What your patient appreciates, and what causes hurt and confusion

Listening to patients for the past two weeks, we learned quite a bit about what patients appreciated about their doctors and what had left them hurt and confused.

The good:

M., an elderly lady with a very close relationship with her primary care physician, said she had been to many bad doctors in her life.  She knew right away that her current doctor was different, that she “could just tell.”  M. didn’t feel like she was wasting the doctor’s time.  What was so special about her?  ”She listened.  She really listened.”  When asked to elaborate, M. had a difficult time describing the intangibles that struck her.  The two just clicked.  ”It’s a gut feeling.”

From a doctor, three A’s: “ability, affability, availability.”

I interviewed a cardiac patient and his family in the hospital who were very grateful for the team of doctors that cared for him.  The family mentioned a doctor at a different institution, who, after a long day, took them aside for a private conversation.  He asked how they were doing and if they were taking care of themselves.  ”Are you sleeping?  Are you eating?” he had asked.  ”You need to take care of yourselves so you can take care of [the patient].”  He spoke to the family for 45 minutes, until nearly 10 pm.  ”During that time, his wife called him several times,” recalled a family member.  ”He just said he’d be home soon.”

The bad:

That same family recounted a time when their father/husband was undergoing a fairly long surgery.  After waiting for any sort of news, the family finally heard from a few staff members that the surgery turned out fine (no more detail than that). A bit later, they noticed the surgeon step out and they approached him and asked him for additional information.  ”Did you talk to my staff?” he asked.  They said they had.  ”Then you know it was fine,” he answered brusquely and turned and walked off.  ”It was as though he considered any of his time talking to us a waste.”

The ugly:

A classmate of mine mentioned that when she had interviewed a patient, the patient had mentioned that she had surgery which had left a scar on her chest.  Her doctor had told her that it shouldn’t be a problem, since she was never going to wear a bikini anyway.

Shara Yurkiewicz is a medical student who blogs at This May Hurt a Bit.

 

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  • http://secondbasedispatch.com Jackie Fox

    Good post. It doesn’t take much; just treat us like human beings.

  • http://kevinmd.com Linda Neider

    Most Patients don”t object to Physicians making a decent salary they mostly want to know that they are truly cared about and included in their care plan without judgement and a plan they understand

  • http://myheartsisters.org Carolyn Thomas

    Shara, thank you for this. May you never lose your skills at listening to patients like this long after you graduate from med school.

    When I asked other heart attack survivors recently to share their own most memorable examples of doctor comments they had heard since their cardiac events, the results turned out to be both hilarious and appalling at the same time. I listed many of the most memorable at: “Stupid Things That Doctors Say to Heart Patients” – http://myheartsisters.org/2011/01/13/stupid-things-doctors-say-heart-patients/

  • http://Www.twitter.com/alicearobertson Alice

    I agree with previous posters…the answer is simple in theory….hear what your patient is saying….they are rarely there to waste your time….they desire to feel better and see your expertise as the road there. And you are paid for the priviledge of service. I think most patients want their doctor to like them…take a personal I interest in them. My dad’s doctor waits until after you leave and makes a file on you on his blackberry. Then the next time he reads the notes before seeing you. He comes in the room in good spirits and picks up the conversation they left last time. It immediately cheers my dad up. I took my dad to the neurologist a few weeks ago….he is a new doctor…but somehow knew things about me. I think he reads this blog….he was serious, thoughtful, empathetically making sure I understand that I am not bothering them if I call when I am overwhelmed. Offered to talk to me at any time. I was impressed….he wasn’t….he felt my hesitation to bother the staff was not healthy…he
    repeated they are here to serve the needs of the patient. Hmmm…few doctors offer that type pf self sacrifice….it gave me great relief and admiration for him.

    When we left this appointment my dad forgot his coat. We went back and the doctor was writing notes in longhand to himself (everything is an EMR here with laptops in each office). I think the notes are an effort to personalize the next visit. I appreciate that very much.

  • http://www.womeninpainawareness.ning.com carol

    It reminds me of what I learned, from reading research as well as doing my own unscientific study. Patients tend not to sue, even when the malpractice is egregious, when the doctor apologizes and offers to do what he can to help. (as well as some level of compensation).
    http://www.usatoday.com/yourlife/health/healthcare/doctorsnurses/2010-08-20-medical-errors-malpractice_N.htm

    Carol
    http://apainedlife.blogspot.com/

  • http://ryanmadanickmd.wordpress.com Ryan Madanick, MD

    Refer back to this post when you are a resident. And then later when you are a young doctor…and again when you are getting into the “prime” of your career.

    It is always worthwhile to remember what it means to communicate well with your patients.

    Nice post.
    RDM

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