Doctor, do you feel O.U.T.? Overworked due to an increased patient load, Underpaid due to diminished reimbursement, and Told what to do because of too many rules and regulations such as the need to utilize an electronic medical record to capture data that will link patient satisfaction/experience with future payment models? As I relate the following story, keep in mind even educated people are vulnerable and often scared to visit a physician and the way things are said can affect patient satisfaction.
For approximately a year, while at work, a vibrant, healthy female attorney said she experienced upper back pain, which she attributed to tension, because it would go away once she got home. After several months, the pain became constant, but not debilitating. She continued to enjoy running, but after a few more months at the end of her run, she started feeling a tightening in her legs then dizziness set in.
She felt frightened and confused due to these unexplained symptoms, so she scheduled an appointment with her PCP. After some treatment options such as a referral to a neurologist, her PCP decided to order an MRI because “she might have a brain tumor." The PCP stated, “We’ll get through this together.” To which the patient thought to herself, “Will you be coming home with me to go through this with me?” As the day progressed, she kept thinking about the possibility of a brain tumor. This thought process triggered her first panic attack, for which she sought treatment at an emergency room.
Her appointment with the neurologist followed. He began by asking, “Why are you in so much pain?” The patient thought to herself, "That is why I’m here . . . to find out." After the exam, the neurologist said, “If you didn’t have insurance, I’d send you home with anxiety medication, but because you do, let’s run all these tests.” She said that literally made her feel like the doctor thought she was making all this up and that she was crazy. Once home, she contacted good friends who surrounded her and validated her sanity.
Fortunately, there was no brain tumor, but another test revealed a cervical disc protrusion for which she is hoping a series of epidural injections will alleviate the pain.
Her experience with the way the physicians spoke prompted her to take someone along to each subsequent appointment to not only be a second set of ears, but also to assist in presenting her as a person so the doctors get a picture of how unusual this whole situation is for her.
Doctor, patients look to you to be competent and caring. They want to receive enough information to understand what you determine their issue(s) to be, what they need to do, why they need to do it, and what you recommend.
Remember . . .
“It’s not what you say, it’s what people hear.”*
*Luntz, F. I. (2008) Words that work; it’s not what you say it’s what people hear.
Dona Constantine is a Senior Risk Management and Patient Safety Specialist for CAP. Questions or comments related to this article should be addressed to dconstantine@CAPphysicians.com. The information in this publication should not be considered legal or medical advice applicable to a specific situation. Legal guidance for individual matters should be obtained from a retained attorney.