From USA Today:
Doctors and patients alike say that when they communicate well, healing goes better, and it can even make the difference between life and death.But a national survey of doctors and hospitalized patients finds that, in reality, effective communication often is sorely lacking.
"Sorely lacking" - according to my email that doesn't even begin to touch the real disconnect in communications between patients and their doctors.
An official from the hospital that commissioned the study (Beth Lown, Massachusetts General) acknowledges this major disconnect. Fewer than half of the patients surveyed felt they had been included in their treatment decision-making. Almost 30% didn't even know the name of the doctor caring for them in the hospital!
We patients can't affect what the hospital does with its survey results, nor can we affect what medical schools do to train their students. Further, and perhaps the biggest problem of all, is that we patients have no way at all of improving the communications skills of doctors who are already caring for us patients. In fact, according to reports from you readers, arrogance on the part of some doctors must be getting worse than ever.
What we patients CAN do, however, is begin to insist that providers share certain kinds of information, and that we be involved in our own decision-making. Here are some practical steps and ideas for doing just that:
• Effective Patient-Doctor Communications
• Diagnosis 101 - Effective Communications with Your Doctor
• Choosing the Right Doctor (includes finding one who can actually communicate with you!)
• How to Make an Objective Medical Treatment Decision
• Sharing Internet Health Information with Your Doctor
• Deciding Whether to Change Doctors
Do you have stories to share (good or bad) about your communications with your doctor? Please share them here:
• How to Improve a Doctor's Bedside Manner
• How to Deal with an Arrogant or Egotistical Doctor
• Have You Shared Internet Information With Your Doctor?
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Learn more ~ or join the conversation!
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Trisha,
Excellent article, but I think that one reason that there is such a huge gap in communication is that sometimes patients are afraid to address their concerns about treatment choices and the decision that is right for handling the problem. One of the things that we are learning in this program that I am taking for Medical Assisting is that knowing how to communicate effectively with patients also crosses cultural boundaries as well. So there are a number of different challenges to the communication process. Makes me wonder if with those surveys if the question was ever asked about the issue of culture, gender, etc.
Trisha,
Right on. While this survey is about hospitalized patients, the same communication gaps also exist (in spades) at the routine doctor’s appointment in many instances.
What’s bizarre is that hospitals are all about creating positive “patient experiences” these days and are beginning to invest in amenities like gardens and the like. Yet the simple notion of having their employed doctor’s (usually hospitalists) introduce themselves by name or tell the patient their diagnosis somehow escapes these creative hospital “experience builders.”
And you think you are cynical…
Steve Wilkins, MPH
To assume patients can do nothing to change the way doctors are trained or surveys are used is defeatist. I have written letters to hospitals describing my experiences and explaining my resulting thoughts and feelings. Twice now, I have either been taken to lunch or received a written reply from a department head telling me how much my comments have made a difference and explaining exactly how the department has changed how it does things as a result. To underestimate the power of the patient is a mistake… particularly if we ever hope to truly empower people.
Thanks for mentioning our recent poll of doctors and patients about the importance of compassionate healthcare. You make a good point about patients being engaged in decisions regarding their medical treatment. In fact one of the poll findings not mentioned in the USA Today piece was that doctors and patients agree that patient involvement in medical decisions is an essential element of compassionate care. You can view the complete survey results here: http://www.slideshare.net/schwartzcenter/survey-the-state-of-compassionate-healthcare-in-the-us
Julie Rosen
Executive Director
Schwartz Center for Compassionate Healthcare
I work with clients to give them the information and “medical speak” to help them get the answers they need. I worked many years in hospitals and home healthcare,and I can tell you that many patients just don’t know what or how to ask a question to get a straight answer. Many seem to feel their questions are “dumb”, not realizing that we sometimes use abbreviations and terms everyday that we assume our patients will know. When I was in the field I realized how often I did this and made a concious effort to break the habit. Now, I use nuts and bolts descriptions and words to convey complicated ideas, and the compliance skyrocketed…imagine what would happen if we applied this with all departments!
Hello Trisha and Readers,
Intriguing survey and results re docs and patients not communicating well, I must say that though we look to the medical professionals for their advise, counsel, test results, diagnosis, prognosis, often in an atmosphere of fright and terror for what those pronoucements are, we patients often do not take responsibility for accepting their pronouncements as gospel truth or for treating them as know-everything gods. Responsibility is paramount in a patients’ retinue of skills and practices. It is surprising how many people do not take personal responsibility for their own health.
How many of us have gotten advice, estimates, and information from numerous companies re HDTV, computer parts + pieces, dishwashers, Internet providers, etc. before making an informed decision? Why don’t we take those same steps when deciding who should be our medical partner in our own health?
In this day of national health care it is more important than ever to stand up and take/make a stand for our own health and wellness and take responsibility. It is our responsibility to demand better communication and care, to demand to be spoken to with respect and dignity, to get “mad as hell” and determine “not to take it anymore”! Have a doc or other medical professional who does not “get it’? Demand another person to be your medical partner. You are the consumer, and if one “company” is not giving you what you want, go elsewhere!
I totally agree that the communication gap is real and regretably, alive and well. I also agree that we as patients have to take responsibility for allowing it to prevail in the system. We do have to become, “mad as hell and (determine) not to take it anymore.”
Blogs such as this one that Trish writes is a huge step in encouraging people to be responsible medical consumers.