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On the Job with: Doris Alwine
The doyenne of patient relations looks back on 18 years of complaints, requests—and human nature

From her office in Admitting, Johns Hopkins Hospital’s patient/visitor service coordinator, Doris Alwine, is pressing on with her latest challenge: the wheelchair situation. Why, in such a large hospital, are there so few? And what’s with those unsightly tags that stick out of their seams? These, she says, must be removed.

Alwine is perpetually attuned to such details—anything that might detract from the Hospital’s public face. Her day begins with lobby and first-floor rounds. Poor signage and dirty bathrooms earn her scorn; a shortage of pillows and blankets for families in Admitting awaiting word on loved ones, her dismay.

Over the years, Alwine’s job has evolved from handling patient requests to coordinating the Hospital’s special services for the public, like the travel agency service she established. Still, when patients or employees are having trouble navigating the system, Alwine always knows what to do next.

What does it take to settle complaints or handle requests in an institution this large?

Lots of experience, maturity and patience. These patients deserve our attention to every detail. Before I try to resolve any problem, I meet each person on his or her own ground. I need to get a good sense of what’s bugging them. Then I call upon a cadre of people in various departments with whom I’ve built good relationships over the years.

Your most difficult request?

A few years ago, I was asked to plan a memorial service for 100 people in the Houck Lobby for a transplant patient who died in the hospital. But I had less than a week to pull it all together, and family members were coming from several parts of the country.

Most frustrating part of your job?

Not being able to help a patient. We often get calls from places like Canada or California from patients with rare diseases, desperate for help. But they have no insurance and no money to get here. Some stories are just heartbreaking.

You’ve dealt with thousands of complicated situations. Can you give us an example of an especially memorable one?

A patient requested a special kind of bed that cost about $2,000. He wanted it delivered right away. I spent nearly an entire day finding a vendor with such a bed and had it delivered to the patient’s room within 24 hours. He had changed his mind, though, and when the bed arrived at his door, he did not accept delivery. He never called to let me know. I found all this out later. From the brother!

Is the customer really always right?

Yes… and no. When one is committed to serving the public, the challenge is to allow your customers to be wrong while still providing them with the necessary assistance.

Of course, being the No. 1 hospital in the country fosters unrealistic expectations. You must let patients know your limits. We can’t be all things to all people. Expecting free shuttle service to Gaithersburg, for example, isn’t realistic.

How have patients changed over the years?

They’re much more educated about their illnesses. Now patients are expected to be partners in the health care team. I see a growing sense of expectation and, in some cases, entitlement. Yet I recognize that these are people going through difficult times.

What have you learned about people since you started this job in 1988?

All of our weaknesses, egos—everything that makes us human—surfaces in a hospital setting. I’ve learned that most of the time people just want you to listen to them. But there’s this tension: You’re representing The Johns Hopkins Hospital, but you’re here for patients. You have to stay on neutral ground, which is sometimes very difficult to do.

Have you ever become too emotionally involved?

Yes. Once a patient came to my office distraught. She claimed the hospital had lost her medical records. For a solid week I tried to track them down, with no success. This patient would come in daily and tell me all her physical complaints, begging to be hospitalized. Eventually we discovered she had Munchausen syndrome, a mental illness in which a patient constantly feigns illness to be admitted to the hospital. I’d been totally taken in.

What would you say are the Hospital’s most pressing needs?

Housing and accommodations for patients’ families and improving communication. Poor communication is the No. 1 complaint among our patients.

What do you see as your biggest accomplishments?

Learning how to resolve billing issues, setting up an on-site travel agency service where one never existed and gaining recognition as someone who can help people navigate our increasingly complex health system.

How did you come to this job?

I’d been managing an insurance office for 10 years. One day, my boss took me to Hopkins to visit one of the agents, who was admitted here. As my boss and I sat in the cafeteria and split a sub and a burger, a light bulb suddenly went on in my head. I knew immediately I had to work here. I found out there was an opening in oncology and worked there for 10 years as a staff assistant for the oncology information system. Then I heard about an opening in patient relations. I’ve always been comfortable around people and jumped at the chance.

What’s to like about it?

I love this job. Anytime you’re involved in the human story, you can’t help but be touched in some way. You learn a lot about people, but you also learn lots about yourself.

—Judy Minkove



Johns Hopkins Medicine

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