What is "Care?"

Patient in ER with care team This post is a follow-up to an earlier post about “perceived care.” It seems that there has been a lot of chatter lately about “care” –who gives it, what constitutes it, and who gets to decide. Today we’d like to talk more about this topic of care and a terrific case illustrating the different perceptions of care by both physicians and patients. What follows is a case-study on the perception(s) of care from npr.org.

A man walks into the ER with chest pain. He is immediately diagnosed and successfully treated for an artery blockage within 22 minutes –beating the national average for such treatment by a whopping 42 minutes! He had zero complications and is expected to make a full recovery. He and his wife are mad and don’t think that they received excellent care. Why?! In short, he and his wife had no idea what happened to him.

Many in the health care community view “care” as something that can be objectively measured; things like making an accurate diagnosis, giving appropriate treatment, and how smooth a patient’s recovery is, are all considered indications of good care. But what about less-tangible objectives, like how well the patient was communicated with?

No one would doubt the good intentions of the physicians involved. And, clearly, good intentions were demonstrated with the excellent care, but they were not communicated verbally to the patient. Thus, the disease was treated, but not the patient. Therefore, I’d say diseases need to be treated with expertise and skill and patients need to be treated with kindness and empathy. Good care requires both.

Finally, in my opinion, isn’t this a classic case of really, really poor informed consent?! Sure, the patient signed all of the consent forms, but, despite this, he clearly had no idea what was going on with his care. Thus, really, there was no informed consent. If someone had truly, properly communicated with the patient, informed consent could have been achieved and, I bet, he and his wife would have felt a lot more cared for.

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