On the other hand, she tells friends and relatives, “Patients, when asked questions, will often respond, ‘it’s in my chart.’ We often don’t have access to a primary MD’s notes/chart, and not all documentation is pristine. When we are asking questions regarding your medical history, it is only to provide you with the best care—not to be a nuisance.”
Be Selective about Your Providers and Hospital
One recommendation from JCAHO’s patient education Web pages is a section entitled “Finding Dr. Right.” “Choose wisely and you could rest easy for many years to come,” it says.
Sandeep Sachdeva, MD, lead hospitalist at Swedish Medical Center’s Stroke Program and clinical instructor at the University of Washington at Seattle, says this may apply even to a patient’s relationship with a hospitalist.
“Sometimes patients come in and tell us their stories [about how providers treat them]. It’s just amazing; I think patients who have family members providing close supervision seem to get better care than somebody [who] is not asking questions,” he says. “And some care providers find questions intimidating, but the patient should not get discouraged by that. … If they feel that the care provider is not listening to them or not being attentive to them, they can always have a recourse: They can talk to the supervisor of that provider or somebody else [to get] a different provider. Patients sometimes have the fear that if they speak up against somebody that their care might be jeopardized.”
Dr. Sachdeva advises friends and relatives that they talk to the nursing supervisor or ask for the physician supervisor or an administrative person or social worker so that they get the attention they need.
Dr. Jenkins agrees. “Informed consent” is one of his tips for friends and family: “If your doctor won’t talk to you about the risks and benefits of your treatments, and alternatives to them, you need a new doctor.”
Our hospitalists suggest being discriminating, savvy, and proactive:
- “Find one hospital you are comfortable with, [where] your family physician is on staff, and use it exclusively if possible,” says David M. Grace, MD, a hospitalist with The Schumacher Group in Lafayette, La. “By utilizing one hospital, all of your previous records and test results are immediately available when needed. Often this translates into a much shorter hospitalization as there are no delays in obtaining old records, and it minimizes the chance of duplicate tests/procedures being performed.”
- “Know who your doctors are [and] what their role is, and understand their input into your healthcare,” says Dr. Farnan, who is extensively involved in medical residents’ training. And “be cognizant of the physician work hours,” she advises. “We often have families who demand to speak with ‘their’ doctor at all hours of the early morning and night.” She tells friends and relatives, “I think more patients need to understand the nature [and] structure of the system [and] what kind of information a covering physician can provide. If the family of the patient has questions [and] wants to speak with the primary MD, it may be best to attempt in the daytime when the primary service is more likely to be present.”
- “Know the full names, and preferably [the] phone numbers, of all your outpatient physicians,” says Dr. Grace. “One area will often have multiple doctors with the same last name, and, frequently, records need to be requested from them. Up-to-date contact information on your physicians helps us request the right records from the right physicians with minimal delay.”