Preserving Patient Dignity (Formerly Patient Modesty) Volume 127

 

A Worthy Posting today on Volume 126 to set off a discussion of  "Preserving Patient Dignity"which should be more acknowledgment that there has been, within the past, some ignorance by the medical profession that the concept of the dignity of the patient exists and should not be attacked and injured. 

Here is the last posting of our contributor Reginald:

Hello,

As I pondered why dignity is such a hard concept for healthcare, I mused regarding what has changed – realizing that what happened in the past was not always something better.
Thirty years ago I had a cardiologist as a GP. Yes, a cardiologist as a GP. That this was possible was astounding, even at that time. I visited him once a year and, the visit lasted for almost an hour. The session started in his office. Yes, in his office, not an exam room. His first statement was, “Tell me what has happened in the past year?” He’d then listen, respond, and ask further probing questions. After at least 30 minutes he’d invite you to the exam room while he followed with his black bag. (One would think that he was a doc out of the 1800’s.) The exam was complete – nothing missed – no rush. Bowel issues might be addressed in the exam room via a sigmoidoscopy, a modified colonoscopy without anesthesia. There was no need for another office or hospital visit. The exam might be interrupted as he was called out to answer a patient’s phone call. He could be heard saying, “No, Mr. Smith. You must take that medication for the rest of your life.” He’d return to the exam, apologize, and continue. His wife was his assistant and his receptionist. This was in Santa Ana, CA not in rural America. Sadly, when he heard that the insurance companies were limiting payments to 15 min. visits, he retired. He was too professional to be directed by non-medical entities.
What’s changed? Aside from the fact that a cardiologist could also be your GP, your visit took some time and the doctor LISTENED. An hour-long visit will not return but, LISTENING doesn’t really require much time.
Today, few in health really listen, nor do they ponder what they’ve heard. A quick diagnosis is made and you’re on your way. In a hospital setting, no one will listen to you AT ALL. For any procedure there’s a protocol and the protocol comes before the patient. Dignity issues are not addressed because they are not part of the protocol or, because they interrupt the procedure. No time is given for consideration of the patient’s requests for dignified care.
I do believe that this is at the heart of our responses (real or perceived) to what we consider breaches or dignity. Yes, there are bad actors; but, overall health care personnel don’t plan to harm. They don’t listen and, they are unwilling to spend the time to consider how protocols might be revised to accommodate INDIVIDUAL dignity. Group “dignity” is attended to via politeness and courteous; however, individual dignity is never addressed. This would require time and, getting to know the patient as a person and not a procedure. Is there any hope that this will change? What can we, realistically, do to affect change? Maybe, more importantly, the question is Would anyone in healthcare even consider the above explication of individual vs group dignity?

Reginald