I'm writing
after seeing my doctor and just being tired of the lack of quality I'm seeing ...
and what I've seen when I've been to other doctors as well.
A few
years ago, the prestigious Institute of Medicine
(IOM) created quite a stir when it released something called the Quality Chasm Report which
indicated a huge gap between best practices and current treatment of many of
the nation's most prevalent illnesses. Depression
was, I think, number one or two on the list. This led to a flurry of other papers
and conferences—doctors all looked at the problem and agreed that SOMETHING
MUST BE DONE. This led to other meetings where people gathered and wrote instructions
and guidelines about what should be done.
Lots of
conversation. Lots of writing. But not much actually implemented yet.
While I
was an active participant in many of those meetings and still hold hope that
they'll make a difference in the future, I think the real quality chasm
is very different and is something to be wrestled with before any changes can
occur within our system. I think the real chasm is the difference between how
doctors perceive their care/treatment and how their patients perceive it.
I was
recently asked to speak to a very prestigious groups of individuals who were examining
quality measures. I shared with them the following survey results that indicate
what consumers want from doctors:
According to one survey we did with over 2,000 people
responding, our number one request of our doctors was this: "Give me hope; make
me feel hopeful about my future." This response was confirmed by another meeting
attendee, a doctor who has made a name for himself in quality measurement in
mental health. He said that while no one's able to quantify this yet, providing
hope will not "go away" as a key indicator of what we consumers consider
quality.
Other things we want from our doctors in a quality
practice?
- Let me make decisions and have some input into my treatment/care.
- Focus on my wellness, not my illness.
- Act in a way that shows you believe that I can recover.
- Listen to what I need instead of telling me what I need.
Notice that
we didn't say we wanted doctors who had more degrees or board certifications,
cleaner offices, better office hours or a fax machine. We wanted hope,
empowerment, recovery orientation and responsiveness.
In another survey DBSA did with NAMI, we asked what the
hallmarks of a good professional were. There were about 900 people who
responded. What did we most want? "Please listen to me," was the number one response.
Did you know studies show that a consumer will speak for less than 20 seconds
before a doctor will interrupt them?
What else did we want?
- Communicate with me (i.e.,
speak in ways I can understand).
- Be compassionate.
- Be knowledgeable.
- Have decent interpersonal skills.
Notice
that only one thing on both lists I've shared so far is taught in medical
school.
