Stossel: I have lung cancer. My medical care is excellent but the customer service stinks

I write this from the hospital. Seems I have lung cancer.

My doctors tell me my growth was caught early and I'll be fine. Soon I will barely notice that a fifth of my lung is gone. I believe them. After all, I'm at New York-Presbyterian Hospital. U.S. News & World Report ranked it No. 1 in New York. I get excellent medical care here.

But as a consumer reporter, I have to say, the hospital's customer service stinks. Doctors keep me waiting for hours, and no one bothers to call or email to say, "I'm running late." Few doctors give out their email address. Patients can't communicate using modern technology.

I get X-rays, EKG tests, echocardiograms, blood tests. Are all needed? I doubt it. But no one discusses that with me or mentions the cost. Why would they? The patient rarely pays directly. Government or insurance companies pay.

I fill out long medical history forms by hand and, in the next office, do it again. Same wording: name, address, insurance, etc.

I shouldn't be surprised that hospitals are lousy at customer service. The Detroit Medical Center once bragged that it was one of America's first hospitals to track medication with barcodes. Good! But wait -- ordinary supermarkets did that  decades before.

Customer service is sclerotic because hospitals are largely socialist bureaucracies. Instead of answering to consumers, which forces businesses to be nimble, hospitals report to government, lawyers and insurance companies. (more)

"Male doctors are more likely to have legal action taken against them than female doctors"

"The relationship between male sex and poor performance in doctors remains unclear, with high profile studies showing conflicting results. Nevertheless, it is an important first step towards understanding the causes of poor performance in doctors. This article aims to establish the robustness of the association between male sex and poor performance in doctors, internationally and over time."

Overall, 32 reports examining the association between doctors’ sex and medico-legal action were included in the systematic review (n=4,054,551), of which 27 found that male doctors were more likely to have experienced medico-legal action. 19 reports were included in the meta-analysis (n=3,794,486, including 20,666 cases). Results showed male doctors had nearly two and a half times the odds of being subject to medico-legal action than female doctors. Heterogeneity was present in all meta-analyses. 

Conclusion: Male doctors are more likely to have had experienced medico-legal actions compared to female doctors. This finding is robust internationally, across outcomes of varying severity, and over time.

Reddit top voted comment...

Aren't males predominantly more likely to have legal action taken against them across all professions?

NYT op-ed: "When Doctors Need to Lie"

"I ONCE had the unenviable task of informing a 22-year-old Jamaican man that he was suffering from severe heart failure and would probably need a heart transplant. The man’s father warned me that his son would be devastated to hear the diagnosis. “It would mean a lot to me if you could go back in and tell him he’s going to be all right,” the father pleaded. “Please tell him that if he does the things you say, he’s going to be O.K.”

Though physicians are obligated to disclose all relevant medical information to their patients, it was obvious that this young man wasn’t prepared to hear the news I had to present. He was lying on his stomach, crying, refusing to turn around to talk to me. So I told him exactly what his father had requested. Then, over several days, I eased him into the knowledge of his true condition. Doctors sometimes have to know how to keep secrets.

The moral basis for withholding information from such a patient is clear: Above all, physicians must do no harm. The underlying philosophy is paternalism. Paternalism derives from the image of the paternal figure, the father, in a family. The father is motivated by an interest in his children’s welfare. He acts on their behalf, but not at their behest. The beneficiaries — his children — may even repudiate the actions taken on their behalf.

Such paternalism was once widely accepted in medicine. In the mid-19th century, the American Medical Association’s code of ethics stated that physicians had a “sacred duty” to “avoid all things which have a tendency to discourage the patient and depress his spirits.” But times have changed. The prevailing ethical mantra in medicine is patient autonomy. Today, patients own their health information. They have the right to direct their own care, and to do so they must be fully informed. As doctors, we no longer “care for” as much as “care with” our patients through their illnesses. READ MORE

NYT op-ed