting room the patient isn't looking at you, if they're staring straight down at the floor, please do not shout out their name. Slowly walk over. Do not march over as though you're in a hurry, act like you have all the time in the world for them and once there use your introductions and invitations along with your smile. If you don't know what the patient looks like or, if you forgotten in that moment what they look like you don't recognise them. Just ask your reception staff to point them out to you.

 

All these things may seem to some like obvious basic standards of practice and if you already do them you will be reading or listening to this thinking that I’m wasting your time by presenting something as though it is special when in fact it is basic. These things probably are basic but they get lost in the demands of a busy job role and clinic. The pressures stop people working like this and then cultures are developed and new staff are indoctrinated into these cultures. The point to drive home is that these aspects of clinician patient interaction have disproportionate implications when working with many mental health patients.