When was the last time you were an hour late for a deeply important professional meeting, sauntered in, sat down and — without so much as a word of apology — began to talk business as if nothing at all were amiss?
I’m guessing never.
But every month or two, I drive a dear friend to one our city’s venerated monuments to medicine, which asks her to show up at 10 a.m. Routinely, lunchtime comes and goes, and she’s escorted in to see the doctor about 1 p.m.
She’s grown used to it. It makes my head explode.
We are blessed to live in a medical mecca, where world-acclaimed hospitals employ medical professionals whose skills are unequaled, people who perform live-saving miracles that move patients and their families to tears of gratitude.
So how is it that these medical wizards, so deft in operating suites and emergency rooms, can be so utterly tone-deaf when it comes to basic courtesy, dignity, and respect?
“Nothing’s more important than respect,’’ said Jim Conway, an adjunct lecturer at the Harvard School of Public Health. “It can’t just be an aspiration. You have to build this into your system.”
And now, remarkably, that’s beginning to happen. Hospitals are treating the kind of suffering imposed by their medical professionals, not by disease or its treatment, as seriously as infections and falls.
So you can imagine how difficult it was for me to resist the urge to seek a group hug the other day with those on the vanguard of this movement at Beth Israel Deaconess Medical Center.
“Whether it’s physical or emotional, it’s all bad,’’ said Dr. Lauge Sokol-Hessner, the hospital’s associate director of inpatient quality. “When we talk about respect and dignity, those are important terms because it’s somehow even deeper than a medication error.’’
Like all hospitals, Beth Israel Deaconess has an urgent protocol it follows when so-called “never events” occur, like wrong-sided surgery or the amputation of the wrong limb. But now, it’s beginning to apply that kind of rigor when dignity is at risk.
The examples are striking. There’s the elderly woman who fractured her hip in a hospital fall, an accident her family learned about only when a surgeon called at 2 a.m. for consent. One patient in a semi-private room was subjected to witnessing a painful procedure administered to her roommate just feet away. No one asked her if she’d like to step outside for a bit. Then there is the story of the patient whose wedding ring is removed in the emergency room, where doctors worked to save his life. But they lost his ring.
“I would call that a never event,’’ said Patricia Folcarelli, Beth Israel’s patient safety director. “We sometimes say they’re cringe-worthy events.’’
The movement is gaining traction nationwide, but give Beth Israel Deaconess credit. Owning up to your errors is one thing. Being willing to talk about it openly is quite another.
“We’re not going to be able to succeed all the time, because diseases are terrible and sickness is bad,’’ Sokol-Hessner told me this week. “But when we have opportunities to prevent it, to limit suffering, we ought to do that as reliably as we can.’’
That means creating a culture in which retaliation is not part of the calculus, in which staff members don’t have to resort to anonymous notes to report problems.
When six different cases of respect and dignity violations were presented at a recent leadership meeting, they were met with audible gasps. “It’s really hard to read them and to know that those were real patient experiences,’’ Folcarelli said.
I hope this movement spreads like wildfire.
There is no other profession that would allow its customers to cool their heels in a sterile waiting room for an hour or two with 18-month-old copies of Popular Mechanics magazine to keep them company.
No other business would consider that standard procedure and survive. Waiting for the doctor shouldn’t be like a date with the cable TV guy.
Respect. Dignity. What a thrilling elixir.