I enjoy talking to random people about their experiences with health care. As somebody who regularly travels all over the country, for both work and pleasure (I far prefer the latter), whenever I meet people in situations where you end up talking — be it on airplanes, a guided city tour, or at a social function — as soon as I say I’m a physician, the conversation invariably ends up turning towards that person’s experience of health care. It could be a major life event they or a family member had, or a more benign interaction. I suspect that’s what happens to many doctors out there.
I’m OK with it, and have no problem hearing their stories, noting how emotional they often are when recounting. Unfortunately, however, on a not infrequent basis, I hear negative stories of what went wrong or was handled in a suboptimal manner. As someone who has an interest in communication and optimizing the patient experience, I always feel a bit sad when I hear the same things mentioned over and over again. In fact more than sad, I’d say I feel disappointed.
Now don’t get me wrong, I’m not making any judgment about what happened to them, or the hospitals or doctors involved. (How could I; I wasn’t there). And in any case, I’ve heard the same things said about places I’ve worked as well. We all do our best as dedicated professionals to provide stellar care in difficult circumstances. We are very good at the clinical part, and acute care almost everywhere in the U.S. is top-notch. Yet those same issues keep coming up:
1. “Everything was really rushed.”
Hospitals and clinics are extremely hectic places. There’s a lot going on, doctors and nurses are super busy, and unexpected situations arise all the time. Realistically, physicians don’t have endless time to spend with every patient. We can’t chat (even if we’d like to) and have to be highly focused on solving the main problem. But is there any way for hospitals, which are supposed to be temples of healing, to convey a more calming and tranquil aura? That’s our challenge.
2. “I kept hearing different things from different physicians.”
I call this “too many cooks in the kitchen syndrome.” It’s okay for different doctors to have different opinions, but why do so many people come out of hospital with this perception? I see it myself every week in general medicine. Patients will sometimes have five or more physicians seeing them. What makes it worse, is that these five doctors will rarely communicate with each other! If I, as the main Attending Physician, am confused myself, how must our patients feel? Another really important question we need to keep asking ourselves.
3. “The follow-up plan wasn’t coordinated.”
As a continuation of point number one, discharging from hospital often happens abruptly and in a complete “discharge haze.” For particularly complex patients, there needs to be absolute clarity regarding what comes next. What medicines to take, what medicines were changed, when exactly will my physicians see me next, and what should I do in an emergency. Unfortunately, the computer-generated printouts we now distribute to patients frequently make things worse and are quite unintelligible.
These are just three of the most common complaints I hear. I could go on down the list — communication problems, noise levels, food, and of course the bills — but the above three are the most heard when it comes to their overall experience. They are also the ones that we have the most control over. It’s a shame if a patient of family member ever comes out of hospital with a sour taste in their mouth because of their experience, beyond the fact that they were unwell, which sucks enough as it is. Whether they are talking about themselves or their grandmother, it bothers me when I hear these things, because it’s unnecessary and something that is very fixable on health care’s part.
Suneel Dhand is an internal medicine physician and author. He is the founder, DocSpeak Communications and co-founder, DocsDox. He blogs at his self-titled site, Suneel Dhand.
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