Prostate Patient

I stand in awe of the skills and responsibilities of medical specialists. And when it's my health or the health of someone I love, I'm prepared to pay the price....as long as I feel I'm getting value.

When I changed specialist to Mr P., my wife Gwen did some checking and got good feedback on other families that had dealt with him. Their feedback backed up the things that he had told us such as:

1. He visits his patients every day in hospital including at the weekend.

2. He gives you his mobile phone number and encourages you to phone at any time if you are concerned.

3. While you are in hospital, he sorts out any problems with nursing staff not following his instructions for patient care and attention. This turned out not to be a concern for me, but I know from this feedback that he is quite firm with nursing staff if the slightest hint of the standard he expects for his patients isn't being met.

4. He is technically excellent and up with the latest techniques.

5. He has a good bedside manner.

Given all of this, I expected his fee to be at the higher end of the scale.

We had the important appointment with him at which I confirmed that surgery was my preferred option and that I agreed that it should be as soon as possible. Gwen then asked the question, "How much will it cost?"

Now, I should point out here that Gwen really just wanted to know what to expect so that she could calculate the gap between our private health insurance cover and the total bill. This was not a prelude to her trying to knock down the price.

Let me pause to clarify that. Gwen is a Londoner and I reckon wheeling and dealing is in their genes. She loves a bargain. I'm sure she would have tried to knock him down on price BUT she was under strict instructions from me NOT to bargain. I'd shared with her one of my two favourite quotes about discounting, from Tom O'Toole of the famous Beechworth Bakery:

"If they ask for a 20% discount, I ask which 20% of the ingredients do they want taken out. I can take out 20% of the ingredients but it doesn't taste real good!"

And I'd stressed, "I don't want 20% less anaesthetic. I dont want him to rush to get the job done in 20% less time. So, promise me, no price haggling!"

Our otherwise calm and confident specialist clearly hadn't heard my other favourite discounting quote, from English sales trainer Richard Denny:

"Never apologise for your prices. Your product knowledge and the service you give demonstrate that your prices are fair."

As soon as Gwen said the words, "How much will it cost?" he became quite nervous, almost stammering as he started to justify the price.

He explained that he was at the lower end of the price scale for urologists. He even went on to detail some of his overheads. I particularly remember him saying that he paid over $3,000 per month in professional indemnity insurance - and I'd thought my professional indemnity insurance as a trainer and consultant was high!

So, there was no need for the nervous justification of his price, which was around about $1,500 less than I'd anticipated. And looking back on the professional and caring way he's handled everything to do with the surgery and post-operative care, he would have been worth every penny of the higher fee.

I wrote an article about 'Dealing With Price Shoppers Over The Phone' a few months ago which is at my website. Its one Mr P. could learn from. Go to the Free Articles section at http://www.terrifictrading.com/ if you would like to read it.

My first few days in hospital involved far less pain that I anticipated, which was wonderful (see Pain Control for Wimps posting 16 July).

Whenever I felt any pain my specialist, or was it anaesthetist, had instructed the nursing staff to check the level of drugs flowing through the epidural machine. This was then increased or decreased as required. If the bag was getting low and they hadn't noticed, I would call the nurse and it would soon be sorted....during the day.

At night sometimes it was a bit different. A couple of the nurses seemed to have real problems with checking and changing the bag, or whatever it is they do, on the epidural machine.

One night I went through a stage of feeling a considerable amount of discomfort, which seemed to suggest that the drugs weren't flowing through the epidural machine properly. I called the night nurse. She was a lovely friendly person, but for some reason hadn't seemed terribly confident with the epidural machine. She fiddled around with it in the same way that I would with a video recorder or a piece of technical equipment that I couldn't get to work properly. In other words, it seemed as if she didn't have a clue!

After much fiddling and tutting, she called another nurse to help. She wasn't much better, but between the two of them, they eventually got things working and I became more comfortable and went off to sleep again.

The following night I had a similar episode. I think it was as a result of the bag being almost empty. I asked the nurse what the problem was with the epidural machine. She rolled her eyes and said, "The staff don't like it. It doesn't make our life any easier, and it doesn't do much for the patients either."

Nothing could have been further from the truth. What we had here was a machine that worked superbly and kept me comfortable, in spite of the major surgery that I'd been through. To me it was like a miracle as long as it was working properly. And the only thing that stopped it from working properly was the occasional nurse who didn't seem confident or competent to handle it.

The following day, I had a visit from my anaesthetist and mentioned to him that the nurses didn't seem to have any problem with the equipment during the day but they did at night. He said to me that this wasn't unusual at my hospital because the night nurses didn't deal with some of the equipment quite as much they tended to be less confident with it.

I hope he realised that this lack of confidence also affects the confidence of patients like me, which in turn affects the level of pain we feel. Pain is a psychological thing as well as physical. Feeling anxious raises the level of pain.


It's really important in any customer situation that service providers are encouraged to build up their confidence as well as their competence. Then they can pass this confidence and feeling of well-being onto the customer, in this case their patients.

It's also important that they realise that their negative comments and expressions can cause a loss of confidence in them as service providers and as ambassadors of their organisation.

My radical proctectomy operation is the first time that I've had major surgery so I didn't know what to expect with pain control. Prior to the operation when the anaesthetist went through the options (see the 29th April 'What does a patient want to know?' posting for more on that!) he stressed that the best way to control pain was to take something to ward it off before it happened rather than wait until feeling the pain.

This is the opposite to what I'm used to. Normally, I never take medication, for example for a headache, unless it is really bad....and for me that's a rare occurrence.

The anaesthetist explained that after surgery its far better to control pain using a preventative approach. So, I got used to this new approach and it certainly worked well. I felt very little pain most of the time during my seven days in hospital and for the first week or so at home was given various levels of pain relief pills to take.

Then I had a follow up appointment with my specialist, Mr P. He started by whipping out the catheter (Youchhhhhh!) and then sat me down before going through a few other things. Fortunately my wife Gwen was there to take in what he was saying because I was still getting over the shock of where he had just put a needle.

He finished by asking if we had any other questions. "Just one", I said and proceeded to ask for his advice on further pain control, particularly as I only had a week's supply of the main prescription pain relief pills. "Will I still be needing them after that", I asked. "Or should I be down to the occasional Panadol or Panedeine Forte by then?"

"Jurek, if you still feel you need the prescription pain relief in a week's time, just phone me up....and I'll tell you you're a wimp!"

The psychology of this is probably to make sure that patients don't get addicted to prescription drugs. It worked!

In my earlier posting on this topic (9th June) I explained that my total education of internal examinations of the prostate was provided by Billy Connolly. A cartoon sent in response by a friend illustrates the first examination experience fairly well. Click here for enlightenment!

Have you noticed in the last couple of years how garden centres seem to have almost as much space taken up with displaying water features as they do displaying plants? It seems to be the trendy thing to do these days.

Well, I reckon there will be more than your average number of males reading this, so it seems the perfect time to find out something that's had me wondering?

Am I the only person in the world who hates water features?

It's nothing to do with aesthetics; it's the effect that the bloody things have on me! I know they are meant to bring a feeling of peace and tranquillity but they certainly don't to me. They just have the effect of sending me in search of the nearest loo....urgently.

I'm not referring to my post-op problems here. This has been the effect they've had on me for at least 5 or 6 years. A bit like Pavlov's experiment with his dog, the moment I see and here the trickling water on a fountain or some other fancy water feature, I am desperately in need of a pee!

So, help me out here. I'm dying to know:

- Do you like water features?
- Would you have one in your garden?
- If you do have one in your garden, would you like to rip it out?

Go on, click at the bottom with your answers YES or NO. You can remain anonymous but it would be interesting to know your age group e.g. under 40, over 50, over the hill and whether you are male or female.

Hospital staff are at an advantage. They can check your name before talking to you. It will be on their records, on the door or at the end of the bed. And when they use your name it’s really lovely.

“Hi Jurek, you're looking different to the last time I saw you.” When a nurse coming on shift said this to me it made me feel special and feel better in myself. In other words, it was a caring, healing way of addressing me and it was personal. I wasn’t ‘the prostate patient’, I was a person.

What then makes a patient feel even better about him or herself, is if they can respond using the nurse’s name. The same applies in a restaurant, reception area or any other service situation.

In the hospital I was in, most staff didn’t have badges pinned on. Instead, they had easy to read large nametags hanging on a cord around their necks. A bit like you often see for delegates at conferences and seminars these days.

Sometimes the nametags had turned the wrong way round. The name needs to be imprinted on both sides of the nametag to overcome this. They hadn’t taken that little design flaw into account at this hospital (and rarely do at conferences either). If the patient can’t read the nametag it defeats its purpose!

Some staff must have found the nametags irritating (I noticed it tended to be those with a fuller figure!) because they actually tucked their name badge into their shirt pocket, meaning that there was no way any patient would be able to see it, again totally overcoming the purpose of the name badge.

When I couldn't identify someone's name that had dealt with me before, it didn't feel as good when I was talking to them. And if our purpose is to make someone feel better about themselves as a result of being with us, then we have to take this into account.

By the way, in my other life I’ve written an article about the benefits of name badges and how to get staff to wear them. Click on ‘Name Badges’ to read or print out a copy.