For want of a four-cent pull chain

Abstract

A noted French ethnographer describes his care in a French private hospital for a hip replacement. He recounts a number of events that are probably typical of many patients' hospital experiences, but which clinicians often do not perceive. The observations are probably similar to those patients might make after exposure to any modern healthcare system, except that they offer a level of detail few would provide. The account focuses on the contradiction between excellent technical operations and the absence of compassionate patient care, basic civility and the needs of patient safety. It addresses marketing of hospital services, staffing levels, conflicts between private enterprise and medical need, fragmented billing, disconnected after-care, and the

Improving reconciliation following medical injury: a qualitative study of responses to patient safety incidents in New Zealand

“…In our study and others,3 66 injured patients frequently expressed the perception that their providers had not listened. Thus, attempts at ‘listening’ do not always give rise to feelings of ‘being heard’.…”

Bad experiences in the hospital: the stories keep coming

“…Michel Villette, a sociologist in France, tells the story of his hip surgery in an ‘elite’ French orthopaedic hospital 1. Melissa McCullough, a bioethicist and attorney, relates the story of her more prolonged ordeal with an uncommon neurological diagnosis in the National Health System in the UK 2.…”

“…Physicians who have ever worked in a clinic that chronically runs behind schedule, has excessive wait times to make appointments or other basic problems with service quality know that, in such settings, the first 5–10 min of each patient visit can be consumed by patients recounting their frustrations for how long they have waited, the unhelpful manner of receptionists (as Villette encountered in the admissions department1) and numerous other problems, from excessive delays in obtaining important investigations (such as McCullough's MRI2) to the inconvenience and expense of hospital parking.…”

“…Nurses do not enjoy telling patients they will have to wait longer to see a physician. And, physicians would prefer to see patients in a timely manner, not have to tell patients they have to wait weeks to months for important investigations, or explain that the hospital does not have funds to maintain beds in working order (as with one of Villette's physicians1), among other examples, from unexpected cancellations of operating room times to the cleanliness of hospital wards. For some staff, dealing with these daily frustrations contributes to burnout and even to discourteous or frankly unprofessional behaviour towards patients, as McCullough and Villette experienced in varying degrees.…”