Bedside Manners: Lessons from Consumer Reports patient safety survey

A good friend of mine recently underwent a significant surgery. Several weeks out, he was still experiencing some negative side effects that were supposed to have gone away much sooner. When he asked the surgeon about it, he didn’t get much more than a blank stare. He was given some medication as a precaution and basically told to go away and stop complaining.

In my view, that’s a lack of respect. And it concerns me, for my friend and for everyone out there trying to get their health care needs met, because it seems to go hand in hand with a low quality of care. I contrast that experience with a relative whose physician was warm, open to questions, and forward-thinking on the downstream effects of a major surgery. The recovery time was quick and, even with a few problems along the way, led to a complete return to a regular routine.

And now I have more than anecdotes to back up my hunch. The Gordon and Betty Moore Foundation recently funded a survey by Consumer Reports of 1,200 people who had recently been patients in a hospital. They found that a caregiver’s attitude toward the patient had a direct relationship to the quality of care. Consumer Reports wrote:

In our survey, we measured perceptions of respect, such as the way hospital staff communicated and whether they acted with compassion, honored patients’ wishes, and acknowledged mistakes. About one in four of those surveyed said that medical personnel did not consistently treat them as adults able to be involved in their own care or ‘like a person.’ One-third of the respondents said doctors or nurses didn’t always listen to them without interrupting, and 34 percent felt that their wishes about treatment were not always honored. Worse, 21 percent of patients thought they weren’t always treated fairly and without discrimination.

Those who felt they were not treated respectfully were also the ones who reported experiencing the most negative outcomes. Consumer Reports wrote:

Those who said they rarely received respect from the medical staff were two and a half times as likely to experience a medical error – such as a hospital – acquired infection, a wrong diagnosis, an adverse drug reaction, or a prescribing mistake – as those who thought they were usually treated well. In fact, 29 percent of people in our survey said an error occurred.

There are some great lessons for patients and for health journalists in the survey report. Here are three of my favorites.

1. Be persistent. If you think there’s a problem with your care or with the care of one of your family members, you need to speak up. If you noticed that a mechanic forgot to tighten the lug nuts after putting on a new set of tires on your car, you would say something. You should not be afraid to say something just because you are in a hospital instead of an auto shop.

2. Remind providers that you are a person, not just a patient. When I read this particular piece of wisdom, I was reminded of Pat Mastors, who wrote a great piece for Antidote after Andy Rooney died. Mastors is a passionate patient advocate who believes that many medical errors begin when providers depersonalize their patients. She created The Patient Pod for just this purpose. It’s a kit that contains hand sanitizer and other things to keep patients safe. The front of the kit features a slot for a picture of the patient in healthier times. “This is the me I want to be again,” the pictures will say. “I have a family. I have people who love me. Treat me like a complete person.”

3. Take good notes. All patients would do well to go through some journalism training. The best journalists know that if you write down everything, you will end up with a mess of words that help tell a story. Similarly, if a patient or family member writes down everything that happens, they will note be able to spot patterns, positive or negative. Consumer Reports wrote:

Medicine is complicated stuff, and sometimes doctors forget you haven’t studied it. ‘This is so much a part of their lives and their vocabulary. Sometimes they rush through an explanation without realizing that the person in front of them has no clue how to interpret what they just said,’ says communications specialist Carolyn Thomas. ‘I simply raise a hand in the ‘stop’ position, and politely remind them that I haven’t been to medical school, so please slow down and translate.’

Photo by Vic via Flickr.

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