The Safe Patient Project is a Consumers Union campaign focused on eliminating medical harm, improving FDA oversight of prescription drugs and promoting disclosure laws that give information to consumers about health care safety and quality.
Photo: Dan Saelinger
A Surprising Way to Avoid Medical Errors in the Hospital
Help Providers See You as a Person, Not Just a Patient
Most of us have a bad waiter or waitress experience. Maybe they were rude, made a mistake with your dish, or overcharged you. Similarly, people have been treated poorly in the hospital, as a patient or family member of a patient. The stakes are high when you’re a patient because you’re sick and trying to get better but the health care system feels so big and confusing. The last thing you want is a rude doctor who you can’t understand because they’re talking too fast or using too much medical jargon. Disrespect in the hospital is a problem that many people have experienced yet not enough people have tried to solve. We’ll give you a better look at this problem and offer concrete advice for how you can be a more engaged patient. Our goal is to help you improve you odds of staying safe in the hospital.
Consumer Reports Finds Striking Link Between Respectful Treatment and Patient Safety
Our colleagues at Consumer Reports surveyed 1,200 recently hospitalized patients and found a striking link between respectful treatment and patient safety. They found:
- Patients who said they rarely received respect from the medical staff were two and a half times as likely to experience a medical error—such as a hospital infection, a wrong diagnosis, an adverse drug reaction, or a prescribing mistake—as those who thought they were usually treated well.
- 29 percent said an error occurred during hospitalization.
- About one in four said that medical personnel did not consistently treat them as adults able to be involved in their own care or “like a person.”
- One third said doctors or nurses didn’t always listen to them without interrupting.
- 34 percent felt that their wishes about treatment were not always honored.
- 21 percent thought they weren’t always treated fairly and without discrimination.
- One in five worried about being “a bother or a pest” to busy hospital staff.
- Those who felt very uncomfortable asking questions about their care and the steps being taken to keep them safe were 50 percent more likely to experience at least one medical error, compared with those who felt very comfortable.
Respectful treatment is when a doctor avoids using medical jargon while talking to you, makes eye contact with you, listens to you, answers your questions, and sees you as more than patient in Room 205 with heart disease, but as [your name].
“It’s rare for a health care professional to be outright rude, but things like sitting when your patient is sitting, taking the time to explain things thoroughly, or making eye contact don’t happen as often as they should,” says Orly Avitzur, M.D., a Consumer Reports medical adviser.
Improve Your Communication in the Hospital
Photo: Dan Saelinger
Just like you might have a technique for getting the best meal possible at your favorite restaurant, such as telling the server that you want to order your dish “medium spicy,” you can prepare yourself to have a better encounter with your health care providers. It’s essential for making sure they see you as a human being that deserves dignity and respect.
In addition to the necessary task of teaching medical providers how to protect patients from medical errors, we believe that doctors and nurses have a responsibility to learn how to be better communicators. Most patients are not even willing to ask caregivers to wash their hands. Providers need to up their game and invite patients to partner. Hospital leaders should establish a hospital culture that is oriented towards transparency, accountability and mutual respect. As a group of Harvard Medical School doctors and researchers wrote in the journal Academic Medicine, “Creating a culture of respect in health care is part of the larger challenge of creating a culture of safety.”
Five Ways to Get Respect (& Better Care) in a Hospital
This is just another example of medical paternalism, no matter a woman writes it. Offload responsibility to the customer/patient. Medicine is not waitressing, it’s a scientific professional endeavor that promises care through an unceasing array of advertising means in media and on-site. The frequency of negative experience reporting is significant. As is the fact that medical error is the 3rd leading cause of death in America (yet it never appears in top ten causes of death charts like those published by leading medical journals).
ANYTHING to avoid placing responsibility where it belongs — with medicine. Reminds me of life in the computer age, sans printed documentation, which we all now are supposed to make ourselves (and also find ourselves, combing website support pages for the files).
Good grief.
Bart, we share your deep concern that medical harm is the third leading cause of death and work to expose the problem by working with harmed patient advocates on policy and public awareness. We believe patients need more information on medical harm, including advice on how to stay safe, as well as hospital-specific information on errors.
Two years ago, while visiting my former mother-in-law in Ohio, she developed chest pains and wanted to go to the ER. When we got there, it was late at night and she was immediately taken to a room. The room was full of bright lights, as all ER rooms are. I turned the lights off, except for one in the corner of the room, so she could get some rest while we waited. She was 95 years old and frail. When the doctor finally came in, he turned on all the lights and asked what we were doing sitting in the dark. I was surprised that he had to ask. I told him that I was trying to give Elsie the opportunity to sleep while we waited. The doctor just looked at me. He examined her and then left, telling us he’d be back. When he left the room, I turned the lights out again. When he later returned, he did NOT turn the lights back on. His demeanor was gentler than it had been earlier. That may have been because the room was gentler in general with the lights off. It may have caused the physician to rethink his general practices with patients in the ER. This is not to make turning the lights out as anything more than a small gesture. However, it did seem to make a difference in his approach to this particular treasured patient.
Kathleen, thank you for sharing your story about getting the ER doctor’s attention. It sounds like the doctor had a light bulb moment.
I hope we don’t forget that the vast majority of medical/health professionals are sincere, caring individuals who serve in one of the most demanding, ever-changing, and technical fields. Too often I fear that many of us as patients or family members/loved ones of patients hold these professionals to nearly super-human standards.
I used to be in the health care profession and I actually don’t hold professionals to “super-human” standards. I do, however, expect them at minimum, to treat me with the same respect they expect from me, to listen to my experiences with my own health concerns (it is, after all, my body, and who better knows how it reacts and responds to things than I?), to provide me an accurate and up-to-date report of my lab results, to avoid immediate judgment about medical or mental health issues they do not understand, to be aware of drug contraindications and interactions, and to advocate for me and not base my treatment on the profits and marketing of the pharmaceutical companies. I have *horror* stories I could share. Not one, not two, but many.
Hi, Clint. Thanks for sharing your thoughts on medical professionals. While we don’t expect doctors to be super-humans, we expect doctors to provide safe care. While the vast majority of doctors don’t harm patients, the ones that do tend to get away with it. No matter whether you work in the hospital or get treated in one, we should all demand safe care.
Many physicians persist in calling mature patients by their given name, while introducing themselves as “Dr So and So.
They do this in spite of many articles complaining about this point.
. It is then left to the patient to offer a correction -and the patient is often in pain, frightened, and undressed-not a good position.
This is a very simple matter to correct-and the frequency with which it occurs leads me to suspect it is a knee jerk attempt to intimidate.
EJW
EJ, thank you for raising this point. There is a great article on KevinMD on this very subject: http://www.kevinmd.com/blog/2013/10/primer-addressing-patients.html
As “people” for hospitalized relatives, I’ve discovered that my mere presence is often a set-up for an adversarial relationship with caregivers. It did not matter that I am a little gray-haired grandma, knitting, in the corner of the patient’s room–caregivers were often nervous or defensive just because I was there and asking at times for clarification.
All the more reason to have family members present as much as possible.
I have to say my presence in one patient’s room prevented death twice.
Thanks for commenting, JP. It’s remarkable how occupying the hospital space for your loved ones caused the caregivers to react. Family members serving as patient advocates need respect and open communication, too. Hospital staff should welcome your presence, as it prevents patient harm.