Monday, April 30, 2012

Today's rant: Do doctors even listen to what they say?

Sometimes I think doctors look at those of us in the waiting room not as family members of patients but as potential plaintiffs in a lawsuit.
And I understand why. I can do a whole blog on lawsuits and tort reform, because I do think while the lawsuits have done a lot of good as far as product safety and corporate responsibility, they also got out of hand and have severely hampered initiative in the business community (and there is no accountability when, years later, the massive rulings against certain businesses - and I'm thinking medical here - have proven to be based on what turned out to be an incorrect cause and effect).
All of my friends who are doctors or in the medical profession, I'm with you.
But some of your colleagues really could stand to learn some communication skills.
Is it really such a bother to tell us what is going on? Who does it hurt to admit you're just not sure of which direction you're going to take, that you might not really know until you get started on the surgery and see what you're dealing with?
Sometimes I really do feel like some of the docs I deal with are just checking the box ... "spoke to patients next of kin - check."
I can't speak for everybody, certainly. But honestly, if you're just the floor doctor and you're only connection to my patient is that you just read her chart before you came in, tell me that. "I'm in charge today on the floor. I just read the chart. If anything happens, we'll take care of it. Obviously I'm not the surgeon who has done anything or will do anything. I'm that guy that is here in case something God-awful and unexpected happens. Let's hope this is the extent of our communication."
Yesterday when I came into the "unit" (what are these little trauma areas called? They aren't rooms because they are so glass-enclosed and open), I saw a consent form that needed to be signed for surgery on MG. I asked if I needed to sign that, and the nurse said yes, and she'd get the orthopedic resident on call to come see me because he had to go through it with me.
A few hours later, this guy I've never seen before comes out and says, "Who is with the Melick family?" since he'd never met me before.
"I am," I say.
"I was told you have some questions for me."
"No, I was told I needed to sign a consent form."
"No. ..." and then he proceeded to go into this song and dance about "you're scheduled to have surgery at 7:15,but it might be 8 or 9. It could be the afternoon...." I halfway expected him to say, "Or we may have already done it and just not told anyone."
At 5:19 this morning, my phone rang. Fortunately and not-surprisingly I was awake.
"Mr. Melick, I'm sorry to wake you, but I need you to authorize surgery for this morning. You'll have to talk to the doctor and can authorize it over the phone."
The nurse was very apologetic, and knew exactly what had happened - she was the one who'd tried to track down the ortho-guy so I could sign the consent form, the one the young resident said I didn't need to sign.

So here we go: communication. I don't care that the resident on-call didn't know me or didn't know about MG's case. I don't even care that he made it clear I was fortunate he had managed to squeeze out a few minutes of his precious time to find me in the waiting room, because he had better things to do (like learning to be a doctor). Heck, we all get busy. I get busy. You think saving the Gulf has been easy?
But all he had to do was ask the nurse, "Do you know why I need to see Mr. Melick?" Or at least listen to her when she explained that he needed to see me so I could sign a form.

I really didn't mind the phone call at 5:19 a.m. It saved me from buying some grout repair kit that was really becoming tempting because if I called in the next five minutes I could get two complete kits for just $10, with a money-back guarantee. I was already thinking about changing the color of the grout in the shower just because with this thing I could do it, then erase it, and do it in another color, erase it again and start over.

A good friend who is a doctor came by to see me. He's everything you want your doctor to be: smart, but also caring. He has the luxury, perhaps, because he's in private practice and not assigned to the trauma unit of a hospital.
He told me something that I appreciated. He said (essentially), "This is a teaching hospital. These guys are among the best at what they do. But they aren't patient-oriented. They are all about the medicine."

Several other people who have dealt with situations like mine shared that their experiences that were very much like my own. So it's not just me.
It wouldn't hurt UAB to make all doctors spend one day a year going through some basic communication skill classes. We do it in media training. We have key people go through practice sessions with someone who is pretending to be interviewing you and ready to turn on you at the slightest miss-statement. It doesn't guarantee that our people won't make a miss-statement because we're human and in the heat of the moment sometimes all of us say things we later regret. But the more they go through it - from the top to the bottom of the organization - the more they know what to expect and how to respond when asked questions.

Doctors - particularly highly skilled surgeons - have reputations for thinking they are little gods. I do understand they are under tremendous pressure to be infallible. Lives are at stake.
As well as the potential for lawsuits.

I wonder if they even listen to the stuff they say sometimes.
These are smart people, well trained, well educated.
I can't help but believe if they did listen to what they say, they'd be embarrassed.

But I could be wrong.

3 comments:

  1. Okay I've cried at app your other posts, but I laughed at this one. I couldn't agree with it more;) ray, Chris and I think of you, mg, and the kids daily. We pray and ask all the "whys" we can until we forget we will never know the answers. We love y'all and are amazed at your strength, and the kids. We had such joy last Sunday when all 3 kids were sitting in front of us at church. We couldn't get to them, but all I could do was cry. What an example your family is in all aspects. I admire sb like she is 10 years older than me! Know that we pray daily and want to know how to help if there is anything we can do. Squeeze MGs hand for me ;)

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  2. The thought of erasing and starting over must be appealing right now. Our family is praying for total recovery!

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