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Even though many educational institutions have abandoned letter grades and adopted a “pass-fail” grading system, everyone still knows what it means to get an “A.” It’s the best grade you can earn, the ultimate reward for knowledge, the top of the class! A “report card” full of “A’s” is a thing of beauty, and hard-working students beam with pride at the sight. 

Recently, an email I received from MDQuip.com contained a quote that drew my attention, and  put “A” in a different perspective. The quote said the following: “A physician is judged by 3 A’s: Ability, Availability, Affability”. Dr. Paul Reznikoff was the author of the quote so to put it in context I will talk about him before discussing the meaning of his comment. 

Paul Reznikoff lived 88 years. He was a world-renown hematologist (blood specialist) in an era before the modern concept of combining hematology and oncology into one discipline. His genius is displayed by earning Phi Beta Kappa distinction as an undergrad at NYU and Alpha Omega Alpha honors at Cornell University Medical School. He spent two years as a research fellow at Harvard after which he returned to Cornell and founded the division of hematology. This was in the late 1920’s when technology was non-existent and knowledge was gained through intense study and experimentation. 

He was a prolific writer, so much so that his collection of writings were archived into seven series that contained speeches, lectures, correspondence, notes, reprints and others. It was in these saved writings his wife donated to Cornell that the above-noted quote was found.

“A physician is judged by the three A’s: Ability, Availability, Affability.” 

Those words ring very true! I have long been concerned about the current state of the medical profession and have written several articles critical of the atttitude of today’s physicians. When I saw this quote I immediately began preparing to share my thoughts on Dr. Reznikoff’s conclusion. I will briefly discuss each of the A’s separately.

ABILITY: A doctor must “know his stuff!” He/she must possess the knowledge to make important decisions about a patient when presented with the patient’s verbal information and observations obtained during a physical exam. If, for some reason, he/she is incapable of making a diagnosis, he/she must know a physician who can and refer the patient to that doctor. He/she cannot pass off patient concerns as insignificant or unimportant. He/she must be truthful with the patient. Ability is defined also as competence, and it must exist for disease resolution and patient satisfaction.

AVAILABILITY: The doctor-patient relationship is an unwritten contract. A patient chooses a doctor and expects the doctor to be there when a need arises. The doctor has a “moral” and professional obligation to be there for the patient, too. If he/she can’t, he/she must provide a surrogate with a similar sense of responsibility to take his/her place. This is where the doctor either earns an “A” or an “F.” When you’re sick, your instinct is to ask help from someone you know; your own doctor, someone you trust and feel confident will help. And you want help sooner rather than later. Being put off by the front office staff does little to improve the patient’s impression of the doctor. “Doesn’t he/she care?” The doctor who avails himself/herself to his/her patients has loyal, satisfied “customers.”

AFFABILITY: This characteristic must be inbred. If it’s not, patients are going to come and go, and the doctor will wonder why. Synonyms for “affable” are agreeable, cordial, congenial, gracious, and warm; nice even fits. So the doctor must be a nice person! A good person; not cocky, arrogant, condescending, paternalistic, distracted, or stubborn; not brusque. He/she must listen and then indicate he/she heard what the patient said. 

It is in this context that people make judgements about a doctor. Dr. Reznikoff was right. Patients are quick to judge doctors and many doctors make it easy for them.

What do people say about doctors, anyway? 

     He/she didn’t listen!

     He/she interrupted me!

     I couldn’t see him/her for three weeks!

     I don’t think he/she knew what was wrong with me!

     He/she told me it was all in my head!

     He/she gave me a drug that made me sick!

     He/she didn’t examine me!

     The office told me to go to the ER!

The treatment you receive or the message you hear sets the tone for your relationship with the doctor. Opinions derived from the three “A’s” reveal the real character of the doctor, and how much, or little, they are a part of the physician’s persona. The patient, congenial doctor who sees you when you’re sick and prescribes treatment that helps you get well is going to have far higher patient satisfaction ratings than the rushed, pushy smart aleck you waited a week to see who gave you an antibiotic just “to make you happy.” 

Which doctor would you rather see? 

Reference: MDQuip.com


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