By Evan Falchuk
A blogger at the event put it simply: As bad as it is being sick, there are many things in our system that make it worse.
All of the clinicians who spoke at the event understood this, and talked about ways to improve the doctor-patient relationship.
But the problem is worse than the clinicians may think, and it’s not something health care reformers are talking about.
Let me share some data with you so you can see what I mean.
My company, Best Doctors, sees “putting patients first” from a unique perspective. We deliver an employee benefit to more than 15 million people that helps them get the right diagnosis and treatment. We see the problems patients face in the system — and what they mean to the quality of their care — every day.
What we hear all the time from patients is that they feel they are on their own. They are faced with important decisions, have a hard time figuring out what to do, and few places to turn to for help.
Here’s our data from a population of about 1 million people in the United States during 2008. It represents thousands of calls we received from people with a broad array of conditions – cancer, heart problems, neurological conditions, orthopedic conditions, and a variety of other ailments. These people called because they were uncertain about something to do with their care, and thought it was important enough to call.
The Reasons People Call Best Doctors
The data reveal a lot about what the patient experience of health care is like.
Almost 60% people reported needing help deciding among multiple treatments, including whether to have surgery. Twenty percent said they didn’t understand their diagnosis or simply didn’t have one, in spite of efforts by their doctors to find one. A small – but in our data, growing – percentage of patients voluntarily reported that the primary reason for their call was skepticism about their doctor.
What’s going on here?
I think we are seeing the real world effect — on patients — of what Atul Gawande called focusing on “money over medicine.”
Most doctor visits feature face-to-face contact with the doctor of 15 minutes or less. Care is increasingly fragmented. Meanwhile, patients have access to huge amounts of medical information on the internet, and feel more comfortable than ever in questioning their doctor. It makes the life of a medical professional pretty difficult. And it makes the life of a patient vying for the doctor’s limited time that much worse.
What’s more troubling is what happens in this set up.
Studies show that 15% or more of patients have their diagnosis missed, delayed or wrong. Others have found that the biggest driver of this poor quality are the cognitive errors that happen when you make complicated decisions with fragmented information and restricted time. Best Doctors data show this happens close to 20% of the time.
The trouble is the way we organize health care today. It systematically undervalues the thinking, processing and deciding aspects of medicine, leaving patients behind.
If we’re going to talk about putting patients first, we have to talk in terms of what is really important to you when you’re sick. You want someone to pay attention to you, think about you, answer your questions, help you understand your condition. You want to be sure you have the right diagnosis and treatment, and above all the best chance to get well.
It’s something I believe we’re all entitled to, first.
