Doctor-Patient Disconnect: Taking Charge of Your Incontinence Care

I went to the Doctor this week and it was a thoroughly unsatisfying experience. I spent about 40 minutes waiting and 10 minutes or less with the Doctor. While all the staff were polite and helpful, I can’t help but feel that I was just one piece on an assembly line. No one really listened to what I wanted to discuss and I left with a treatment plan I don’t really understand and more than a few questions unanswered.

Turns out, I’m not alone. Earlier this week, Steve Wilkins of Health Messaging wrote a fascinating blog article contrasting the responses patients provide on satisfaction surveys and other published data. He suggests that there is a significant disconnect between what patients say in surveys and what happens in practice. Based on my experiences this week, I would agree, so I thought I would share some of the highlights with you all here.

Studies of primary care physicians show that:

  • Patients are interrupted by their physicians within the first 18 seconds of their opening statement during office visits
  • Physicians and patients agree on the reason for the office visit only 50% to 70%  of the time
  • Physicians underestimate the patient’s desire for health information 65% of the time
  • 50% of patients walk out of their doctor’s office not understanding what their doctor told them to do
  • Patients are not asked if they have any questions in up to 50% of office visits

Despite the stats above, most patient satisfaction surveys show a consistent satisfaction rate of 80%-90%. So, what’s the disconnect? Wilkins argues that it’s really three things –

  1. Beginning with childhood, we all have been socialized to assume the “sick role” when seeing the doctor. From our initial visits to the pediatrician with our Mom we quickly learned the doctor is in charge and our role is to sit passively by while the doctor does most of the talking. Notwithstanding all the “talk” about how empowered patients are today, most of us still assume the sick role when seeing our doctor.
  2. Accustomed as most of us today are to the sick role, and accepting the fact that physicians are very busy, we are not surprised when doctors don’t seem to listen to us or interrupt us. We are not surprised they don’t have time for all our questions or frown on us bringing in lists of things we have researched on the internet. This for most patients is what we are used to … it is what we are satisfied with, given that most of us don’t have another or better point of comparison, i.e., a highly patient-centered physician.
  3. Consistent with the sick role, we as patients “tend to be overly patient.” We “grant our doctors the benefit of every doubt.” Most of us begrudgingly put up with poor service, inconvenience and unnecessary discomforts until we can’t overlook it anymore. Even then we are reluctant to take our busy, overburdened doctor to task for these shortcomings by giving them a low score on a satisfaction survey.

So what can we do? For one thing, “be cautious about putting too much credence in patient ratings of physician communication skills.” And as the patient, be proactive. Don’t shy away from doing your own research and asking your Doctor about what you find. Most people with incontinence never mention it to their doctor. And when a patient comes in wearing a diaper, the Doctor may not even bring it up!

If the study above wasn’t enough a related article that also came out this week. A study of 1,068 adults conducted by Consumer Reports National Research Center for the Institute of Medicine’s Evidence Communication Innovation Collaborative found that 90 percent of patients wanted their doctors to offer them options – not just their best recommendation – for making a medical decision, but far fewer people were actually offered this information by their doctors.

Two-thirds of patients agreed they wanted to know the risks of each option, including how a choice might affect their quality of life. Nearly half agreed that they wanted to discuss the option of doing nothing. However, patients’ experiences rarely matched up to their desires. According to the study:

  • 61% strongly agreed that their provider listens to them
  • 50% strongly agreed that their provider explains the risks of their options
  • 36% strongly agreed that their provider clearly explains the latest medical evidence
  • 47% said that their provider takes into account their goals and concerns
  • 37% said that their provider explains the option of not pursuing a test or treatment

“This gap represents an enormous missed opportunity,” William D. Novelli, a Georgetown University professor and former AARP CEO wrote. “Healthcare practitioners have a key role to play in bridging this gap by routinely offering all the reasonable options for healthcare decisions through systematic implementation of unbiased, evidence-based tools, such as decision aids,” they continued.

Here at Men’s Liberty we sit on the other side of this divide. Patients are desperate for something better to manage their incontinence; they find us and end up introducing the product to their Doctor. There are thousands of products, pills and treatment options out there. Even the best Doctor can’t keep track of everything new that comes out. But proactive patients are seeing the benefits!

Does your Doctor know about Men’s Liberty? Would you like to send them information or take the information to your next appointment? Click here to send them information!

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For more information on either study, please click on the links above to the original blog posts/articles.

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