Quality of Clinical Care vs. Quality of Interpersonal Interaction

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Love Your Patients! Improve patient satisfaction with essential behaviors that enrich the lives of patients and professionals.  The article below is a story from a woman whose fiancée has had a difficult hospital course.  In fact, at the time she wrote to us, he was still hospitalized. This article is an example of quality care and the personal touch that results in a good patient experience and why it is important to “love your patient.”


My fiancé underwent a radical prostatectomy on June 26, 2006, and his surgery was lengthy due to the aggressive and high grade nature of the tumor. There have since been multiple unanticipated complications, leading to an additional surgery as well as multiple procedures.  The projected hospital stay was 5-7 days, and we are now on day 29.

Throughout all of this, Dr. Blackwelder has provided exacting care, attentiveness and compassion.  He has been at the bedside during early mornings, late nights, weekends and holidays.  He consistently returns calls and responds to pages from nursing staff within minutes.

Dr. Blackwelder has gone “above and beyond” in ensuring that we understood each arising circumstance and course of treatment, as well as involving us in the decision making.  He has made himself personally available to us. I have spent many hours at the hospital.  


Dr. Blackwelder has been completely approachable, providing explanations and information to me, as well as allowing me to ask questions.  He is never abrupt and is consistently kind and patient in giving his time.  He has inspired confidence and made this ordeal bearable.  


He has earned my admiration. Dr. Blackwelder is genuine.   The consequences of the complications would have been disastrous if not for his attention to detail, immediate availability and commitment to patient care.  We feel blessed to have been under his care throughout these trials and tribulations.

Complications

Do you think our writer would have had the same response to the complications and prolonged hospital course if Dr. Blackwelder had been aloof or unapproachable or (gulp!) arrogant?


Usually, complications are a cause for upset and hostile families.  But this physician bucks the trend.   How does Dr. Blackwelder earn high praise and commendations in such a minefield?


He’s a great provider; not only for his clinical skills, but because of the way he works with the patient (and family).  He scores maximum style points.  This letter was written by a grateful family member.  Not grateful for a bunch of complications, but grateful for a caring provider.

Actions speak louder than words.

Here are some of her words which jumped out at me:

“attentiveness”

“compassion”

“at the bedside”

“He consistently returns calls”

“ensuring that we understood”

“involving us in the decision making”

“completely approachable”

“providing explanations”

“allowing me to ask questions.”

“He is never abrupt”

“is consistently kind and patient”

“He has inspired confidence”

“Dr. Blackwelder is genuine”

“commitment to patient care”

And, among these examples of stellar behavior, the action words stand out.  “Ensuring,” “involving,” “providing,” “allowing,” etc prove that earning patient satisfaction is a dynamic, deliberate constellation of proactive behaviors.

Now, you might say, what kind of life does Dr. Blackwelder have, being available to his patients all the time?  I’ll bet it’s a great life, doing as good a job as he is doing.  And, since he is putting a few extra minutes in with each patient each day, he does not spend time in depositions or courtrooms later.

Great interpersonal interaction skills are a key part of great clinical skills

The quality of our clinical care is of paramount importance, and should never be compromised.  However, our patients’ perception of quality of care is not necessarily in terms of outcomes and results.  Our patients’ experience a gestalt*, a big picture.  How we behave with them is a crucial part of that big picture.

I believe that our patients see primarily our actions.  They do not discern the quality of their care as separate nor distinct from our personal interactions.

Patients and families judge, rate and score the quality of our clinical skills based on the quality of our interpersonal interaction.

So, while you go about your clinical day, ask yourself,

“What does it mean to you to be a “good doctor” or a “good nurse?”

To me, it’s not just about the quality of care.  It’s about how that care is ministered.

“Good” is not just a measurement of clinical skills or outcomes.  Good is in the eye of the beholder.

About the Author

Dr. Scott Louis Diering is a practicing emergency medicine physician, who also gives lectures and workshops on patient satisfaction. He founded Love Your Patients!, Inc. to make the world a better place.


He currently lives and works in western Maryland. Previously, Dr. Diering worked in Scottsbluff, Nebraska, where he was hospital media spokesperson, wrote and hosted the hospital’s TV segments, and was county Medical Society president.

Before attending medical school at Wake Forest University School of Medicine, Dr. Diering practiced as a clinical psychologist. He earned his Master’s Degree in clinical psychology from the University of North Carolina at Greensboro.