It should not be a great surprise to any of us, but a recently published study in the August issue of Archives of Internal Medicine concluded that there are significant gaps between what doctors think their patients know and what patients say they know!  The study consisted of a survey of 89 patients and 43 physicians which was given between October 2008 and June 2009 at the Waterbury Hospital, an affiliate of the  Yale School of Medicine.

Researchers found that there are  significant information discrepancies that reach all the way to even the most basic information.   Shockingly, the discrepancies even included  what was the doctors name! Two-thirds of physicians thought patients knew their names, but only 18 percent of patients could correctly tell the researchers their doctor’s name.

The other information gaps were as clear and were more critical as they could easily affect patient safety and their quality of care.   Seventy seven percent (77%) of the physicians thought that patients knew their diagnoses, while in reality only fifty seven  percent (57%) of patients correctly knew their diagnoses!

Furthermore, while two-thirds of patients reported receiving a new medication in the hospital, 90 percent of them said they had never been warned of the medication’s adverse side effects. Virtually all doctors (98 percent) said that they discussed their patients’ fears and anxieties. Still, only about half (46 percent) of the patients  agreed.

The survey respondents were older, indigent, and less educated than the average population, but these findings  still have  significance, including for the better educated patients.   These findings suggest that doctors do not accurately understand their patients, address their patient needs nor effectively communicate with  their patients.

According to researchers from the University of Maryland, poor communications  in U.S. hospitals costs the nation $12 billion per year or approximately 2 percent of national hospital revenue. This represents more than half of the average hospital profit (margin) of 3.6 percent.

Much of this waste could be eliminated by investing in better health IT solutions that could streamline communication among hospital caregivers.  Even more important, medical schools need to develop extensive programs designed to teach basic communication skills  to doctors in training as well as continuing education on basic communication skills.

By 2050 there will be 2 seniors over the age of 65 for every adult under the age of 65 and by that same time the US populace will be composed of more than 50% immigrants and minorities, many of which will be less educated, have poor English skills and be poorer than the average US citizen.
Without significant improvements in the ability of the healthcare system to reach, understand, address the needs of and communicate effectively with all patients; those less educated, immigrants, racial and ethnic minorities,  healthcare costs  will continue to escalate but provide ineffective care.

Joel T Nowak, M.A., M.S.W.