November 30th, 2011 by StevenWilkinsMPH in Opinion
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I may not know how to tell the difference between an empowered patient, an engaged patient, or an activated patient. But I do know that the fastest way to disempower, disengage, and de-activate any patient is a trip to the doctor’s office or the hospital. A visit to an average primary care physician (or specialist) is to an empowered/activated/engaged patient what Kryptonite is to Superman. It will stop all but the strongest willed patients dead in their tracks.
We patients have been socialized that way. Think about your earliest memories of “going to the doctor.” For me, I remember my Mom taking me to the Pediatrician. Early on I learned by watching the interaction between my Mom and the doctor that they each had a role. The doctor’s role was that of expert – he spoke and my Mom listened. I was there just to have one or more extremities twisted and prodded. And oh the medicinal smell…
Things haven’t changed much in the 40 years since I was a kid sitting in Dr. Adam’s office. Read more »
*This blog post was originally published at Mind The Gap*
September 3rd, 2011 by Michael Kirsch, M.D. in Health Policy, Opinion
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There was an extremely popular game show where several times each episode the emcee would shout out, “Survey Said!”. Of course, this was just a game, not real life. Now, several times each week I am asked to respond to surveys. They pop up uninvited on the internet and are often veiled advertisements for products and services. They are on the back of receipts from coffee houses and doughnut shops. Is it worth 10 minutes of my time clicking through the doughnut survey for either a free chocolate frosted doughnut or the chance to be entered into the grand prize drawing months later? Hotels I stay at routinely follow-up with e-mail surveys for my feedback. I suspect most folks delete these instantly, which skews the customer base to those who do respond. (Remember, disatisfied folks are often more motivated to give feedback than the rest of us are.) How often do we call a restaurant, a retail store, a bank or even a doctor’s office to offer hosannas about great service?
Medicare recently released fascinating patient-survey data that raises interesting issues. In over 120 hospitals, patients rated the hospitals very highly, despite high death rates for heart disease and pneumonia. So, who do we believe here, the patients or the death rates? I wonder if the patients’ survey results were more optimistic since only the live ones were available to complete them.
Surveys are now serious bu$ine$$. Read more »
*This blog post was originally published at MD Whistleblower*
August 26th, 2011 by Davis Liu, M.D. in News, Opinion
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The New York Times recently published an article titled, Finding a Quality Doctor, Dr. Danielle Ofri an internist at NYU, laments how she was unable to perform as well as expected in the areas of patient care as it related to diabetes. From the August 2010 New England Journal of Medicine article, Dr. Ofri notes that her report card showed the following – 33% of patients with diabetes have glycated hemoglobin levels at goal, 44% have cholesterol levels at goal, and a measly 26% have blood pressure at goal. She correctly notes that these measurements alone aren’t what makes a doctor a good quality one, but rather the areas of interpersonal skills, compassion, and empathy, which most of us would agree constitute a doctor’s bedside manner, should count as well.
Her article was simply to illustrate that “most doctors are genuinely doing their best to help their patients and that these report cards might not be accurate reflections of their care” yet when she offered this perspective, a contrary point of view, many viewed it as “evidence of arrogance.”
She comforted herself by noting that those who criticized her were “mostly [from] doctors who were not involved in direct patient care (medical administrators, pathologists, radiologists). None were in the trenches of primary care.”
From the original NEJM article, Dr. Ofri concluded Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
August 25th, 2011 by RamonaBatesMD in Research
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I was alerted to this Archives of Surgery article (full reference below) by MedPage Today: Role Playing Boosts Surgical Residents’ Bedside Manner.
I find it intriguing. Role playing gives you a chance for a “do-over” when you make a social or communication faux pas.
So much of medicine is communication. Those of us who have been at it for years, deliver bad news differently (learned the hard way) now than we did previously. You choose your words more carefully (though I still occasionally screw up). Some words are more emotionally charged than others. Some patients want more information than others.
The University of Connecticut Health Center conducted a prospective study of a pilot project designed to teach surgical residents patient-centered communication skills.
The study offered Read more »
*This blog post was originally published at Suture for a Living*
August 11th, 2010 by Davis Liu, M.D. in Better Health Network, Health Tips
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As a practicing primary care doctor, I continue to work incredibly hard on making my bedside manner even better so that patients feel heard. The other reason is because as most doctors learned in medical school 90 percent of getting the right diagnosis comes from taking a good history from a patient.
Unfortunately with shorter doctor office visits and doctors interrupting patients within 23 seconds of starting, you need to know how to get your concerns across. While I don’t believe this is the responsibility of patients, the reality is not everyone has access to doctors with great bedside manner.
How to talk to your doctor is quite easy if you follow three simple steps. Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
We patients have been socialized that way. Think about your earliest memories of “going to the doctor.” For me, I remember my Mom taking me to the Pediatrician. Early on I learned by watching the interaction between my Mom and the doctor that they each had a role. The doctor’s role was that of expert – he spoke and my Mom listened. I was there just to have one or more extremities twisted and prodded. And oh the medicinal smell…
