Hospital Impact: Singing the wrong tune on patient care

Closeup of hand on cello

headshot“Do you remember the show ‘Name That Tune’?”

I did, of course, but also wondered why a cardiologist would be posing this question.

Back in April, I had received the following message from Dr. Cary, the cardiologist in question:

“I've given my whole life to trying to put the patient first and would love to know if you are aware of any ways in which I could use my education and experience to further the cause.”

And over the next couple of months, she continued to share:

“You know I have always been passionate about patient care, but if possible I am more so now.”

“I have seen 'healthcare' from so many different viewpoints, and pray that my recent further eye-opening role as a patient will be of some benefit in reforming what appears to be a system in continual decline.”

“I found myself in my own ER recently, and couldn't have conceived of a more pathetic interaction in a room where I'd stood so many times before. I know that you need to have 'connection' to the patient, but that can't be done in 5 minutes.”

During this time, we discussed the flames of goodness in healthcare and the challenges, many of them significant, before us.

We discussed Dr. Pam Wible’s work relative to physician abuse and suicide.

We discussed the importance of relationship and trust in healing and at the end of life.

We discussed innovative new tools that could better position patients as they enter the complexity of the healthcare system.

And the sharing was inspiring as hearts and minds connected to better the system for others.

But back to “Name that Tune” …

This wonderful physician went on to share that some years ago she left a group practice where the other physicians were literally betting each other that upon entering a new patient’s exam room how quickly (in minutes) they could be in and out and on to the next patient.

“I can be in and out of the patient’s room in 8 minutes.”

“Well, I can be in and out in 7 minutes.”

And so on and so on … just like “Name That Tune.”

Yes, regardless of the circumstances that brought the patient and family to the clinic that day, regardless of the information in the patient’s electronic health record, the patient’s prior test results or the socioeconomic factors that may be a key driver of his or her health concern, regardless of the patient’s emotional condition, mental health challenges, health literacy, cultural background, the root cause of the health concern, the patient’s support system, financial considerations, etc. … regardless of the patient, these clinicians had their approach and would apply this same approach as quickly as possible.

And they would maximize revenues in doing so.

Efficient? Perhaps, using strictly a short-term impact lens.

Effective? Well, let’s define our aim first. To maximize revenue? Apparently--or at least in the eyes of the physician practice owners.

But was the model effective in preventing overtreatment, keeping patients safe, improving patient experience, engaging patients, creating a safe space for relationship and trust to develop and to truly listen to and understand the patient’s whole story, providing compassion and empathy, and producing optimal clinical outcomes?

At this point, let’s simply say that these betting physicians lost many of their patients to my new cardiologist friend. Yes, they lost many patients to the physician who shared time with her patients, listened to their stories and leveraged this new understanding of her patient with her own clinical wisdom and evidenced-based medicine to co-create a care path aligned with optimal care and the patient’s preferences.

I have often written of caring physicians, nurses and other healthcare workers who have been called troublemakers, abused by the system and not positioned well by healthcare leaders to share compassion and truly care about their patients.

That said, I would like to speak with the specialists noted above and hear their story. And ask them, for starters:

  • Is this really true?
  • If so, please explain to me so that I can understand how this is good medicine.
  • And is it true for all of your patients?

And then, depending on the responses, ask:

  • Is this how you would want someone you love treated?

Lastly, I would ask a question based the rhetorical one my new cardiologist friend shared with me most recently:

  • “Which is worth more: Having the money or laying your head on the pillow at night knowing you did the right thing for those you are blessed to care for? I made my choice.”

Thank you, Dr. Cary, for being one of the flames of goodness within the healthcare system. I look forward to working with and supporting you as you follow your passion to improve care and outcomes for all those you serve.

Thomas H. Dahlborg, M.S.H.S.M., is an industry voice for relationship-centered compassionate care and servant leadership. He is a keynote speaker, author, consultant and adviser and is the president of the Dahlborg Healthcare Leadership Group.