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Communication Complications


A recently published study in the August issue of Archives of Internal Medicine reveals that there are significant gaps between what doctors think their patients know and what patients say they know. The findings are based on a survey of 89 patients and 43 physicians conducted between October 2008 and June 2009 at Waterbury Hospital affiliated with Yale School of Medicine. Researchers found that some of the discrepancies relate to basic information. For example, two-thirds of physicians thought patients knew their names. But only 18 percent of patients could correctly say their names.

Other information gaps are more critical and could affect patient safety and quality of care. Roughly three in four (77 percent) physicians thought that patients knew their diagnoses, while in reality only 57 percent of patients knew of their doctors' 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 med'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 seemed to agree.

The survey respondents were older, indigent, and less educated than average. Despite being a small study, these findings potentially have huge significance. If these findings are anywhere near to what we would find if we looked at patients all across the country, it suggests that doctors may not accurately understand, address patient needs nor effectively communicate with some of their patients.

On the other hand according to researchers from the University of Maryland, poor communication 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. Researchers say much of this waste could be eliminated by investing in health IT solutions that could streamline communication among hospital caregivers. Consumer Health IT tools may also improve communication among patients and between patients and providers. 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 and poorer than the average US citizen and some of these individuals will also possess poor English language skills. Thus without significant improvements in the ability of the healthcare system to reach, understand, address the needs of and communicate effectively with seniors, those less educated, immigrants and racial and ethnic minorities, healthcare disparities among these groups, and healthcare costs for everyone may still be on the verge of significant increase.

We may actually 'ix healthcare financing & reimbursement issues yet find ourselves still unable to reduce healthcare costs, effectively address healthcare disparities or improve national health outcomes among large portions of the US populace. If this is indeed the case, can we really claim to have the best healthcare system in the world?


More Blog Posts by Chris Gibbons

author bio

Chris Gibbons, MD, MPH, is the associate director of the Johns Hopkins Urban Health Institute, the director of the Johns Hopkins Center for Community Health, and holds faculty appointments at the Johns Hopkins Schools of Medicine and Public Health. Dr. Gibbons is the Chair of CFAH's Board of Trustees. He blogs on the Healthcare Disparities Solutions Blog, a blog about healthIT innovation for disparities solutions. Want to read more from Dr. Gibbons? Subscribe to the RSS feed.

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Minority Health and Health Disparities   Chris Gibbons   Communicate with your Doctors  

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