Tuesday, April 15, 2008

When Doctors Don’t Know Best…

One of the great paradoxes of medicine is that often the patient in most need of treatment is least able to communicate with doctors. If we have a minor affliction we can explain our symptoms to our doctor clearly. If we are less than fully lucid that becomes difficult, and of course id we are unconscious we can’t contribute to our own care at all. So you would think that it would make sense that in those circumstances a doctor would speak to family members both to get relevant details of a patient’s history, and to report any progress made back to the family.

But apparently that’s not the case. The New South Wales Inquiry into Acute Health Care Services has heard of the concerns of the Willesee family. The daughters of journalist Mike Willesee, Amy and Jo, have told the inquiry of their concerns for their mother Carol who died in 2006. Initially, Carol Willesee was told that her problems were psychosomatic, but her condition deteriorated until she could no longer walk unaided, and ultimately could not communicate. When she was taken to the Emergency Department at Nepean Hospital it was almost four weeks before she was correctly diagnosed.

Amy Willesee has told the inquiry that medical staff did not document symptoms that she had witnessed, and did not tell the family about tests being undertaken. In fact no member of the family ever had the opportunity to speak to the treating specialist, despite repeated requests. Their point of contact was a junior doctor who provided only minimal information.

Obviously, senior doctors are very busy, and sometimes worried relatives might be a nuisance. But the fact is a close family member has a special duty of care which should be both recognized and respected, and could very well have detailed knowledge of some aspects of the patients symptoms, behaviour and circumstances. Close family members should have the right to be both heard when they have something to say, and informed of matters which are relevant to the diagnosis and treatment of their relative.

It’s in everybody’s best interests to keep the lines of communication open.

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