In Dr. Wes Fisher’s article, A Growing Culture of Hostile Dependency on Doctors, published on KevinMD, Fisher states his belief that the media is schooling doctors about the importance of improving communication and empathy with patients, instructing physicians on how to care for their patients. And he’s pretty angry about it. Indignant even.
It isn’t the media asking doctors to show empathy or communicate more effectively with patients, to look up from their lap tops during interactions with patients, to engage patients in care—patients are. And the media is picking it up.
Medical journals are also publishing studies on the importance of doctor-patient relationships, successful communication, shared decision-making and patient engagement.
It’s not to drive Dr. Fisher crazy with increased demands on his time but to show that these concepts can increase the quality of care, increase patient safety, increase treatment adherence, and increase both patient and medical provider satisfaction.
I understand Dr. Fisher’s point that successful communication must come from both physician and patient and that staff shortages, time and financial constraints pose a significant challenge. But I have to disagree with Dr. Fisher’s statements that patients are “expecting perfect data, perfect health care access, error free health care with perfect delivery.”
Patients simply expect more from physicians, nurses and hospitals than the 195,000 annual deaths attributed to hospital medical errors, the 1.5 million medication errors which harm patients every year and the 1.7 million preventable healthcare-associated infections that occur annually.
As patients we simply want to feel safer. We are asking for better. Not perfect, but better. And we are willing do our part to help make that happen.
In my most recent book, The Take Charge Patient, I explain just how difficult it is for physicians and nurses alike in today’s complex healthcare climate. I interviewed over 200 of them for this book alone, which is why I ask patients to do their part, to take some of the responsibility for themselves as patients and to meet the medical provider half way. I offer tools so patients can communicate more effectively with their doctors, prepare for medical appointments with a list of questions and medical concerns to maximize the 7-15 minutes. I encourage patients to organize their own medical records and to become well informed about their conditions, medications, and other proposed treatment plans. I offer tools to enhance the quality of their care in light of pressures on medical providers. I also make it clear that patients must honor physicians’ and nurses’ expertise and training, but at the same time be well informed so they can make better choices.
In both of my books, The Take Charge Patient and Critical Conditions, I emphasize mutual respect between doctors and patients, mutual discussion, and more. I’m not alone. There are plenty of authors, patient advocates, patients, doctors and nurses who have written and spoken about the importance of patient centered care. We all emphasize partnership and a culture of collaboration—to increase the quality and safety of care for patients. According to the HRSA, if patients and their families are engaged, healthcare outcomes improve.
Dr. Fisher states, “There is a growing culture of hostile dependency that continues to grow toward doctors these days.” He then likens that hostility to adolescents who become angry with their parents when they realize that parents are human and are capable of mistakes. What Dr. Fisher misses in his pseudo-psychology analysis, is that with a successful doctor-patient relationship (mutual respect, empathy, effective communication, shared decision making, patient engagement and more) comes a more satisfied patient who is less likely to sue. See the JAMA article here http://archinte.jamanetwork.com/article.aspx?articleid=618939
According to this article and others, what prompts medical malpractice lawsuits against physicians is the perceived lack of caring and/or lack of collaboration in the delivery of healthcare, communication breakdowns or lack of a good doctor-patient relationship.
Fisher’s anger is blatant when he describes patients as adolescents with narcissistic rage toward their doctors.
The movement toward patient centered care does not, for the most part, involve a bunch of whiny patients and medical professionals who are stomping their feet in rebellion against physicians, as Fisher implies. It is about awareness of the frightening statistics and about putting forth effort so a team effort can be fostered to increase the quality of care and reduce medical error. According to the recent article in Health Affairs, New Era of Patient Engagement , research shows that more informed and empowered patients who participate with their providers in making decisions, experience better health outcomes.
For more information, please visit www.thetakechargepatient.com