The Lost Art of Medicine: Patient care is paramount in practice

The Art of Full Disclosure

One of the most important aspects of good patient care is keeping the patient fully informed. If the physician uses a variety of methods to inform the patient, seldom will the patient have questions. When he or she does, the physician must set aside time to answer any and all questions that arise. The physician should be seated when explaining things to a patient. It puts the patient at ease.

If surgery is to be considered, the procedure should be discussed in detail covering all the possible benefits and complications. Ideally, this should be done in person. However, there are several ways a surgeon can accomplish this in a busy practice.

Camcorders are inexpensive, and there are easy-to-use editing programs available to allow the doctor to produce his own DVDs. Sitting at a desk in front of the camcorder, the doctor should carefully explain each procedure using illustrations to emphasize how the surgery is to be performed as well as all the possible known complications. The patient needs to understand the complications because if one occurs, he will know what to expect. After the patient has viewed the DVD with family members, the surgeon should see them and answer any questions they might have. The patient should also be given a printed brochure that further explains what the surgeon covered on the DVD. With this approach, the surgeon seldom has to elaborate. Not only is this helpful for the patient, but it saves the doctor valuable time.

The Art of Listening

The physician should take time to listen to patients. Studies have shown that during the initial interview with a patient, the average doctor interrupts the patient’s story within the first seventeen seconds (Ann Intern Med. 1984;101:692-696). This frustrates the patient. Doctors want a chronological history but unfortunately most patients don’t relate their symptoms in chronological order. They wander around, thinking of things as they pop into their heads. This frustrates the doctor.

When a patient is in the hospital, the good physician/surgeon makes rounds twice a day. That requires a few minutes at the foot of the patient’s bed going over the chart and answering questions. This can be done in three to five minutes. During these visits it’s permissible for the physician to stand. Patients know that doctors have more than one patient in the hospital and that they’re busy.