Do Frustration and Inconvenience Equal Suffering?

A page-1 article in the February 18, 2015 New York Times caught our eye. It focused on patient “suffering” caused by the often frustrating, inconvenient, and noncommunicative way health care is delivered. Thomas H. Lee, MD, chief medical officer of the patient-satisfaction consultancy Press Ganey, was quoted as saying, “Every patient visit is a high-stakes interaction…And all you have to do is be the kind of physician your patient is hoping you will be.”

However, according to several online comments about the article from clinicians, alleviating this type of patient suffering may not be as simple as Dr. Lee suggests. Here’s a sampling:

MainerMD from Cleveland, OH:

To think that listening and communication will solve all of our problems cited here is horribly naive. Take 4 AM labs, for example. Doctors don’t order 4 AM labs to irritate patients. We do it because labs take time to run…What are we supposed to do? Let the patient sleep in, draw the labs at 8 AM, and then get called out of surgical cases or office visits to interpret the results and make a plan? …Wait until the end of the day to make plans, thereby delaying discharges and lengthening hospital stays? …The point is that these systems are complex, and things which irritate patients are not just the result of a lack of effort or personal shortcomings of doctors or nurses.

Rosy from Newtown, PA:

The bottom line is that we need to spend more time with patients, which is increasingly impossible.

Dr. DR from Texas:

Yes, feedback is great, and I think doctors can learn a lot from some of this data. But we also have to note that patients’ priorities (especially in a post-care survey) are not always in line with the best, evidence-based medical care.

Leo F. Flanagan from Stamford, CT:

It is time training in mindfulness, positive psychology, and hardiness is integrated into medical education. Caregivers who are trained to be resilient will not only be more attentive to patients, they will provide better clinical care.

Gary, an ER physician from Essexville, MI:

Inconvenience does not equate to the stroke or trauma patient’s suffering.

Dr. Abraham Solomon from Fort Myers, FL:

The patient is not his/her disease. The patient is a person with a medical problem. The whole person needs to be considered in solving the problem.

Rick, an ER physician from Pennsylvania:

Using patient surveys creates artificial and arbitrary measures that distract from the real questions of who gets better with the fewest complications, errors and inefficiencies. My highest ratings as an ER doc was when I gave everybody narcotics liberally, and ordered every fancy expensive test I could, “just to be sure” and to convince the patient I was “thorough” and I “cared.”

Regardless of one’s perspective, measuring patient satisfaction with the delivery of medical care is here for the midterm, at least. It would behoove us to consider the patient point of view as we balance how to interpret and respond to these measures.

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