Make the call

Issue: BCMJ, vol. 61 , No. 1 , January February 2019 , Pages 6 Editorials

“Hello Mr Smith, I’m Dr Richardson and I have been assigned as your physician during your hospital stay,” I stated as I approached a frail, cognitively and hearing impaired elderly gentleman on the ward. “You have pneumonia, and we are going to try and make you better,” I explained.

“What? You have to take my leg off?” he asked, somewhat surprised.

“No, Mr Smith, you have pneumonia, and we are going to make you better,” I restated in a louder voice.

“Well, you gotta do what you gotta do,” he said somewhat resigned to his fate. 

Fortunately, Mr Smith improved with IV antibiotics and was discharged with both legs intact, much to his relief. My point is that good communication is a big part of being an effective physician. Not only are informed patients more accepting of necessary treatments, but I would argue that their clinical outcomes also improve.* Good communication takes time, and before granting my halo please realize I often fail miserably in this department. 

My aging mother has spent most of the last few months accessing and consuming the health care dollars she contributed through her lifetime of MSP premiums. She is currently in the midst of her third protracted hospital stay involving numerous tests and procedures. This has highlighted another area of communication for me—the often forgotten job of keeping families informed. My mother doesn’t have any cognitive issues so her care team is able to communicate with her directly. However, when I ask about her treatment plan she often shrugs her arthritic shoulders claiming it isn’t clear to her. The cleaning staff who are in the area, while very good at their job, fall a little short when asked about the next step in treating heart failure. In addition, attempting to get further information from the various nurses who come on and off shift is very difficult. I so appreciate when one of her physicians takes a moment to call me and update me on her condition and next steps. Sadly, telephone contact like this is quite rare. My recent experience has encouraged me to keep the families of my patients, particularly those in hospital, more informed. I have always found family members incredibly thankful for a brief update about further investigations, treatment plans, and potential length of stay. This information prepares them for the worst or allows them to make plans for potential discharge or a change in level of care. I find these phone calls take only a few minutes, but they are appreciated by all and well worth the effort. 

So, one of my resolutions for 2019 is to call relatives less sporadically and more regularly. I encourage you to do the same. Happy New Year to you all. 
—DRR

*I have no proof of this and I am certainly not going to perform a low-response survey study as evidence (see my September 2018 editorial concerning such studies).

David R. Richardson, MD. Make the call. BCMJ, Vol. 61, No. 1, January, February, 2019, Page(s) 6 - Editorials.



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