Question: I work with someone who assumes patients are okay with being called 'sweetie, honey, or 'darlin.' The person frequently asks patients about family, friends, and their personal lives. The person also shares their own personal information, which I feel is very unprofessional. The person has a loud voice that carries, and other phlebotomists have stated they don't want to overhear such conversations, but our manager won't address it or even investigate. We all have to work together in close proximity, so what can I do to curtail this person's overly personal patient interactions? The person is other-wise a great phlebotomist. What should we do?

Our response: We agree the coworker is going too far. Calling patients pet names is not professional and assuming every patient is comfortable with them is presumptuous. The probing personal questions and sharing of personal information goes beyond what's necessary to make the patients' experiences positive. 

To be fair, the person is likely of the opinion that by adding such personal touches, he/she is putting the patient at ease. He/she likely considers the personal flair to be a trademark of sorts that reflect good customer service. His/her intent is no doubt well-meaning, but misguided.  The manager needs to step out of the office and assess the appropriateness of the banter first-hand. By not following up with your complaint, the manager is choosing not to be involved. That's never a good idea. Not only does it fail to identify problems, it sends a signal to you that your concerns have no merit. If everyone on staff feels the same way, morale will tank, the team will lose cohesiveness, and the quality samples and patient experiences they deliver will rapidly degrade.

Of greater concern is the potential for HIPAA violations. When personal information is exchanged in an environment where others can overhear, patient confidentiality is lost. The manager may consider the pet names and too-cozy dialog as trivial infighting, but he/she has an obligation to monitor the exchange of confidential patient information and curtail its transmission. Failure to do so carries substantial fines and legal liability. So, while the manager may not want to intervene, he/she has a statutory obligation.

You, and other coworkers who feel the same, should approach your manager with specific statements you feel should not be made and overheard. For whatever reason, your manager may not turn the same deaf ear to your coworkers as he/she does to you. When the same concerns are expressed by several employees, the responsible manager takes action. It's appropriate for the manager, at the very least, to tell the boisterous coworker to soften his/her voice and tone down the pet names. But an audit of the nature of patient interactions is in order, and he/she can't conduct an audit without having a momentary presence in the area on multiple occasions spanning several days. The audit should be conducted with and without the employee in question on duty.

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