Sitting Down with PatientsPosted: March 18, 2013
This past weekend, I had the wonderful opportunity to give the welcoming remarks at the Annual Recent Advances in Obstetrical Care conference in Baltimore, MD. Being an anesthesiologist, I have worked closely through the years with many obstetrical caregivers in the labor and delivery suite, and I am always honored when asked to share a few thoughts on healthcare today. A few attendees who knew of our blog asked if I would post my opening remarks on Educate the Young. Following is an excerpt sharing my comments on the increasing demands for transparency and the true value of patient partnerships:
What types of transparency are now being asked of us by our patients?
They want Transparency in outcomes. I have heard Peter Pronovost say, “consumers can get more information about the toothpaste they buy than about the care they will receive”. Patients want information on healthcare similar to the information they can obtain and review before buying a new car, choosing a hotel for a vacation, or selecting a restaurant for dinner. They want to be able to make more educated choices about their care options.
They want Transparency in shared decision-making. Informed consent doesn’t cut it anymore. More and more patients want their caregivers to fully understand their values, preferences, needs and goals before any discussions on care options, risks, benefits and alternatives begin. They want information on the hospital and their physician’s experience related to the procedure they will undergo–more succinctly–how many similar procedures have we performed, and how well have we done? They want to know our infection and complication rates. And more and more patients also want to understand the costs related to different treatment options.
And they want Transparency related to medical errors when that error has led to personal harm or loss. They are understandably frustrated and angry when traditional “deny and defend” approaches to unintentional patient harm are used because of medical malpractice fears, or when they are “passed off” to administrators and lawyers when trying to get basic questions answered about their care and possible follow-up treatment needs.
It is my opinion these new patient demands for transparency have been long overdue, are badly needed, and will help move us to a more cost-effective, higher quality, lower risk patient care model. It will be a new and better healthcare system, but history has taught us change will not come easily or quickly.
As you begin your educational meeting today, I want to leave you with one “take-home” suggestion – truly engage and partner with your patients. Many of us who work in quality and safety have learned so much from our patients and family members through the years. For me, one example of this valuable partnership is what I have learned through Carole Hemmelgarn, an amazing woman and patient advocate who taught me the following important communication skill.
When you enter a patient’s room, instead of standing at the foot or side of the bed (as I had done for so many years) pull up a chair, sit down and have a true conversation with them. Research has shown that patients perceive caregivers who did this to have spent twice as much time in the room with them, versus a comparison group of physicians, who actually spent the same amount of time with the patient, but stood at the foot of the bed while talking to them.