Five Ways Doctors Let You Down
How do doctors fail their patients? Let me count the ways. Better yet, let researchers at Johns Hopkins School of Medicine count the ways, as they did for a recent study of interns’ interactions with patients. A Johns Hopkins news release reports that trained observers followed 29 internal medicine interns — physicians in their first year out of medical school — at The Johns Hopkins Hospital and the University of Maryland Medical Center for three weeks during January 2012. They witnessed 732 inpatient “encounters” during 118 intern work shifts. The observers used an iPod Touch app to record whether the interns employed five key strategies known as etiquette-based communication: introducing oneself, explaining one’s role in the patient’s care, touching the patient, asking open-ended questions such as “How are you feeling today?” and sitting down with the patient. The bad news? Interns touched their patients (which could be either a physical exam or just a handshake or a gentle, caring touch) during 65 percent of visits and asked open-ended questions 75 percent of the time. They introduced themselves only 40 percent of the time, explained their role only 37 percent of the time and sat down during only 9 percent of visits. Wait, there’s more: interns performed all five of the recommended behaviors during just 4 percent of all patient encounters, and were only slightly more likely to introduce themselves to patients during their first encounter than a later one.