WHAT COULD THEY DOThey could go to ---police --media -tv -press -internet --consumer forum
INTERNET BLOGS-just avoid Dr X at this hospitalas he is incompetent-Dr Y is fooling patients with false degrees— ?Mch(orth)USA -please avoid Y hospital—WORST EXPERIENCE —20 year old equipment -uncaring nurses etc
UNHAPPY means-----sad, unlucky, depressed (webster dictionary) first used in 14th centuryPatients do not care how much you knowThey ONLY want to know how much you care.
Why is the patient unhappy?-communication gap in doctor-patient relationship-mismatch between expectations and reality
“You are as strong as your weakest link”Unhappy with -- hospital/clinic -- doctor -- nursing care -- surgical result —good/bad --cost -- re-surgery/rehab
HOSPITAL--APPROACH ROADS POOR--DIFFICULT TO PARK--TOO FAR--WOULD LIKE HOSPITALS NEARHOME
--INEFFICIENT RECEPTION--INSURANCE SECTION-- PILLAR TOPOST-POOR AMBIENCE-LONG WAITING TIME
CR LEFT HIPNO PAIN RELIEF RIGHT HIP-----SCREW/WIRES REMOVED--BIPOLAR
PATIENT PRESENTED LIKE THISBILATERAL LOOSER’S ZONES AFTER MANY SURGERIES- NO PAIN RELIEF-VERY UNHAPPY BILATERAL ADDUCTOR TENDINITIS – PAIN RELIEVED WITH SIMPLE LOCAL INJ & OSTEO-MALACIA TREATMENT ---HAPPY
CASE 3• Male 55Years• RTA 2 years ago . Gr III B comminuted fracture Right Leg• debridement-• minimal Internal fixation+ Ex-fix, Vascularised free flap.
X-RayNON-UNIONPAINFULUNABLE TO WEIGHTBEARVERY UNHAPPY
HOW TO MANAGE UNHAPPY PATIENTS-Listen to the patients and they will tell you what is wrong. Lawson Smith-Welcome the complaints. “If you’re happy with the way we treat you, tell yourfriends. If you’re unhappy with the way we treat you, tell us.”
Do not run away from unhappypatients. -see patient repeatedly -make house calls -refer patient to your friends for second opinion (you may have missed out something) -take patent’s permission - discuss his problem on internet eg. Indiaorth
Inform patients about -- limitations of surgeryEg “If you had a hip replacement, you are not going to run amarathon next day”. -- inform that, despite our best efforts, no treatment is without risk or carries a 100% guarantee of success
PREOPERATIVE STAGE--- Discuss entire procedure in detail withpatient Informed consent-Talk in numbers and give percentages eg, ’Twenty percent of patients may needan adjustment with this procedure.’--- Stress the time required to heal.
POSTOPERATIVE STAGE-- never disagree with what a patient sees is wrong-- Remind the patient that healing takes time eg: from 6 months to a year.-- See the patient with increased frequency - show that you care - Don’t send the patient away for a month andhope that they will cool down.
DEALING WITH ANOTHER SURGEON’S UNHAPPYPATIENT--Never say anything bad about another surgeon. “If you see a little fire, put a little water on it, not a little gasoline.”-- Make a friendly call to the other surgeon who did the originalsurgery. Let him know you have seen the patient. Mention that you supported his original work.
CONCLUSIONS---FOR UNHAPPY PATIENTS-WHEN IN TROUBLE--STAY CALM-LISTEN TO THE PATIENT- RE-ESTABLISH RAPPORT-KNOW YOUR LIMITS-DON’T COMMENT ON ANOTHER DOCTOR
-WHEN IN DOUBT, REFER AND TAKE HELP-EXPLAIN LIMITATIONS OF SURGERY-PROVIDE OPTIONS-TREAT THE unhappy PATIENT LIKE A VIP