Improving Education 281
Improving Content: Specific Areas of Increased Sensitivity
As a result of experiences with their own providers, these doctor-patients often became more sensitive not only to the form of interactions, but also to several specific content areas.
‘‘ Routine’’ for Whom? Increased Sensitivity to Medical Tests
Frequently, these physician-patients altered their understandings of the meanings of diagnostic tests. They came to realize that every test, even if they considered it‘‘ routine,’’ was critically important to the patient undergoing it. Jennifer, the internist infected with HIV from a needle stick, commented:
Here we doctors are, sitting with a piece of paper. We tell them the result, and want them out of our office for the next patient, without really going through the emotions of what that one result, what that specific one, means.
Seen from patients’ perspectives, tests were no longer merely ritual or rote, but traumatic and defining, with profound implications.
Waiting for Test Results
As a result, several physicians now tried to provide patients with test results more swiftly. Jacob, the radiologist with cancer, for instance, was more likely to interrupt what he was doing to give patients their results.
I always try and run out to them to tell them the results of their scan.... But now, I’ ll interrupt anything I’ m doing to tell them the results. In the past, I would get them the results as quickly as possible, but if I was talking to someone else, I wouldn’ t get up. Now I pretty much drop everything, or call the tech:‘‘ Go and tell the patient everything is ok.’’ I prefer to do it myself. When patients say,‘‘ It’ s nice you did that,’’ I say,‘‘ I’ ve been there, and know what it feels like.’’
Yet again, competing pressures can hamper physicians’ ability to respond as fully and immediately as they would like. Daily challenges ensue.