Kevin MD published an op-ed in USA Today titled “Violence is a symptom of health care dysfunction” which discusses patient frustrations as one source of violence against health care workers. I’ve been busy this week and the comments section is apparently closed on Kevin’s post, so I didn’t get the chance to put my 2 cents in … yet.
The premise of Kevin’s post is that our system is broken and we need to better protect our health care workers. Agreed.
A second premise is that there is a deterioration of the doctor patient relationship. Also agreed.
But Kevin then says that “Patients are rightly frustrated, and some are lashing out.” The way this sentence is phrased almost makes it seem as if it is OK for patients to lash out when they are frustrated.
Kevin ends his op-ed piece by stating that health care providers could use more empathy and that patients need to realize that health care professionals are doing the best they can and should avoid violence.
Again, the impression that I was left with after reading the last couple of paragraphs in the article was that health care providers need to empathize with patients in order to stop the violence.
So I have a couple of thing that I need to set straight.
First of all, it isn’t just patients that are frustrated about the health care system. Providers are just as frustrated about the state of affairs. Patients think they’re frustrated? Take that level of frustration and multiply it times 24 hours a day, 7 days a week. Now put yourself in a position where federal agencies are micromanaging you, where the people you are trying to help have the potential to wig out and injure you, where your payments are being decreased, where your liability is being increased, and where you often work way more than 40 hours per week. Welcome to medicine. Not only do we have your frustrations, but we also have a plethora of other frustrations on top of that.
Second, some of the patients commented in Kevin’s op-ed about wishing they had an old-school doctor patient relationship. If you’re expecting a Marcus Welby experience in the emergency department, it isn’t going to happen. Most of the time is you show the staff a little respect, chances are good that you’ll get respect in return. Not all the time, mind you. Everyone has a bad day, so you might not have the warm fuzzies after every emergency department visit. However, if you come across as a foul-mouthed, demanding, bad attitude wretch, I can almost guarantee you that you will be treated as a foul-mouthed, demanding bad attitude wretch.
But I also have some good news. If you want a Marcus Welby relationship with your physician, you can have one. Find a doctor you like and actually stick with the doctor. Stop playing hopscotch with your doctors every year when your health plan changes and then complaining when the new doctor you see once or twice (before you change doctors the following year) hasn’t committed your complete medical history to memory. Yes, I know that doctors move and that residents graduate, so patients aren’t always at fault. But I see a whole lot more of the former scenario than I do of the latter scenario.
I don’t care if patients are “rightly frustrated” about the health care system. Never should society accept violence against another person as an outlet for those frustrations. It isn’t OK to punch a police officer because you’re “rightly frustrated” about your speeding ticket. It isn’t OK to threaten a judge because you’re “rightly frustrated” with his ruling. I’ll bet that even hospital administrators would agree that it isn’t OK to stab them with a knife if you’re “rightly frustrated” about the way that they are running a hospital. Violence can never be an acceptable outlet for frustrations.
Kevin has become a prolific medical blogger because his opinions are consistently well-grounded and well thought out. I agree with his position 99+% of the time which makes me think that the way he phrased some of the statements in his op-ed piece did not express his true intent and created an unintended picture in the minds of many readers, including me.
The fact that so many health care organizations and so many health care providers tacitly accept violence against health care workers as an outlet for patient frustrations just shows how low our health care system has sunk.
Even Marcus Welby couldn’t fix that.