Last month, the National Post’s Tom Blackwell reported that a growing number of hospitals say patients and their families are secretly recording doctors and nurses. Some say it’s a symptom of the breakdown of trust being patients and their physicians. Welcome to a Cowardly New World.
The biggest examples that reported in the National Post included a video camera installed in a clock radio to secretly record doctors and nurses as they treated a patient. The footage was used as evidence regarding substandard care at Sunnybrook Health Sciences Centre in Toronto. At Toronto’s University Health Network, a video camera was reportedly concealed inside a teddy bear. A camera concealed in a wrist watch was used to record evidence against a Calgary psychiatrist. Smart phones are also being used overtly and also surreptitiously.
I have experienced this first hand in the ER. On one occasion during a night shift, as I was about to stitch up a patient’s cut, his buddies asked if they could record me doing it. I thought it was kind of cute and innocent. The recording took place in a closed room away from other patients so there was no risk anyone else could be filmed surreptitiously.
To be clear, that example was overt. I had another patient encounter that was quite different. I remember seeing an elderly patient who came to the ER with a medical problem. Both the patient and a relative were present in the room the first time I saw him. I came into the room a second time to give the patient and the relative some test results. As I walked into the room, I noticed that a cell phone was on a chair in the room; it was seated in the middle of the seat cushion, sort of like an invited guest. I paid no further attention to it.
The relative said the patient’s daughter (a physician) and was en route the hospital to speak with me. I started to tell the patient and the relative my working diagnosis and my management plan. Suddenly, the cell phone talked! A voice emanated from the smart phone’s speaker disagreeing with me! The daughter had been surreptitiously listening in all along.
We expect a level of perfection from our doctors, nurses, surgeons and care providers that we do not demand of our heroes, our friends, our families or ourselves. We demand this level of perfection because the stakes in medicine are the highest of any field — outcomes of medical decisions hold our very lives in the balance.
It is precisely this inconsistent recognition of the human condition that has created our broken health care system. The all-consuming fear of losing loved ones makes us believe that the fragile human condition does not apply to those with the knowledge to save us. A deep understanding of that same fragility forces us to trust our doctors — to believe that they can fix us when all else in the world has failed us.
I am always surprised when people say someone is a good doctor. To me, that phrase just means that they visited a doctor and were made well. It is uncomfortable and unsettling — even terrifying — to admit that our doctors are merely human — that they, like us, are fallible and prone to bias.
They too must learn empirically, learning through experience and moving forward to become better at what they do. A well-trained, experienced physician can, by instinct, identify problems that younger ones can’t catch — even with the newest methods and latest technologies. And it is this combination of instinct and expertise that holds the key to providing better care.
We must acknowledge that our health care system is composed of people — it doesn’t just take care of people. Those people — our cardiologists, nurse practitioners, X-ray technicians, and surgeons — work better when they work together.
Working together doesn’t just mean being polite in the halls and handing over scalpels. It means supporting one another, communicating honestly about difficulties, sharing breakthroughs to adopt better practices, and truly dedicating ourselves to a culture of medicine that follows the same advice it dispenses.
Researchers from Ghent University in Belgium took forty men and women (seventeen men and twenty three women) – none of whom were health professionals – and showed them photos of six different patients labeled two each with negative traits (e.g. egoistical, hypocritical, or arrogant), neutral traits (e.g. reserved, or conventional), or positive traits (e.g. faithful, honest, or friendly). After viewing the photos, participants watched short videos of the same six patients undergoing a standard physiotherapy assessment for shoulder pain. Then they were asked to rate the level of pain the patients were experiencing while undergoing the assessment.
Here’s where it gets interesting. If two patients in the study had identical levels of shoulder pain, the study participants concluded that the patient with the positive attitude had worse pain than the one with the bad attitude. In other words, if you had pain and had a nice manner, your pain was taken seriously. If you had the same amount of pain and you weren’t deemed “likeable,” your pain was more likely to be ignored or underrated.