There seems to be a Disconnect. How can we bridge the gap between patients and providers?
Let’s start today by making a promise between one another.
We’re not casting blame in any direction.
Talking about the medical field these days can feel like tiptoeing through a minefield, as health care professionals who endured the last two-plus pandemic years rightfully demand recognition for their sacrifices and professionalism. Likewise, patients across the board – but especially those who are older or in long-term care facilities – have often felt overlooked and dismissed.
The entire situation has left everyone, patients and providers alike, frustrated and exhausted. Yet too often in looking at the problems and searching for solutions, it feels as though the two sides are talking past one another.
There seems to be a disconnect.
Today we’re going to see what we can do about bridging that disconnect. But we’re not going to say anyone has caused the problem individually or that anyone has set out to create the problem. Medical professionals want to do the best for patients by using all they’ve learned. Those inside the healthcare system want to get better.
So for a first step, let’s lay down our respective arms and deal with one another face to face.
This needn’t be complicated or painful, but it should at least be honest and transparent. Here are three ways the disconnect has erupted before our very eyes and two things we can do about it.
Problem one: The pandemic has reshaped our health care system — for everyone.
It doesn’t matter who you are. You could be a doctor or a nurse. You could be a patient or the family member of a patient. You could be someone who suffered an extreme case of COVID-19 or someone who has managed to go through the last two years plus unscathed.
Regardless, the pandemic has changed you. Back in February, Health Affairs crunched the numbers to show just how much.
Here are their big four changes:
- U.S. life expectancy has dropped by a staggering 1.8 years. And before you say this happened around the world, please note that this change is three times as much as that seen in peer countries.
- Fewer people actually used health care in 2020. They have yet to make up the delayed or missed appointments, with all of the toll on the general population that implies.
- Spending on the sector from consumers and insurers declined for the first time ever in 2020, but robust federal relief boosted the overall sector.
- Finally, most folks experienced telemedicine. While that helped keep some people in touch with health care professionals, we still saw that one in four adults went without care during that time.
What does this mean for health care providers? Stress, stress and more stress.
Doctors and nurses faced unparalleled daily stresses. Government dollars flowed in, then were reduced. Insurers covered some things but not others. The public became sicker and went to fewer appointments, meaning that providers had to deal with more complex cases. And while telemedicine allowed for greater convenience, learning a new platform with new advantages and drawbacks took time and effort.
Problem two: Baby Boomers are putting exceptional new stress on the system.
As we wrote about on this blog back in August, providers in the long-term care field are facing an avalanche of problems in the years ahead.
Some of those problems apply more generally, to all health care providers.
Baby Boomers – one of the largest generational cohorts – are shifting from vigorous late middle age into the elder years.
CNBC reports that the oldest baby boomers will begin turning 80 in just three years from now. Some of those folks will require skilled, round-the-clock care, while others will simply be going to health care professionals more often.
“This is an enormous issue,” said Howard Gleckman, a senior fellow at the Urban Institute, in the CNBC story. “Advances in technology and public health have allowed people to live longer in a condition of frailty, and we haven’t developed a long-term care system to keep up with that.”
Throughout their lives, Baby Boomers have been accustomed to having society move around them, shifting to meet their every whim. They will no doubt expect the same of doctors and hospitals, nursing homes and hospice centers.
They’re coming, and we don’t have much time.
Problem three: Not all patients have been treated equally.
With all of the aforementioned in the air, doctors could be forgiven for trying to do as much as they can, as quickly as they can. Patients need taken care of, demographic shifts need addressing and it all needs done yesterday.
Problems happen, unfortunately, when these health care providers act before thinking. More and more patients are paying attention and noticing when their care falls short, according to a report from the New York Times.
“We know that women, and especially women of color, are often diagnosed and treated differently by doctors than men are, even when they have the same health conditions,” said Karen Lutfey Spencer of the University of Colorado, Denver. She studies medical decision-making.
Patients have seen the pattern repeatedly.
Times reporter Melinda Wenner Moyer offers an easy list for patients to see if their health care providers are gaslighting them. That means ignoring or dismissing what patients say, up to and including suggesting they’re making it all up.
- “Your provider continually interrupts you, doesn’t allow you to elaborate and doesn’t appear to be an engaged listener.
- “Your provider minimizes or downplays your symptoms, for example questioning whether you have pain.
- “Your provider refuses to discuss your symptoms.
- “Your provider will not order key imaging or lab work to rule out or confirm a diagnosis.
- “You feel that your provider is being rude, condescending or belittling.
- “Your symptoms are blamed on mental illness, but you are not provided with a mental health referral or screened for such illness.”
As stated way back at the beginning of this piece, we’re not blaming anyone. Any single health care professional is likely doing his or her best. But you can’t afford to treat patients as obstacles.
Solution one: Give patients the power.
One of the very best ways to address all of the three problems just listed?
Take a step back and let patients have their say.
“I always tell my patients that they are the expert of their body,” said Nicole Mitchell, the director of diversity, equity and inclusion for the obstetrics and gynecology department at the University of Southern California, according to the Times. “We work together to figure out what’s happening and what we can do about it. It really should be a shared decision making.”
That simple advice applies in so many situations for health care providers. If you’re seeing a patient who has avoided medical care since the spring of 2020, take the time needed to listen to their reasoning and how they’ve taken care of themselves in the interim.
If you’re dealing with a surging wave of aging Baby Boomers, similarly, let them outline their concerns. Yes, older folks may have more symptoms and concerns. Let them share their experiences and listen with open ears.
Finally, if patients say you’re not hearing them, stop everything and make sure you do. Don’t just nod and think about your next appointment. Actually take the time. Imagine what you would do if another doctor shared these symptoms, rather than a patient.
If you’re a patient, you have options as well, wrote the Times’ Christina Caron.
“See another doctor if you feel dismissed,” McGregor advised. That might mean finding a physician who is a woman or person of color, someone who might “understand your perspective and language.”
You can also simply try to reframe the discussion you’re having with a health care provider or, if you feel comfortable doing so, appealing to their supervisor.
Solution two: Help is out there for providers as well.
Med Law Advisory Partners understands and appreciates these stresses. We’ve seen the landscape from the perspectives of providers and patients.
“Our medical-legal team is comprised of highly experienced legal nurse consultants and dedicated support staff,” they note. “In addition to a nursing degree, our registered nurses have extensive clinical experience in the areas of acute/critical care, long-term care, health systems management and many specialty areas within the nursing profession. Additionally, 75 percent of our legal nurse consultants carry the Legal Nurse Consultant Certified (LNCC) certification.”
And while Med Law does handle malpractice matters, its goals and knowledge go much further. They also provide executive consulting to hospitals and healthcare systems to identify risks and impact healthcare delivery within the enterprise.
Providers need a trusted partner who understands the changes we’ve all been through, while continuing to put patients first. That’s what Med Law offers.
While there might seem to be a disconnect, we can help connect those pieces for you.