Beyond the White Coat: Improving Patient Care

Doctors' coats

Patient care encompasses more than just treating the patient, as seen in the following scenario.

Jamie’s mom was strapped to a gurney; her eyes were vacant and her features pallid. The ambulance ride was a whirlwind of monitors and barked orders, somehow muffled by Jamie’s pounding heart and the unidentified rushing in her ears. When they arrived at the hospital, the girl helplessly trailed the paramedics’ purposeful steps as they shouted numbers and called for action. A woman in a white coat approached Jamie.

“Can you tell me what brought your mom in today?” asked the woman, her pen poised on her clipboard.

The girl took a deep breath, clasping her hands to halt her shaking fingers as she explained her mom’s extensive heart attack and stroke history and recent gallbladder surgery. She then recited as many details about the car accident as she could.

“So it was a car accident?” the clinician asked, not writing anything down. She seemed to have ignored everything Jamie had just said. The whole point was that it probably wasn’t just a car accident.

“Well, technically yes, but something caused it. Mom just passed out suddenly,” offered Jamie.

“Syncope then,” said the woman in the white coat, scribbling the word and departing, appearing frustrated that Jamie hadn’t just said that at the beginning.

A quick Google search on Jamie’s iPhone defined syncope as “a temporary loss of consciousness.” She flushed, frustrated for two reasons: not recognizing the term and that the woman seemed focused on finding one magical medical word to fill in on her chart.

Family interactions, like Jamie’s, require healthcare providers to “think beyond their white coats,” which simply means briefly stepping out of their typical role and remembering that the individual could be experiencing trauma or confusion. This is what distinguishes a good doctor from a great one.

In a previous post, we addressed ways to improve your bedside manner. It’s important to remember that those same courtesies extend beyond the person in the hospital bed to the patient’s family members. With small adjustments, Jamie’s experience could have been positive.

The provider could have spoken to her in layman’s terms, asked if she had any questions, and appeared receptive to the additional medical history. That information could have been pivotal for the diagnosis, indicative of an underlying cause for the patient’s lapse in consciousness. Even if it didn’t make a difference in a medical sense, the provider would have developed a positive experience, established trust with the family, and encouraged partnership in the patient’s care.

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