In any industry, there will always be unhappy customers. Having a formalized method of dealing with complaints is absolutely necessary to protect consumers and patients. What isn’t discussed enough is the severity of these complaints’ psychological repercussions on physicians and other medical providers.
Most providers spend years of their lives in school, sacrificing family plans, social events, and sometimes their own well-being, all on a mission to care for others. Despite our training and best intentions, there will be cases that lack the desired outcome. For people working in most other fields, a complaint about services or outcomes may indicate a need to review what steps went wrong or could’ve gone better, but in medicine, complaints from patients cause distress about the providers’ knowledge and ability to continue practicing in the field.
There is a difference between malpractice, an undesired outcome, and a poor patient experience. Lack of support from hospital administration can emphasis provider feelings of being inept, insecure, anxious, and even suicidal. The balancing act of patient advocacy and preserving physician integrity is delicate and by no means simple. When hospitals or private physician groups routinely write off patient balances for frivolous reasons as a means to appease angry patients, or worse, angry family members, they are saying it’s ok to abuse the benevolence of health care providers. It detracts from the value of the care a provider spent years achieving through school and residency.
Health care’s fear of litigation is contributing to physician shortages, as doctors do not want to practice in locations where they feel undermined by their employer. Health care’s lack of emotional/psychological support available to physicians to cope in a healthy way with patient complaints, grievances, and lawsuits contributes to sleepless nights, anxiety, depression, and physician desires to leave clinical practice. There needs to be a better way. A better way to protect patients and help support physicians.
The commercialization of medicine has benefitted some, but without healthy doctors to provide care, the future of medicine might look very different. Patients talking to computer algorithms to obtain a diagnosis, prescription, or referral may become the norm. Artificial intelligence won’t have a conversation with you, although it will ask you numerous questions to fit you into a specific profile. It won’t palpate your abdomen or do a neurologic exam, but you may get a fancy watch to track your vital signs.
I believe there is an art to medicine, a psychological connection to your patients through a hands-on patient encounter. There are nuances AI may take decades to compete with. For now, in my lifetime, I hope that people examine patients and when there are questions about the quality of care, institutions perform a deeper dive into the real problem. (Was it the overall experience, a poor relationship with the doctor, financial stress that would be assumed by paying the medical bill, or actual malpractice?) Without support from our employers, physicians will continue to feel the accumulation of burnout and insecurity that leads to emotional duress, leaving medical practice or the worst outcome: physician suicide. We are not machines. The burden cost is evident, but when will the medical community, investors, and hospital administrators begin to truly support physicians and prevent these terrible outcomes?
Gina Ambrose is an emergency physician.
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