Patient Care

Diagnose Your Dialogue

Jeffrey Richards, MBA, RCIS, Massachusetts General Hospital

Boston, Massachusetts

Jeffrey Richards, MBA, RCIS, Massachusetts General Hospital

Boston, Massachusetts

Remember, there’s a patient in the room.

“This may be a normal day at work for you, but it’s a big day in my life. The look on your face and the tone of your voice can change my entire view of the world. Remember, I’m not usually this needy or scared. I am here because I trust you; help me stay confident. I may look like I’m out of it, but I can hear your conversations. I’m not used to being naked around strangers. Keep that in mind. I’m impatient because I want to get the heck out of here. Nothing personal. I don’t speak your language well. You’re going to do what to my what? I may only be here for four days, but I’ll remember you the rest of my life.”

   — Advice from a Patient, Anonymous

For us, it is just another day in the “office.” Colleagues with whom we spend more time than our families quickly become friends with whom we can’t wait to share stories. We divulge intimate anecdotes from the weekend, paint pictures of the bloodied procedure the night before, and dissect our coworker’s new Facebook photo. We chat, snicker, complain, shout and even text — sometimes draping a half-naked, nervous patient in our personal and unprofessional dialogue.

But while it may be our third shift of the week, for some patients, it is their first time in a hospital — a very cold and intimidating place. We strip them down, paint them orange, cover them from head to toe, and instruct them not to move. And as they lay there wondering why we have shaved their groin when we are supposed to be looking at their heart, we carry on with our vacation plans. As we grumble about not going to lunch on time, they believe they are the reason we are hungry, even though they have been NPO since yesterday. While we think we are whispering about how Dr. Johnson never washes his hands, their hyperacute senses allow them to hear every word and they suddenly worry about infection. When we laugh at the new fellow trying to gown and glove, they are confident we are actually laughing at them. And when we complain about how many cases we have left, they assume they are the burden.

So it is time to diagnose this dialogue for what it is: unhealthy for our patients, and toxic to safety and success. It may be another day in our office, but for our patients, it is the scariest place on earth. As cardiovascular professionals, we care for the 735,000 Americans who will have heart attacks this year.1 We help treat and heal the even greater number of patients who are living with coronary artery disease. For us, it is a job — usually demanding, but often rewarding and exciting. For patients, it is life-altering. They trust us to not only obtain accurate results, but to also protect and care for them during their procedures. Put the phone down; the text can wait. Stop scrolling; those likes will be there after the case. Close Facebook. Pay attention to their rhythm. Lunch may not come at noon, but it will come. Walk around the patient instead of shouting over them. Share vacation stories and midnight traumas in the break room, not at the charge desk. Today’s schedule may be hefty, but your shift will come to an end soon. Speak softer. Remain professional. Our patients deserve nothing less than our full attention and outstanding care. And remember, there’s a patient in the room. 

Jeffrey Richards, MBA, RCIS, can be contacted at

  1. Heart Disease Facts. Heart Disease Statistics and Maps. Centers for Disease Control and Prevention. November 28, 2017. Available online at Accessed May 15, 2019.