New Survey Reveals Most Patients Uncomfortable Confronting Medical Personnel

PROVO, Utah -- Medical mistakes are the bane of millions of well-intended health care professionals who are working to fool-proof their systems and practices.  In support of National Patient Safety Awareness Week (March 6-12, 2005), VitalSmarts has released results from a new study that suggest patients often play an unwitting role in bringing about these mistakes by not confronting their healthcare practitioners.


The study identified patients who had recently encountered problems from

feeling mistreated by healthcare practitioners, to feeling worried their care

provider was making a significant mistake.  It found patients usually say

nothing about their concerns -- and their silence puts them at risk for

significant personal harm.


"Patients often find themselves in a quandary, worrying their health care

professional is acting on poor information," says Joseph Grenny, author of the

study and president of VitalSmarts.  "The patient feels they have to choose

between being respectful and sharing their concerns.  Given these two choices,

they don't speak up."


    The survey found:

     *  Less than half of patients spoke up when the caregiver was unclear

        about the diagnosis, treatment options or next steps.


     *  One in five of these people have suffered "substantial" health

        problems as a result of not speaking up.


     *  When patients believed the care provider was making a medication

        error, they were more inclined to speak up -- yet more than a third

        did not.


"The key is to be candid without being offensive," says Grenny.  "People

worry about speaking up because they don't want to cause offense.  We've spent

more than 10,000 hours watching people who know how to respectfully handle

these crucial conversations."


Grenny says there are some simple communication skills patients can learn

to step up to crucial conversations with their care providers and avoid

preventable errors:


     *  You are the expert.  Realize you have important information about your

        past experiences, your current symptoms, etc. that your medical

        professional desperately needs to make informed decisions.  You are

        the expert -- and should not defer by assuming the caregiver knows



     *  Speak up early.  Often we wait to speak up until we are so angry we

        end up offending our caregiver.  Speaking up sooner when you are less

        upset, worried or angry, will inevitably yield better results.  If you

        are already angry or upset, remind yourself this is probably a harried

        professional who is doing their best under the circumstances.  Then

        open your mouth in a way that helps them rather than insults them.


     *  Show respect.  Your doctor or nurse feels "unsafe" when they believe

        you don't respect them.  This feeling causes them to become defensive

        with you.  Before describing your concerns, start by affirming your

        respect for their competence and position.  For example: "I'm grateful

        for your attention to me and want you to know that I value your

        experience and skill in treating me."


     *  Share the facts.  Caregivers have a hard time with vague statements

        like, "Are you sure that's right?" or accusations like "I don't like

        the way you're talking to me!"  Stop and think about what is happening

        that is making you uncomfortable.  Look for the concrete facts that

        will help the caregiver understand clearly what is bothering you.  For

        example, "The last time I took this medication I was given a white

        tablet to take twice a day.  This time it says four times a day and is

        a yellow tablet."


     *  End with a question.  Show once again you are interested in the

        professional's point of view by ending with a question.  "Is this

        correct?" or "Why should I not be worried here?"


Grenny's tips are based on his New York Times bestselling book, "Crucial

Confrontations: Tools for Resolving Broken Promises, Violated Expectations,

and Bad Behavior.


Source: VitalSmarts, L.C.