Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

What Can Physicians Do About Their Dissatisfied Patients?

While by no means a representative sample of how we think about physicians, there is a clear pattern to the comments.  A lot of people feel disrespected by their doctors…and they are pretty angry.

Here’s what patients (including a lot of former patients) had to say.  I attempted to summarize the comments by category and included the top five categories of comments below.

#1 – “Being on time is a two way street.” – patients are expected to be on time for their appointments – why aren’t physicians expected to be on time.   Doctors think and act as if their time is more valuable than the patient’s time.

#2 – “Listen to what I have to say.” “Doctors should realize that many patients have more life experience and have done more research about a condition and drug and may possibly know more than them. God forbid!”  “If you do not like listening to your patients and getting proper information from them, you are in the wrong business.”

#3 – “Don’t just hear one or two of my complaints.” You try telling the doctor all the problems you have and the doctor stops you mid-way, telling you that he or she will take care of two and to come back again for other issues!”  “What about someone like me who is on disability for a multitude of health problems?  What then?”

#4 Read more »

*This blog post was originally published at Mind The Gap*

When Physicians Have To Say No: Does Patient Satisfaction Suffer?

The short answer: No.

At least not in the context of a strong physician-patient relationship.

Many physicians have legitimate concerns about the prospects of having their salary or level reimbursement linked to patient satisfaction. I would too given the way most health care providers go about measuring and interpreting patient satisfaction data.

A major concern of physicians is the issue of patient requests – particularly the impact of unfulfilled (and unreasonable) requests upon patient satisfaction. According to researchers, explicit patient requests for medications, diagnostic tests and specialty referrals occur in between 25% to 40% of primary care visits. This figure is much higher when requests for information are factored in. Read more »

*This blog post was originally published at Mind The Gap*

What Makes A Great Oncologist?

I had a WOW experience yesterday when I accompanied my wife to interview a new doctor for her.   As some reader may know she is being seen by specialists at MD Anderson Medical Center in Houston for Stage IV lung cancer.   She has not had a local oncologist for the past 6 years…but she does now.   And we both love this guy!

You need to understand that I have been very underwhelmed by the local oncologists I had met up till now.   I am sure they were clinically proficient…but as a group not a one could muster a smile….or any sense of interest or curiosity in my wife’s medical condition.  I held out little hope that this new doctor would be any different.

After being ushered into the exam room, a Physician’s Assistant came into the room to get smart about my wife’s history and records (which she brought).   Three things surprised me about the PA.  1) She was incredibly thorough actually reading the radiology reports and reflecting with my wife on what she learned, 2) her empathy – as she read the reports she actually used terms like “bummer” when she read how my wife developed pneumonia during her treatment, and 3) she faithfully summarized the results of her review to the doctor before he came in.  In other words – the PA listened and heard what my wife shared with her!

Now enters the doctor.   He has a warm smile on his face while he extends a hand to my wife and me.  He says just enough for us to know that he has talked to the PA.  He asks my wife to sit on the exam table and does a physical exam (also a rare event these days). Read more »

*This blog post was originally published at Mind The Gap*

Enough About Physician Empathy

Is anyone else tired of hearing about how important empathy is in the doctor-patient relationship? Every other day it seems a new study is talking about the therapeutic value of empathy. Enough already!

It’s not that I don’t believe that empathy is important — I do. I also believe the data that links physician empathy with improved patient outcomes, increased satisfaction, and better patient experiences.

A recent study released in Academic Medicine reported that “patients of physicians with high empathy scores were significantly more likely to have good control over their blood sugar as well as cholesterol, while the inverse was true for patients of physicians with low scores.”

Findings from this study by Hojat, et al. are consistent with a 2009 study by Rakel, et al. which found that among patients with the common cold, those with physicians displaying high empathy had a significantly shorter duration of illness and trend toward lesser severity of illness and higher levels of immune response compared to those patients whose physician displayed less empathy. Read more »

*This blog post was originally published at Mind The Gap*

Doctors And Patients Wish Their Relationship Was Better

Physicians said in a survey that noncompliance with advice or treatment recommendations was their foremost complaint about their patients. Most said it affected their ability to provide optimal care and more 37 percent said it did so “a lot.”

Three-quarters of patients said they were highly satisfied with their doctors. But they still had complaints ranging from long wait times to ineffective treatments.

Those are just some of the findings from two surveys, the first a poll of 660 primary care physicians conducted by the Consumer Reports National Research Center in September 2010 and the second a poll of 49,000 Consumer Reports subscribers in 2009. The magazine reported its results online.

In the doctors’ poll, physicians named these top challenges:

— 76 percent of doctors said when it came to getting better medical care, forming a long-term relationship with a primary care physician would help “very much.”

— 61 percent said being respectful and courteous toward doctors would help “very much,” while 70 percent said respect and appreciation from patients had gotten “a little” or “much” worse since they had started practicing medicine. This was a two-way street, since patients reported the same feelings.

— 42 percent physicians said health plan rules and regulations interfered “a lot” with the care they provided.

Also noted in the poll, 37 percent of physicians thought they were “very” effective when it comes to minimizing pain and discomfort for their patients, though 97 percent thought they were “somewhat” effective. But, 79 percent of patients said their doctor helped to minimize their pain or discomfort, according to the Consumer Reports blog. The gap might be explained by doctors thinking of their overall effectiveness with all of their patients, including those with chronic pain conditions that are difficult to diagnose and treat, and who are as a group less satisfied with their physicians. Read more »

*This blog post was originally published at ACP Internist*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »

Commented - Most Popular Articles