Sunday, October 04, 2009

How can doctors learn from their patients ?

Doctors have always learnt medicine from their patients and all good doctors will agree that we continue learning to do so daily. When patients respond well to their treatment, they reinforce our confidence in our skills and techniques. When they don't do so, they teach us how to deal with failures and problems.

Every patient has something to teach. In some cases, the lesson maybe so easy, that the doctor does not even realise he is learning. In others, it may be so obvious, that the doctor may not even think it worth learning . However, I am not referring to just learning about human biology and disease. Equally importantly, doctors can learn how to tackle setbacks and disappointments from those patients who show amazing resilience and fortitude in battling their illness.

There is another group of patients from whom we can learn a lot , but from whom we don't get a chance to do so . These are the patients who are unhappy with us and don't come back. In fact, these are the ones who are likely to be able to provide critical feedback which can help us to improve the most ! Patients who are under treatment are often intimidated and are not likely to say anything uncomplimentary, because they don't want to upset the doctor. However, patients who have decided not to come back have nothing to lose by being frank and forthright.

Unfortunately, we all tend to get overestimate our competence , clinical skills and bedside manners because we deal daily with patients who have chosen to come back to us for their treatment. They provide positive feedback daily - and like all human beings, we prefer focussing on positives, rather than dwell on our shortcomings. While the patients who do come back to us testify to our ability to provide good doctoring, why don't the others come back ?

These are questions I try to ask myself when a patient does not come back for a treatment after a consultation.

Did they prefer another doctor ? Why ?
Am I too expensive ? Was I too rushed ?
Did I do a bad job in explaining the treatment options ?
Did I seem to be too curt ?
Did I order too many tests ? too few ?
Did they not like my clinic ambience ? Was my receptionist unfriendly ?
Am I the wrong doctor for them ? Is this the wrong patient for me ?

The good news is that it's now possible for patients to provide this feedback - and for doctors to review it - at doctor rating sites. While some of the ratings are unreliable and biased, many of them are useful - and clever doctors will use the negative feedback to try to improve for the future ! If they don't, they will continue making the same mistakes, and will continue losing patients !

I wish patients would provide feedback - both good, bad and ugly ! After all, every complaint is a gift !

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