Why are so many patients dissatisfied with their doctors?

by Carolyn Thomas  ♥ @HeartSisters

If you sometimes feel like you don’t get enough respect from your physician, you may not be alone. In fact, two new global studies* from 23 countries show that two-thirds of patients around the world feel disrespected by their physicians – no matter which country they call home. For example, about one-quarter of patients surveyed complained that their physicians don’t answer questions, don’t involve them in treatment decisions, and use medical jargon with no explanation.

This appears to be a direct outcome of doctors not spending enough time with patients (44%).  About a third of patients also believe doctors show disrespect by not being punctual for appointments. 

PR Newsire reported last month that these findings about physician/patient relationships were drawn from two major studies: the first was a study of 22,581 adults in 23 countries; the second – designed to delve into the reasons behind the first findings – looked at 5,000+ adults in the U.S., the U.K., Germany, France, Japan, Australia, China, Singapore and Sweden.

Patients in China (55%) and Germany (51%) were particularly displeased with the limited time they get from their doctors. Chinese patients are also far more likely than respondents in other countries to say their doctors don’t explain medical terminology. In contrast, in Australia (55%), France (48%) and the US (46%) patients are much more concerned about physicians’ lack of punctuality.

Chris DeAngelis of Strategic Initiatives, who undertook one of the studies, explained:

“When we look across 23 countries, we see that only three in 10 patients rate the care they receive from their doctors as excellent — and less than half would recommend their physicians.”

Around the world, patients’ unwillingness to recommend their doctors is primarily due to long wait times (26%).  The one exception is China, where the number one reason patients would not recommend their doctors is “lack of medical expertise” (44%).

In fact, more than half of Chinese patients report their doctors need to improve both the instructions they give on follow-up care and the thoroughness of exams, areas only 12% of American patients and a fifth of patients globally see as problems.

The two international studies also show that only one quarter of patients are happy with their involvement in treatment decisions.  Almost half of patients around the world (46%) say that they would be more satisfied if physicians would explain the treatment process and possible side effects in more detail.  Chinese respondents in particular (72%) are looking for more detailed explanations.

Besides improving explanations of treatment and side effect details, when patients were asked to name the action that would increase their satisfaction with the treatment decision process, their answers included:

• listening to patient concerns (37%)
• physicians spending more time discussing options (32%)
• greater availability of literature about specific medical conditions (23%)

Since Canadian patients were not included in these two studies, I began to wonder how the doctor-patient relationship is faring here in my own country.  I was surprised to find a surprisingly bold assessment from Dr. Louis Francescutti of the Royal College of Physicians and Surgeons of Canada, who, in an online interview with The Medical Post, cited these four big problems between Canadian patients and their doctors that seem to go even farther to explain what’s wrong:

1. The health care system is oriented around the needs of doctors and other health care providers instead of patients. Dr. Francescutti explains:

“There’s no disease I know of that shuts down at 5 p.m. and opens again at 9 a.m. the next morning. The whole model of health care delivery quite frankly makes absolutely no sense. It’s designed for the convenience of the administrators and those who work in the system. It’s definitely not designed for the patient.”

2. Doctors have too many vested interests to be agents of needed reforms. Younger doctors want high incomes, but they also want to work fewer hours than their mentors and predecessors. For example:

“Younger physicians today are saying ‘I’m not interested in working as hard as the people who taught me. I’m going to take my time off. I’m going to spend time with my family. I’m not going to work nights. But I want to have the big salary and I want to have the profession, the specialization, that allows me to have evenings and weekends off.’ And younger female doctors are more likely to take their full extended leave for maternity – and there’s nothing wrong with that – but the numbers are compelling: you need 1.6 females for every one male physician.

Doctors today are more individualistic. Among our current crop of medical students in our classrooms today, there’s an enormous sense of entitlement that I’ve never seen before.”

3. Because it costs so much to go to medical school, medical students are mostly from affluent backgrounds.   He adds:

“Medical school has become very expensive and it’s only the elite who are able to get into it. I’m a little concerned that we might not be admitting the right students in medicine today.  Quite frankly, some poor kid in rural Canada or downtown Toronto hears their parents saying, ‘Don’t even think of medical school. There’s no way you’re going to be able to go there because I can’t afford it.’

“So all of a sudden, who gets into medical school? Doctors’ sons and daughters, lawyers’ sons and daughters, politicians’ sons and daughters – and you have people who are out of touch with what life is all about.”

4. Doctors and politicians are so concerned with being politically correct that they are afraid to tell people what they really need to do to improve their health:

“Unfortunately we still have quite a ways to go in making sure that our patients are not smoking, and then getting people to be more physically active. Weight reduction will drop blood pressure, so that will take care of hypertension and heart disease and (it) will reduce the likelihood of developing cancer down the road. Weight reduction also reduces the risk of diabetes. Weight reduction – getting out and getting active – actually improves your mental health as well.

“Unfortunately, you never hear politicians and you rarely hear medical organizations telling people what they need to do to get their lives together”

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* Studies undertaken by SSI and The Research Intelligence Group (TRiG)