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Why don’t doctors LISTEN?

September 7, 2012

I heard yet another story from one of my friends with chronic heart problems of being mistreated in the hospital.  It’s so frustrating to hear these stories again and again, especially being a nurse and knowing how things work behind the scenes.  In my friend’s case, she was admitted for a planned surgery unrelated to her heart condition.  She made extensive preparations for this hospitalization including providing a letter from her heart specialist explaining her special needs to all doctors who were supposed to be involved in her care, carrying an education sheet written for doctors about her particular condition including many references to peer-reviewed research articles by experts around the world, and explaining her needs to the doctors “caring” for her.  Despite her efforts, the doctors at the hospital failed to follow the recommendations of her specialist, causing her to suffer several days of treatable chest pain.  Her take on this is that the doctors involved read the first paragraph of the letter from her specialist which stated her condition was stable and then did not pay attention to the rest of the letter which spelled out the recommended treatment for the coronary artery spasms she was likely to suffer during her recovery period.  Most of the hospitalization when she requested appropriate treatment for her cardiac ischemia, she was told this was “normal angina” for her.

Another friend had a similar experience a few years ago when she went in for her coronary artery bypass surgery.  In her case, she is a chronic pain patient who takes moderate doses of narcotics daily to control this pain.  What this means is that when she is in the hospital, she needs to be given higher than standard doses of pain medication.  In order to address this, she had her pain specialist write a letter to the cardio-thoracic surgeon explaining her medication requirements.  She had an in depth discussion with the surgeon prior to surgery.  All was for naught as the surgeon ordered the standard post op pain meds which did not come near relieving her severe post-op pain.  She suffered tremendously her first night post-op.  It took a day or two to get the medication situation straightened out.

People who have chronic illnesses with complex treatment regimens often encounter these situations in the hospital.  Sometimes meds are withheld or timing changed for good reasons, such as reducing someone’s insulin and letting sugar run a little higher to lessen the chance of hypoglycemia in an unstable patient, since hypoglycemia is far more dangerous than hyperglycemia.  But sometimes necessary treatments are withheld due to the ignorance of the doctor (or sometimes the nurse) regarding the patient’s condition.  These two friends were proactive and attempted to educate their doctors ahead of time, but their attempts were ignored and they were treated in a “father knows best” manner that actually increased their risk for post surgical complications and caused great suffering.

Sometimes it feels futile to educate doctors who won’t listen.  It makes people give up educating any of them.  I hear stories every week from people who were suffering unrelieved chest pain yet elected not to go to the ER because they are tired of being treated poorly.  What can we, as patients with chronic and sometimes rare conditions, do to get appropriate treatment in the ER or the hospital?  When even letters from other doctors don’t make a difference, what else can we do?

All we can do is advocate for ourselves.  Continue trying to educate the doctors and hospital staff.  Bring along a friend or relative who can advocate for us if we are too weak to do so ourselves.  Speak out!  If treatment in the hospital is inadequate, discuss it frankly with your nurse.  If this is unsuccessful, speak to the charge nurse.  Go up the chain if you have to to the nursing supervisor.  Write letters to the Chief Executive Officer, the Chief Medical Officer, and the Chief Nursing Officer of the hospital.  Do not suffer in silence.  And know when you make this herculean effort to be heard that you are helping not just yourself, but all the other people who will be treated at that hospital.  When doctors are blatantly ignoring your medical needs, call them on it.  This is probably the hardest of all for two reasons.  First is the way doctors make themselves scarce.  They breeze through, write some orders (often without discussing them with you), and then refuse to talk directly to the patient when the patient has questions or concerns.  Some nurses are so intimidated by the negative response they get when calling doctors that they don’t call when it is clearly warranted.  The second reason is the intimidation the patient feels.  Many doctors do not make much effort to engage in a collaborative relationship with the patient.  We get beaten down by repeated negative experiences and either fear confronting the doctor or feel it is a futile exercise for which we no longer have the energy.

We deserve to be treated with respect and for our medical needs to be addressed.  Condescension and outright abuse should not be tolerated.  It disgusts me that this even needs to be said.

4 Comments leave one →
  1. Terry permalink
    September 11, 2012 8:34 pm

    I have Rheumetoid Arthritis and have very much ran into doctors who don’t listen. I have gone through my regular doctor and 2 rheumatologists. I am now driving just over an hour to a doctor that is worth every minute I drive. My first visit he spent almost an hour and a half with me and answered all my questions finally.

  2. September 17, 2012 9:30 am

    There was one paragraph that was ME!! I have chest pains and have been to the ER twice to be released and ignored. The last time it was an hour, sitting in an exam room before anyone even came and took my vitals by then I was ready to walk out the door! Still have them and I REFUSE TO EVER go to the ER!

    • September 17, 2012 10:05 am

      Dawn, I am sorry to hear you have not been treated well at the ER. I would encourage you to follow up with your primary care doctor about your symptoms. If that doesn’t seem to go well, see another doctor. In the future, please don’t ignore serious chest pain. You may want to go to a bigger hospital if you had previously tried a smaller community hospital. Bigger hospitals are more up to date and more likely to do a thorough work up. If you are in a small town you probably need to be seen in a bigger city with better facilities. Best of luck.

  3. Maria permalink
    October 1, 2012 2:47 am

    It took two visit to the ER before I was admitted. The first hospital sent me away hemorrhaging, diagnosis hemorroids. Second hospital four hours later still bleeding heavily now diagnosed complete ablation of the large intestine. Stayed a week in the hospital. So sometimes the sicker you are the least likely you will be taken care of.

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