Do You Shop Your Diagnosis Until The Doctor Tells You What You Want To Hear?

the new culture in radiology
We all can tell stories about the visit to the doctor’s office. It was too crowded. I had to wait too long. The Doctor was insensitive to my complaints. I left feeling confused. A friend recently described what the impending physician visit entailed: three days of surfing the internet until she had diagnosed her complaint, 1 hour travel to the doctor, 1 hour wait to see the doctor, 15 minutes in the doctor’s presence, 1 hour travel home and back to the internet since she did not get the diagnosis she was seeking.
Many physicians are rushed and overwhelm their patient’s with information that is not understood. Those without the exposure to the medical jargon and terminology have no idea what the doctor just said. There is a huge disconnect between the patient’s understanding of his disease and the satisfaction they have with their physician. This has huge implications when physician’s pay for performance is somewhat dependent upon the patient’s perception of the physician and his treatment.
In a recent study published in the New England Journal of Medicine, oncologists studied the patient’s expectations of chemotherapy treatment options. In many cancer patients, the chemotherapy does not provide a cure. It may provide some help, but it also has tremendous toxic side effects. The study found that 69 percent of patients with lung cancer, and 81 percent of patients with colon cancer did not understand that their chemotherapy would not cure them. This says a lot about how we communicate medical information to our patients. The study also highlighted a second more disturbing finding suggesting the more patients understood about the grim nature of their future, the less they liked their physicians.
If this is true, the path to alerting the patient to the disease and treatment options for his improvement will surely also lead to physician mistrust.
If I have an injury incurred from overuse or misuse of my body and it is caused by my repetitive behavior, I know what it takes to make it improve: give my body time to heal and not continuing the behavior that caused the injury. Many of us still think that we can plow through it and not recognize we are the root of the cause. We don’t listen to the physician and think they don’t listen to us. Maybe we continue to the next doctor until we find one that says what we want to hear. And if we find the physician that tells us that the problem is not with our body, but with our behavior, we begin to find things about the doctor we don’t like. Things such as: his office doesn’t answer the phone as they should, he doesn’t return my messages, he’s always late. Likeability of the physician or the health care facility is linked to the all-powerful patient satisfaction survey.
Our health care industry is out there competing for our business and wants to assure their likeability. Therefore we are seeing renovated rooms, new entrances, gourmet chefs, valet parking, free phones and coffee in the waiting areas, and entertainment in the main lobby during the day. These are nice perks and undoubtedly will lead to a high score on the patient satisfaction survey. But does this make us healthier? So far, the answer seems to be no. There has been no correlation between satisfied patients and better health. In fact, one study quotes that they found the most satisfied patient group had the highest rate of mortality.
The next time you are presented with a patient satisfaction survey, think about your health. Are you informed about your health? Have you done your part to be healthy? Have you accepted responsibility for obtaining the information that you can understand to take healthy actions? Have you heard what the physician said? It is difficult to evaluate specific characteristics of doctors, hospitals as distinct from their likeability. But we must try.

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