There is so much talk about patient-centeredness and yet I see a long way to go. I think that there are very good intentions, but when it gets difficult, human nature is to slip back into what is comfortable for us. For as long as I can remember, physicians have made rounds early in the morning. Why? It works for them. They can make their rounds and head into the office or the operating room. But how well does it work for the patient? Not so well.
My sister was just discharged after 7 days as an inpatient. During that time the doctors would make rounds very early in the morning when she was still sleeping. They would wake her to get an update from her and proceed to “discuss” the day’s plan of care. Then I would call or come in and ask her what they had said. On some days she didn’t even recall that they had been there. On other days she’d recall a smattering of information that wasn’t useful in planning next steps. Twice she requested that they come later in the day so that she would be more awake and participative. That never happened.
I’m not naïve about why doctors sometimes need to make rounds at the crack of dawn, but when patients specifically ask for a different approach so that they can more actively participate, it’s important to work with them.
My sister’s experience isn’t unique. Yet it is disconcerting on many levels. She wanted to talk with medical team and discuss the plan, yet they weren’t available when she was awake and ready to talk. She needed information and reassurance particularly since this was a re-admission just two weeks after another, similar episode. It reminded me of a YouTube video where a young woman discusses her dissatisfaction with the traditional morning rounds.
It’s time to think outside the proverbial box and figure out how to make rounds a more patient-centered experience.