A failure to communicate

In the movie “The Defiant Ones”, Sidney Poitier and Paul Newman are chain gang prisoners, shackled together, who attempt an escape, only to be quickly caught. Lying on the ground, the “boss sheriff”, wearing mirrored sunglasses and holding a shotgun, looks down at the two and says, “Boys, what we have here is a lack of communication.”

Last week, the Agency for Healthcare Research and Quality announced the release of a five-minute online video with tips for communicating with your doctor, in the interest of reducing medical errors and improving patient outcomes. The video is in response to a recognized problem in high quality care - what we have here, physicians and patients, is a lack of communication. Each has their complaints, as Nancy Cadora wrote recently in her blog:

      Patients complain that they:

·        have to wait too long in the doctor’s waiting room when they have an appointment;

·        can’t schedule an appointment within a week, sometimes within a month;

·        don’t get enough face time with the doctor during the appointment;

·        don’t get prompt test results from the doctor’s office; and,

·        don’t get prompt responses to their phone calls to the doctor’s office. 

Doctors complain that patients . . .

·        wait too long before seeking an appointment;

·        are reluctant to completely and candidly discuss their symptoms;

·        request unnecessary tests or prescriptions due to something they read or saw on TV or the Internet;

·        do not follow the doctors’ instructions and prescriptions for treatment;

·        ask doctors to misrepresent to insurance companies, seeking unwarranted reimbursement; and,

·        are not truthful in giving symptoms, in describing their actions that may have aggravated their condition and in claiming to have complied with doctor instructions. 

When you have an educated, relatively healthy population with good family and social supports, physicians can get what you need. Maybe. Throw in illness, worry, anxiety and other pressures, and patients will not be great patients.

We can talk about the role of a physician, specifically how assertive physicians should be towards patients. Against this, however, are the pressures of flat and declining revenue, which plays out in a series of behaviors that don’t support patients being great patients.

I will continue to argue that most of physician’s complaints listed above could – and should – be addressed to some degree by physicians. This is a marketing issue, and a marketing opportunity that leads to better care, loyal patients and a more satisfying practice.

Tomorrow I’ll take a look at these complaints and how physicians can help make patients “great”. Good to Great for Medicine……….?