Dr. Fred Southwick speaks to why we should realize the doctors are both imperfect and human; and as patients we need to work to fill in the gaps.
I have experienced poor doctor treatment and care. I’ve witnessed highly dysfunctional care systems and distracted physicians. Doctors mismanaged my ex-wife’s heparin dosage, resulting in severe damage and a terrifying near-death experience.
In retrospect, I can see how I accepted this poor treatment from physicians during the early part of my wife’s illness. I should have immediately taken action and found a new physician as soon as I learned that doctors had mismanaged her care. My fear of insulting the senior physician who outranked me academically delayed me from making this change. The delay necessitated incredible heroics on the part of her new team of doctors to undo the damage caused by the first physician team’s inaction.
The simple truth is that doctors are not perfect. Patients need to recognize that doctors make mistakes. Physicians deal with many patients with many different medical problems. A patient deals exclusively with his or her own illness.
As a result, it’s my experience that patients with chronic illnesses gain a remarkable expertise in regard to their disease. Patients acquire a firsthand knowledge of an illness that doctors only read about in textbooks and clinical studies. Patients stay abreast of the most current medical information regarding their illnesses, especially in this era where medical information is only a click away.
This is a great tool for doctors to utilize! Obviously, each patient is highly motivated to understand his illness and maximize his treatment. Knowledgeable patients are able to describe which therapies did not work or were associated with serious side effects, in their specific cases. The information provided by the patient can save time, money, and heartache. Doctors need to merely listen.
An effective clinician acknowledges patient expertise and encourages patients to share what they know. Too many in this profession become threatened by patients’ suggestions or opinions. Physicians should be grateful to have knowledgeable patients actively contributing to their care, rather than sitting on the bench and passively watching.
It’s important to realize that doctor care is a small percentage of the overall care required for chronic illnesses. The majority of the care will be provided by the patient or his family. It is, therefore, critical to view each patient as a member of the care team. Physicians need to encourage questions and suggestions to further a patient’s medical expertise because the patient will, ultimately, be responsible for the management of his illness.
A doctor’s ego or overloaded schedule can prevent the development of his or her team’s communication. Patients need to recognize this potential problem and understand how to effectively handle it.
I recommend that when patients encounter a physician with a poor bedside manner, they ask constructive questions that encourage the physician to explain in layman’s terms what is going on. It’s completely acceptable to say, “Doctor, I’m sorry, but I don’t quite understand what you’re saying. I want to understand so I can assist you in curing my problem.” There’s a chance that some doctors won’t respond to these statements well and will continue to ignore your suggestions. In my opinion, if this poor treatment and communication is consistent, then it’s time to find a new doctor. Doctors aren’t in the position to demand loyalty from patients they themselves don’t commit to.
Patients must be on the lookout for other key indicators of poor systems of care and know when it’s time to switch physicians. Other things to watch for are: the head physician devoting minimal time and effort to your care; an absence of communication between physicians, nurses, and other caregivers; doctors or nurses conveying a lack of knowledge about current laboratory data; and an unwillingness to entertain suggestions by consultants or family members.
It’s critical that all patients and their families have access to good physicians and information regarding their illnesses. Everyone must understand the key processes expected for effective healthcare delivery systems; this knowledge allows patients to be discriminating consumers. When your healthcare is of poor quality, you can end up with permanent damage or fatal injuries. A patient’s understanding of his illness could turn out to be difference between life and death.
I have, unfortunately, far too much experience with doctors and our healthcare system. Between my father’s leukemia growing up and my hemophilia, I know all too well the wide range of doctor quality. I also know that in my experience, the vast majority of doctors are somewhere between bad and terrible. As someone with a rare, chronic condition, I have never had a doctor that approached me with anything but arrogance except the very very best specialists. Most doctors simply ignore your knowledge as a patient and pretend that they know more than you even if they have never dealt… Read more »
Hi Collin,
Thank you for sharing your all too common experience. I am planning on creating a face book site where patients can share their experiences, and I am hoping to write a patient edition of Critically ILL that will describe all the problems patients encounter in their healthcare systems and to provide advice on how to better navigate the system and identify the doctors who are willing to listen. Do you have any advice on how to find and encourage better care?