Doctors, Patients and a Failure to Communicate
“What we have here is a failure to communicate.” Fans of Cool Hand Luke (and who is not?) will recall the phrase in graphic detail–and for those of you without that memory, the video will provide.
A recent study highlighted in the Wall St. Journal’s Health Blog points to both a discrepancy in perception between hospital doctors and their patients and a failure to communicate.
The study was conducted by Douglas P. Olson, MD and Donna M. Windish, MD, MPH. The authors noted as “Background” in the study abstract that:
Hospital surveys indicate lack of patient awareness of diagnoses and treatments, yet physicians report they effectively communicate with patients. Gaps in understanding and communication could result in decreased quality of care. We sought to assess patient knowledge and perspectives of inpatient care and determine differences from physician assessments.
The results of the study were derived from two validated questionnaires given to inpatients treated by “house doctors” over a course of roughly eight months at one hospital.The corresponding doctors were also queried. Eighty-nine patients and 43 doctors participated.
The survey — which the authors note is limited by its reach (one institution), patient characteristics (older, indigent and less-educated than average), and general responses, rather than one-to-one-patient-physician comparisons — is published in the Archives of Internal Medicine.
The results? From the abstract:
- Only 18% of patients knew their main doctor by name.
- Sixty-seven per cent of doctors believed their patients knew them by name.
- Fifty-seven per cent of patients knew their diagnosis.
- Seventy-seven per cent of doctors believed their patients knew their diagnosis.
- Fifty-eight per cent of patients thought that physicians always explained things in a comprehensible way.
- Twenty-one per cent of doctors stated they always provided explanations of some kind.
- Sixty-six per cent of patients reported receiving a new medication in the hospital, 90% noted never being told of any adverse effects of these medications.
- Ninety-eight per cent of doctors stated that they at least sometimes discussed their patients’ fears and anxieties.
- Fifty-four per cent of patients said their doctors never did this.
Interestingly enough,the WSJ article notes that the
responses didn’t significantly differ by sex, age, race, language or payment source, for the patients, or level and type of training, for the doctors.
Only 57% of patients knew their diagnosis? Which is to say that 43% did not? 90% not told of potential adverse reactions to new medication?
Res Ipsa Loquitur.
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