I Don’t Order Pickles on My Double-Double!

Listening to your patient could mean the difference between life and death

I’ve never been one for fast food, but I am obsessed with In-n-Out Burger. Perhaps I associate my first time through their infamous drive-through in Ontario, CA with my first trip to Disneyland; regardless, I am obsessed.

In twenty years, I think my order has only been screwed up twice, to which I promptly returned it and received a fresh burger the right way. In-n-Out has a process: they are efficient, they listen to your order, repeat it back, take your money, and present you with a culinary fast food work of art. (T-minus 10 days until my next double-double.)

What happens when these same efficiencies and communications are not practiced in the healthcare setting? Misdiagnosis, unnecessary procedures, denied claims, even death. “Patient Communication” became such a mind numbing topic that it was rebranded to get our attention. Why does listening matter??

Last year I had a medical doctor present on patient communications, using her own history as a backdrop. Her sister, who was experiencing odd, but chronic side effects from, was constantly ignored by her physician. As it turns out, for one year she was suffering continuous small cardiac events that were warning everyone around her that trouble was on the horizon. Sadly, trouble came in the form of a massive heart attack that killed her.

Last April, my own father fell off the last step of a ladder and was diagnosed with a broken ankle. After six months of excruciating pain in his heal, my parents insisted on seeing a different doctor in the health system. Upon further review, the new doctor found that my dad had broken his ankle and his heel, which was initially missed. The displaced heal fracture was pressing into his fibula where it had settled in as a permanent resident. His entire foot, his now healed ankle and fractured heal, had to be surgically broken and repaired with pins and screws. Ten months after the initial fall, his plaster cast was finally removed and he has (another) walking boot.

Yes, there are hypochondriacs and Munchausen syndrome by proxy, but when do you stop listening and give someone pickles on their double-double? Or better yet, when do you start listening?

Patient engagement is not a sexy new term that educators have coined to pad their bottom lines. It’s an integral part of medicine. First, do no harm. Maybe the “first” means listen then diagnose; only Hippocrates knows for sure.

What does listening cost? It could mean the difference between life and death.

Healthcare is crazy. There are a record number of patients, not enough clinical staff, and still only 24 hours in a day. Take a breath. Take a knee. Call a time out and listen. It could save a life.

And please hold the pickles!