PVI recently was contacted by Dr. Sosena Kebede*, a physician at Johns Hopkins who is passionate about helping patients engage meaningfully as stewards of their health care journey. Below, she writes a heartfelt and brutally honest piece about the obstacles, limits and complexities physicians face in caring for their patients on a daily basis. It can sometimes be easy to blame the physician for oversights, but are we asking our medical professionals to do too much in too little time? When under the ‘time crunch’, we need to acknowledge that doctors are human and make mistakes just like the rest of us.
I PRAY FOR MY PATIENTS
I recently saw two patients who were discharged from two separate hospitals for hospital follow up. Neither of the patients had a discharge summary with them when they came to see me. One was an elderly black male who had an aborted surgical procedure due to an infected gall bladder that was determined to be too friable [not sufficiently intact] to remove. The other was a middle-aged female with mild cognitive impairment who was told she had a urinary tract infection and diverticulitis [a bowel disorder], and was put on Keflex.
The former patient was not put on any antibiotic, and although the discharging physician had written discharge instruction to flush the drain twice a day with saline solution, the patient was unaware that was necessary and had not flushed his drain for 3 days before he came to see me.
The latter patient was put on an antibiotic that is not the typical treatment for either of the medical conditions she was told she had.
In both cases, the patients appeared well, and none the wiser that anything was amiss.
I initially got on my moral high horse and started to rant to the staff around me how unbelievable this was and how unacceptable. My half-day of work had stretched to 3pm, and I walked to my car with a sinking feeling in the pit of my stomach. I reflected on how many potentially harmful decisions or oversights I could easily have made that day when I approved medication refills for 10 unknown patients in a row without reading their charts, or the lab result I meant to go back to and review in detail that might need an intervention sooner rather than later, etc.
I have been on both sides of the game – a hospitalist who was frequently indignant by poorly detailed and investigated patient history that comes from primary care physicians’ offices, and now as a primary care physician, I am equally shocked by a plan of care the patient seemed clueless about, and that didn’t make sense to me.
I am now willing to acknowledge that the majority of my colleagues and I are not shoddy practitioners who are negligent. We are human beings who have been forced to constantly cram sometimes life and death-magnitude decisions into 20 minutes or less. I had stopped praying years ago, but have picked up the practice once again. I now pray for my patients every morning as I drive to work – that I may not harm them.