What About Talking to Patients

It struck me that in hospitals, physician offices, and medical claims adjudication we face a similar dilemma. Which presents a problem for healthcare leaders. Health care is, of necessity, becoming a more operationally efficient service. More forms, more automation, more decision matrices, shorter visits, more intermediaries using precisely defined scripts, and less time in human-human unstructured interaction. Ask anyone who has seen a physician in the past week.

This is probably good for efficiency and certainly good for adhering to standards of care and documentation. And likely great for charge capture. But I can’t help thinking that something is missing. If we fail to consistently discern the humanity of patient needs how can we make the right decisions about the nature of the real health problems to be solved, which to investigate and in what order – and whether to deliver care, and how much care to deliver, and which kind of care and in what sequence. So consider the story below.

I joined my wife for a medical procedure today – we were concerned about ominous symptoms she had recently experienced. The procedure was certainly indicated and fortunately negative, thus ruling out serious pathology. But the symptoms are likely to remain, to be either monitored or investigated comprehensively. Left to our own devices, even though we are both physicians, we would likely have opted for investigation.

The decision for expectant management was made because the physician – whom we had never met previously – spent several focused and undistracted minutes with us reviewing the issues and alternatives, explaining why serious illness was a remote possibility, and reassuring us that the expectant path was unlikely to be dangerous. We departed reassured and disinterested in the further expensive investigation at this time. Had we not been touched with humanity it would have been easy to go down a long and costly road to dissatisfaction. Regularly replicated, isn’t this a viable component of a utilization management strategy? Only if we “innovate” by encouraging that professional time is spent this way.