Continuity leads to relationship, trust and better care

170622 hear-attack

Original published by FierceHealthcare's Hospital Impact - May 2011

170310 Fierce-Healthcare-Hospital-Impact

I went to the gym the other day to work off some stress and improve my fitness level. And as I prepped for my big workout, I saw one of my son’s former coaches (let’s call him Jim). This individual is a great coach and leader, he is also a soldier, and someone who is clearly in very good shape.

“Hey, how are you?” Jim asked me with little enthusiasm and energy.

And being the smooth talker, I of course responded with, “I’m good. How are you?”

Have you ever asked a seemingly innocuous question only to find it was not so innocuous?

“I’m not doing very well. I was told I had had a heart attack.”

Jim proceeded to share that he had recently gone to a new doctor (one who was supposedly part of his care team but one he had never met and who he had not selected) for a routine EKG (are they ever really routine?) and upon completion, this unknown doctor said casually, “So, when did you have your heart attack?”

Jim at first thought this doctor was joking. (Yes, I know … sick joke indeed.) Jim responded that he did not have a heart attack (or at least never thought he did) and didn’t know what the doctor was talking about.

But the doctor remained adamant and stated matter-of-factly that based on the test results Jim clearly had a heart attack in the past and he needed to follow up with his physician right away.

So even though he was in absolute shock, being a soldier, Jim followed orders. He called his personal physician’s office again and set up an appointment to discuss his heart attack with HIS doctor.

As Jim continued his sharing with me, he noted that from the time he heard the news until the time of his follow-up appointment with his doctor he experienced chest pain, pain in his jaw, arm numbness, etc. And each time he thought, “is this another heart attack … am I going to die?”

Finally, Jim saw his personal doctor, who spent a great deal of time doing an appropriate assessment, reviewing the notes and test outcomes associated with the EKG and previous exams, as well as talking and listening for understanding with Jim. He then said, “Jim, you did not have a heart attack. The other physician had misinterpreted the results. You are fine. Don’t worry. See this and this and this … and based on your history and this and this … you are fine. No need to be worried.”

NOTE: Although Jim’s physician shared a lot of information, once Jim had heard “no heart attack” he was so elated that everything after that was just a blur of sight and sound.

Jim said he was truly “thrown for a loop” with the original declaration that he definitely had had a heart attack, and the emotional roller-coaster he and his young family experienced really impacted them all.

In the end, Jim realized how grateful he was for HIS physician — the physician with whom he has a trusting relationship, the physician who truly knows and understands him as a patient and as a person, the physician who shared compassion,empathy and time with Jim, the one who listened, and who (of course) provided such GREAT news!

He also noted that this “care team” model which placed him with a physician with whom he had no history nor relationship, was not something he signed up for, he believed it was not patient-centered because he was never included in the creation of the team, and in his mind it almost led him down a path toward many more tests and the potential for great harm … in addition to the unnecessary stress and worry it placed on him and his family.

Time, continuity, relationship, listening, empathy, compassion and trust (healthCARING) is essential to optimal healing … and it still amazes me how consistently we in the healthcare “system” consider these items the “soft stuff”, afterthoughts and/or position them as unimportant, or worse, set them aside for efficiency, productivity, revenue generation, or to achieve other financial aims through new healthcare models (e.g., care teams) which we “experts” create without including the patient and family in the innovation process.

Yes, we experts who have also created a healthcare model where …

And a model where the tried and true healing powers of relationship, compassion, listening, empathy and trust are pushed aside and indeed mocked in certain industry circles.

It is time for we “experts” to rethink our True North. To reconnect with our WHY and the WHY of healthcare. To reset our sights and both our personal and professional missions to improve healthcare. And include patients and families in the process.

No longer can we tolerate any focus other than on the safety and well-being of the patients and families we are entrusted to care for and care about.

And no longer can we exclude patients and families in the planning and development process.

We are doing harm. And we must do far better … together.








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