Can you imagine someone having the gall to tell you they want to punch you in the face while disparaging everything about the way you look and act? If this has happened to you, you probably were at a bar, sporting event, or some other raucous occasion where alcohol is heavily consumed.
How about the doctor’s office?
Can you imagine if that someone trashing you was a licensed medical practitioner whose care you were in at the time they said it? Not only that, but imagine if they said it while you were under sedation and unable to respond.
That nightmare situation was reality for one patient. There are levels of disrespect and there is what Tiffany Ingham, M.D., the most infamous anesthesiologist in the country did.
As reported in The Washington Post and several other mainstream media outlets, a Virginia man who had a colonoscopy ended up recording his entire surgical procedure by accident. He intended on recording the post-op instructions from his doctors on his smartphone and forgot to stop the device when the procedure started.
As soon as he went to sleep, Dr. Ingham, the anesthesiologist on the procedure, began to lay a verbal lashing against the patient for no reason at all. According to a suit that the anonymous patient filed, Ingham said, “After five minutes of talking to you in pre-op, I wanted to punch you in the face and man you up a little bit.” When an assistant noted a rash on his arm, Ingham told her not to touch it, saying she might get, “some syphilis on your arm or something.”
Ingham and another doctor, who was also charged in the suit but was dismissed from the case, talked about intentionally misleading and avoiding the patient after the surgery was over. Ingham said she’d write hemorrhoids on his chart even though she didn’t see them. She made fun of him for attending Mary Washington College, which used to be all-female school.
The insults didn’t end there and neither did Ingham’s incredibly cynical outlook on patient care. She reportedly said, “People are into their medical problems. They need to have medical problems.” At the end of the day, a jury in Fairfax County, Va. awarded the man $500,000 in damages. Normally, I’m not a fan of our country’s lawsuit tendencies, but in this case she got what was coming to her.
As I noted, the candid camera-style news story has gotten pretty good coverage in the mainstream media. I think it speaks to the innate challenges we see in the evolving doctor-patient relationship. That is, many doctors still look down on us patients.
I’m sure 99.99 percent of doctors are not as outwardly malicious as Ingham, but that condescending attitude is not something that can be dismissed entirely. It’s still there and it’s the biggest barrier to patient engagement. Yes, there may be some technical challenges but as Judy Murphy, R.N. said at a recent conference that was covered by my colleague Rajiv Leventhal, the keys to consumer eHealth are action, access and attitude. Two of those three have little to do with technology and everything to do with shifting behaviors.
Patients want to be engaged but they’re not getting the resources available to do so—or at least they don’t know they are getting those resources. A recent survey of healthcare consumers conducted by researchers from the Johns Hopkins Bloomberg School of Public Health found a gap between what patients want to use and what’s available to use. Fifty-seven percent of respondents want to use websites to access their health information. Only seven percent had done so.
We know these resources are available, in theory. After all, people in this industry talk about portal overload. So what’s causing the gap? My guess is that their doctor isn’t engaging them and patients are being made aware of their options. They aren’t telling them about where they can find their health information, and they’re not educating them or telling them where to find resources.
When it comes down to it, engaging the patient is a sign of respect from a doctor. It’s putting the patient on their level.
That quote, “People are into their medical problems. They need to have medical problems,” is a prime example of the challenges patients are facing in this evolving landscape. It comes from a doctor that is immediately dismissive of most of the ailments patients discuss with her. No one wants the patient to call all the shots, but this holier-than-thou, doctoring from the mountain top attitude needs to go away in order for patient engagement to find success. It’s not going to work—not for the patients, or for the doctors.
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