18-13 Segment 2: Teaching Doctors To Listen

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We all know that doctors endure years and years of schooling and training in order to learn how to diagnose their patients and provide them with the best care. But, studies have shown that many doctors tend to miss details about other aspects of a patient’s life that can also have an affect on their wellbeing. Dr. Saul Jeremy Weiner, Professor of Medicine, Pediatrics & Medical Education at University of Illinois and co-author of Listening For What Matters: Avoiding Contextual Errors in Health Care, explains that patients will make important comments that do not necessarily pertain to their symptoms, but that this information is often overlooked despite being critical for a doctor to understand in order to provide the patient with an effective care plan. But, what is the overall impact of this on the patient?
Dr. Weiner and Dr. Alan Schwartz, Michael Reese Endowed Professor of Medical Education at University of Illinois, Chicago, and co-author, Listening For What Matters: Avoiding Contextual Errors in Health Care, have done their own research that has shown the effects of doctor’s that are too focused on the biomedical details in providing care for patients. Dr. Schwartz explains that the results of their research showed that doctors who address the patient’s personal life were able to provide a much more successful care plan for the patient. Furthermore, the study also showed that the cost of healthcare for the patient increased when the doctor was too concerned with the science of the diagnosis. In order to have the most successful outcome without increasing the cost of healthcare, doctors must address more than just the patient’s biomedical symptoms.

So, how can doctors learn to listen to their patients more efficiently? Dr. Weiner suggests using an approach commonly used in other industries: mystery shoppers. In the medical field, a mystery shopper is an unannounced standardized patient that is trained to go into a physician’s office and provide data to help identify problems–a tool that many doctors have found to be helpful in improving their practice. Dr. Schwartz states that by investing in improving contextual care doctor’s will be able to provide better care for their patients and decrease the cost of healthcare, too. However, all patients and employees in the medical field must be willing to undertake these methods and procedures in regular practice in order to improve the overall experience for everybody.

Guests:

  • Dr. Saul Jeremy Weiner, Professor of Medicine, Pediatrics & Medical Education at University of Illinois and co-author of Listening For What Matters: Avoiding Contextual Errors in Health Care
  • Dr. Alan Schwartz, Michael Reese Endowed Professor of Medical Education at University of Illinois, Chicago, and co-author of Listening For What Matters: Avoiding Contextual Errors in Health Care.

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18-13 Segment 1: Sexually Abusive Doctors

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Almost every portrayal of doctors depicts them to be unequivocally good, and many people believe this portrayal. However, this belief has been under scrutiny recently. In light of the recent case against Dr. Larry Nasser, physicians and patients have started to focus their attention on doctors who sexually abuse patients and investigate the outcomes of these crimes, and the results are nothing short of disheartening.

Danny Robbins, an investigative reporter for Atlanta Journal-Constitution, has spent a lot of time examining the official response to this problem of doctor’s who sexually abuse their patients. He found that more than 2,400 doctors have been sanctioned by medical boards for sexual abuse of their patients, but more than half of these doctor’s still had their medical licenses. Among the doctors who did have their license taken away, Robbins discovered that many were able to easily get them back and continue practicing. The reasoning behind this is similar to a reasoning found in the criminal justice system: people working in these fields do not want to report each others misbehaviors. Robbins explains that oftentimes medical boards will shield these crimes from the public by not reporting them to the criminal justice system unless the victim reports it. But, even in the event of a victim reporting the abuse, the attorney general is left to negotiate with the doctor’s lawyer, and the medical boards follow the negotiation agreed upon by the doctor and the attorney general. Despite the number of doctors that are reported for sexually abusing their patients, few of them face punishments, and among those that do, the punishments are not severe and leave the abuse unknown to the public.

With little being done to deter doctor’s from misbehaviors, what can patients do to protect themselves? Dr. Altaf Saadi, neurologist and former sexual assault crisis line worker, explains that patients are always given the option to have a nurse present in the exam room. Along with this, Robbins also states that patients can go online and see if their doctor has been sanctioned at all. However, these records are often left vague, and one might have to do a little more research in order to determine what the violation was. However, Dr. Saadi believes that physicians also have a role in changing this. She explains that physicians should work to counter the environment that allows for these crimes to go unheard. Furthermore, it is important to address the medical boards that allow these doctors to get away with sexually abusive behaviors. Robbins states that the medical boards need to consist of a more diverse group of members who are not all doctors because many boards have few consumer members, if any at all. In order to see a change in the ways that these cases are handled, both physicians and patients have important roles in changing the ways in which medical boards and the criminal justice system pursue these offenses in the future.

Guests:

  • Dr. Altaf Saadi, neurologist and former sexual assault crisis line worker
  • Danny Robbins, investigative reporter for Atlanta Journal-Constitution

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Medical Notes 18-13

 

Medical Notes this week…

Chemicals called PFC’s are used to make non-stick pans, stain-resistant carpets and water-repellent jackets. They’re already linked to a variety of diseases. Now a new study finds that PFC’s may also make it much easier for people to regain weight after a diet. The study in the journal PLOS Medicine followed more than 600 people during and after being on a diet. The average subject gained back about half what they’d lost but those with the highest blood PFC levels regained an average of five pounds more. Researchers say resting metabolism rates were much slower in those with high PFC levels leading to easier weight gain.

We’ve reported on bullying and incivility in America’s offices recently and we noted that women report more incivility against them than men. But the source of most of that incivility may surprise you—other women. A study in the Journal of Applied Psychology shows that the queen bee syndrome is alive. Women reported that other women were more likely than men to put them down, make demeaning remarks or ignore them in a meeting.

And finally, when it comes to living past age 90, which is more important to partake in—exercise or alcohol? The answer–drink up. A study presented to the American Association for the Advancement of Science shows that 15 to 45 minutes of exercise per days cuts your risk of premature death by 11 percent. But two glasses of beer or wine per day cuts that risk by 18 percent.

And that’s Medical Notes this week.

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