- Patient advocates
- Health consumers looking out for themselves
These two articles make interesting reading for anyone involved with the medical profession, dealing as they do with communication skills and standards of care.
In modern medical courses, students are trained in the art of communication skills, but there is always going to be a "Bell curve" in terms of implementation, ranging from lack of bedside manner to superlative skills. Most people will be in the middle, making an effort to communicate effectively with their patients. However, simply by working in the medical profession, one becomes 'medicalised', and it becomes a challenge to remember what it was like to be an ordinary patient or a medical student or a junior doctor and to "stand in another's shoes" and communicate or behave appropriately. These challenges are compounded when you are facing time pressures or dealing with patients suffering from an impediment, whether that be age, infirmity, level of education or English language capacity. In these circumstances, it is easy to appreciate why a patient advocate service might appear to be useful, but the very fact of its existence shows that overall health professionals still need to work harder in terms of tailoring communication to patient needs.
The second article concerned with avoiding mishaps and receiving appropriate care clearly conveys the challenges for patient care inherent in a cash-strapped and resource-stretched health system. Even within my own family over recent years we have experienced less than optimal care of an elderly relative and a tendency to ignore the requests and instructions of carers. It can be very difficult to have issues addressed and problems solved in a positive way. Stepping into the role of patient yourself is always an interesting experience. Over the past twelve months I have personally experienced doctors ignoring or trivialising presenting symptoms, failing to follow up on blood tests, not following through with referrals and not bothering to read the medical history and test results that I brought to the appointment. I have also experienced waiting months to get an outpatients appointment and then waiting hours to be seen and subsequently waiting months more for investigation bookings and a further appointment. I understand how patients have to live with their symptoms and uncertainty for an extended period in the hope that someone will eventually work out what is causing the symptoms and offer a positive solution. In the end, when we are patients we are all living on faith that the health system will 'do the right thing' by us and that we will receive appropriate and timely care. If it is hard for those of use who are part of the system to get that care for ourselves and our own families, imagine how hard it is for others who lack that context. There is certainly a role for empowerment and respectful assertiveness, but to mirror this we need systems to promote acceptance of constructive feedback and continuous improvement of practices. We can learn a lot from human factors theory and research, but responsibility for and openness to continuous improvement and doing the best that we can by our patients must occur at both an organisational and individual level. This includes overcoming the notions that either someone else is the problem (including the patient/relatives) or that it is someone else's problem.
In modern medical courses, students are trained in the art of communication skills, but there is always going to be a "Bell curve" in terms of implementation, ranging from lack of bedside manner to superlative skills. Most people will be in the middle, making an effort to communicate effectively with their patients. However, simply by working in the medical profession, one becomes 'medicalised', and it becomes a challenge to remember what it was like to be an ordinary patient or a medical student or a junior doctor and to "stand in another's shoes" and communicate or behave appropriately. These challenges are compounded when you are facing time pressures or dealing with patients suffering from an impediment, whether that be age, infirmity, level of education or English language capacity. In these circumstances, it is easy to appreciate why a patient advocate service might appear to be useful, but the very fact of its existence shows that overall health professionals still need to work harder in terms of tailoring communication to patient needs.
The second article concerned with avoiding mishaps and receiving appropriate care clearly conveys the challenges for patient care inherent in a cash-strapped and resource-stretched health system. Even within my own family over recent years we have experienced less than optimal care of an elderly relative and a tendency to ignore the requests and instructions of carers. It can be very difficult to have issues addressed and problems solved in a positive way. Stepping into the role of patient yourself is always an interesting experience. Over the past twelve months I have personally experienced doctors ignoring or trivialising presenting symptoms, failing to follow up on blood tests, not following through with referrals and not bothering to read the medical history and test results that I brought to the appointment. I have also experienced waiting months to get an outpatients appointment and then waiting hours to be seen and subsequently waiting months more for investigation bookings and a further appointment. I understand how patients have to live with their symptoms and uncertainty for an extended period in the hope that someone will eventually work out what is causing the symptoms and offer a positive solution. In the end, when we are patients we are all living on faith that the health system will 'do the right thing' by us and that we will receive appropriate and timely care. If it is hard for those of use who are part of the system to get that care for ourselves and our own families, imagine how hard it is for others who lack that context. There is certainly a role for empowerment and respectful assertiveness, but to mirror this we need systems to promote acceptance of constructive feedback and continuous improvement of practices. We can learn a lot from human factors theory and research, but responsibility for and openness to continuous improvement and doing the best that we can by our patients must occur at both an organisational and individual level. This includes overcoming the notions that either someone else is the problem (including the patient/relatives) or that it is someone else's problem.
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