In a recent article in the New York Times, the prolific Danielle Ofri makes the point that inpatient and outpatient medicine are so different as to be on different planets. She's right, of course. In the hospital, illness is more acute and everything needs to be done faster. More resources are used. Life or death can often hang on every day's decisions. In the clinic, most things are slowly developing, many things get better on their own, and decisions are less weighty.
Or that's what we think. From a patient's point of view, the hospital and the clinic share many similarities:
1. The language can be bewildering.
2. No one spends enough time.
3. Decisions are made without asking you.
4. You are given medications without full information or the chance to say no.
5. People process you without introducing themselves.
6. You are made to dress and undress at the drop of a hat.
7. Everything costs too much, and it's hard to figure out why.
8. There's nowhere to put your kids.
9. If you speak another language, you have to wait for an interpreter - or sometimes you don't get one at all.
10. You are too confused, or sick, to think straight, but sometimes you are expected to share in the decision as if you are fully empowered.
11. You wait and wait for your questions to be answered.
Ofri's point is that, once upon a time, the same doctor would see patients in the hospital and in the office. Nowadays, it's most common for special doctors to see patients in the hospital, and other doctors, of the outpatient variety, to see them outside. The technical requirements of the two environments are two different for one doctor to be able to deliver good care in both.
What does it tell us, though, if the experience of the patient is similar in important ways in the two environments? Does it mean that the right kind of doctor can provide superior care to patients in the hospital and the office? Does it mean the care needs to be reshaped, in equally serious fashion, in both places? What do you think?
Or that's what we think. From a patient's point of view, the hospital and the clinic share many similarities:
1. The language can be bewildering.
2. No one spends enough time.
3. Decisions are made without asking you.
4. You are given medications without full information or the chance to say no.
5. People process you without introducing themselves.
6. You are made to dress and undress at the drop of a hat.
7. Everything costs too much, and it's hard to figure out why.
8. There's nowhere to put your kids.
9. If you speak another language, you have to wait for an interpreter - or sometimes you don't get one at all.
10. You are too confused, or sick, to think straight, but sometimes you are expected to share in the decision as if you are fully empowered.
11. You wait and wait for your questions to be answered.
Ofri's point is that, once upon a time, the same doctor would see patients in the hospital and in the office. Nowadays, it's most common for special doctors to see patients in the hospital, and other doctors, of the outpatient variety, to see them outside. The technical requirements of the two environments are two different for one doctor to be able to deliver good care in both.
What does it tell us, though, if the experience of the patient is similar in important ways in the two environments? Does it mean that the right kind of doctor can provide superior care to patients in the hospital and the office? Does it mean the care needs to be reshaped, in equally serious fashion, in both places? What do you think?
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