John R. Tkach, M.D.
300 North Willson, Suite 203B
Bozeman, MT 59715
(406) 587-5442


How We Get Things Done

Teamwork - Mary and Kaire

There is more to the successful treatment of skin problems than just submitting yourself to my treatment. What you have to say is important. How the treatment affects you is important. My style is to listen to you and to examine you closely, sometimes with my magnifying glasses. There are thousands of skin diseases. Many look alike. The more clues I can gather, the better. You can help me by telling me about the problem. It is especially helpful to know what previous treatment you have had for this problem and how well the previous treatment worked.

I propose teamwork. I invite and encourage you to work with me in this way. The members of the team are you, I, my assistants, Mary and Kaire, and if you have a spouse, I encourage your spouse to participate. There may be some other significant person whom you would like to include such as one of your kids who has grown up, a close friend, or some other relative. Our team starts by your initiative when you schedule your visit. Kaire helps out a lot here by scheduling your appointment and by sending you reminder notices for follow up visits. Your cooperation in making follow up visits is vital to our team and excellence in your medical care. When you are escorted to my examination room, ask your spouse or significant other to come along if that feels comfortable to you.

Most of the time, the treatment is not painful. But, if the treatment hurts you too much, let me know. It might be better to stop a minute and let you rest. Just let me know.

Dr. John Tkach using a microscope

If I miss the point when I am examining and treating you, please let me know. If a spot seems peculiar or worrisome to you, please point it out to me. If you feel I am not getting the job done, or if I unintentionally hurt your feelings, let me know. I need to hear the bad news as well as the good news if I am going to improve my work with you to give you the best medical care. This is what teamwork is all about. One person on the team may notice something other team members missed. If the team members work together, the final result will be better care of your skin problems. Even if you are not a doctor, your input is very valuable to me.

Please give me critique and feedback when you feel I need it. If the skin problem has been treated several times and is not improving, just let me know. You could say to me, "Doctor, you have treated this spot three visits now, and it's not getting better." If you feel I have not listened to you, stop me and say, "Doctor, listen to me. You are not listening to what I am telling you." I would rather have you do that than not get your problem taken care of.

It is easy for me unwittingly to shift into a patronizing mode. Patronizing means that I am taking the attitude of "Do it because Doctor knows best." If you detect that, please let me know. It would be off target for me to be patronizing to you since I am not your dad. Another problem with my being patronizing is that it cuts you off from being a member of the team and taking a part in decision making.

Also, it is important for you to understand what the diagnosis is and what the treatment, risks, and side effects are. If I have not done a good job of explaining them to you, let me know.

Thanks for taking the time to read this. Some of these ideas may seem trivial to you, but if we work together, I think things will go better with the treatment. Welcome to the team.

[Dr. Tkach] is not just a nine-to-five doctor. On most weekend, he spends several hours in the Montana State University library doing searches of the on-line medical literature and data bases for assistance in treating his patients who have highly challenging cases.