Vinay, as a neurosurgeon, I agree with you 100%. Every patient should feel that their complaints are being heard by their treating staff, no matter whether it is the nurse aide, nurse, attending physician or surgeon. I will pour my patients their water if their cup is empty and they ask for it. If they ask for me to help them get a drink of water through a straw from their cup, I will help them out. It is not a requirement that I do this as their neurosurgeon; it is a requirement of me as a decent human being to lend aid to people who request it, and it is in my power to lend that aid.
I never called it being on shift as many doctors do, I called it being on service... there is a reason it used to be called medical service.... thank you for what you do.
I’m a nurse practitioner and agree 100%. Yes, it may make the visit a few moments longer, but it’s part of treating the patient with kindness and humanity. Believe me, the nurses, CNAs etc will notice that you as a neurosurgeon are not “too important“ to help the patient! With the nursing shortage, they are incredibly busy!
May I ask you a quick question? If you don't want to answer, it is ok. How can international medical graduates get a position in surgery or neurosurgery in the US?I mean, the rumor says the US keep these specialties for their citizens.
As an academic anesthesiologist in an academic institution, I was paged one night on call by a nurse that needed a patient pronounced. I thought that was an unusual call and not something I'd ever been called to do before. "Did you call the in-house intern on call?" She said she did and that he refused to do it because "that's not my job." So, I went and did it, and then sent an email to his program director the next morning about it. The program director's reply, "it's not his job." I shot back, "when I was a resident, if someone said they needed me, I went." Times have changed.
@@nancienordwick4169 Technically, the patient was a neurosurgical patient not on the medicine service. But there are no neurosurgical residents in-house. So, the intern refused on the grounds the patient was not on his teaching service. Interns are on the code blue team so they have to respond to cardiac arrests throughout the hospital, irrespective of service. So, they do have global responsibility for all hospital patients in distress. I was shocked and disappointed that his program director stood up for him. Over my career I certainly noticed a more entitled and less responsible attitude shift in my trainees.
I’m glad I work in a hospital where this is a highlighted part of the culture. Show a lost visitor the way to where they need to go. Find answers to questions that seem off-topic. Get the water. Get the coffee and ask them how they take it. And you know what? When you build rapport with patients and families, stress decreases, and the patient does better. It is so easy in interventional medicine to overlook the emotional well-being of the clients!
Very good point. No one likes to think about it but people essentially feel unsafe in a hospital. Patients are putting their lives in the hands of strangers, so if staff can make them feel genuinely cared for it makes sense that the energy being used by the patient in the subconscious flight/ fight/ freeze response can be reallocated to healing.
Also being a doctor isn’t just you solving a health puzzle, it’s about building trust and respect. It’s also part of a business and you’ll lose patients if you treat yourself as royalty.
As a medical student at a top school, I’m routinely disgusted by the percentage of physicians and colleagues who think themselves above doing basic things for patients
These days, to be a student at all... in any subject or discipline... one is likely to be relatively privileged. And one's attitude is likely to reflect this.
I'm ashamed to say as a doctor I might not always help them out. Getting water I sure do, but things that can take a few minutes, maybe not. The days are so compressed already that that extra time is just not always there, even if it seems crazy that it isn't. But sadly that's how crammed the workday can be. Ofc what he describes here is more a question of the attitude, which is another thing.
@kennethg9277 relatively privileged? Bah. I was raise in a broke ass indebted home. That lived paycheck to paycheck. I worked my ass off in school and am a medical student on my way to a decent six figure salary. And most of my peers in university come from a similarly modest background. This notion that your privileged if your in college is nonsense. In the western world success in higher education is readily accessible to the vast majority of people regardless of "privilege" The real issue here, is that too many people (not most, just too many for the good of the field) who are on the career path to becoming a doctor are in it for the money and they don't actually care enough about the patients
Just when I thought I couldn't love you anymore!!! WOW...THIS!!! I'm a new NP but I've been an RN for a long time...this is something everyone should abide by INCLUDING PHYSICIANS!!! Our attitude should be we GET to serve these people. 💯 Thanks for keeping it real!!
It is beneath no one to act as a true loving and compassionate human being and a title does not negate that simplistic deed. Thank you Vinay for being so real and saying it like it is! Why are people and our world becoming so unnecessarily hardened???
I think about this a lot and I think it’s a result of widespread tech addiction. In some sense, much of humanity has assimilated with the borg and they forgot how to human. These devices are leading us down a dark path.
I have dealt with this attitude as a board certified Emergency Medicine physician for the last 25 years... Apparently they, in all their blinding disrespect of me and my patients, forgot Francis Weld Peabody-- "the secret of care of the patient is in caring for the patient" ....This is the way I was educated and trained, by outstanding physicians and human beings, and this attitude has almost been crushed out of existence by HMO's, Big Government, Big Pharma, Medical Administration, for profit systems, the health insurance industry, and most distressingly, by the system of medical education itself. It is time to return to respect for all that provide care, and most importantly, to those in need.... that is what being a physician should be about-- and the knowledge, training, and experience should only be tools to that end.
Bravo!!! As a nurse practitioner I always ask before I leave the room if there is anything I can do or get for you before I leave? It cost me nothing and is a comfort to the patient
Hi Vinay, you are SOOOO right on this! Patients are vulnerable people who rely on others - those involved with them, at whatever level, should show them they care. That is REAL professionalism.
1. Knowing where to get the pillows, sheets, water and most importantly warm blankets will make patients like you and nurses love you. It’s your job to care for the patient. We thankfully don’t have to touch the Pyxis, we can get the coffee. 2. One of my more humbling moments was doing a consult on a patient who was on hospice for cervical cancer and since she was there and had a GYN condition a GYN consult to say follow plan was a necessity. I’m pretty sure she didn’t really understand that I was the doc, but I was the lady in scrubs and she needed a bed bath so I helped her out with it. I was the attending. I was exhausted because it was 9 at night, but you know what I wasn’t? Dying of cancer. In that moment, it was the only service I could provide this woman. It’s very humbling.
I agree with you completely. It also goes the other way...so many times I hear staff saying things like "that's above my pay grade" when it is definitely not - it usually involves calling someone or finding out information. Many staff expect doctors to do everything and refuse to help because they feel we are adequately paid. Anyone can do that - we all need to be better caregivers and stop using excuses.
Thank you again Vinay. I watch all of your videos (even the oncology ones … My training is as a psych NP.) “Caring” … An attending I had the privilege to work with both in Boston, and subsequently here in Charleston in 1987 who used to ask out residents and interns, “is that the care you would prescribe for your “Uncle Charley?” In Boston, we worked in a VA Medical Center- I will never forget his words and sentimentnnsentiment- even though he rose to Medical Director, moved to the Ralph A Johnson VA here in Charleston, then up, up up in the VA system. I appreciate your comments today, they reminded me of a long ago place in time. Best Regards, Monica.
Part of it is that a generation or two ago, so many more doctors grew up poor. My uncle grew up without running water and became an ENT surgeon. Do you think he ever skipped out on getting a patient a glass of water? He was kind, humble, and I would be shocked if he did.
They act like mini gods protecting their turf, which is usually a specific organ of your body. It’s like having a mechanic who only fixes brakes and you have to go somewhere else for an oil change because not my specialty…
Hospitals are rife with “not my job attitudes” and I’ll be honest, almost two decades working in one I feel it. The healthcare industry and corporations are skimming whatever they can for profit causing one person to do three people’s job. I think that doctor is reflecting the current climate that corporate healthcare is enforcing upon the staff.
My previous primary Doctor which I had for a decade was excellent. He and or his staff handled so many things for me as I have a multitude of issues one being major. Like an idiot we decided to move to another state and while there are several large medical networks within 30 minutes from my home, getting Dr’s who are willing to treat me, see me, or take over erring prescriptions for medications, and treatments I have been on for over a decade has been an absolute nightmare. I find myself having to drive the 4 hours back to where I previously lived in order to be treated which is hard when you have a neuromuscular disease.
Thank you! I’m a NICU nurse and I can tell you the strongest residents are usually the ones who take a minute to change the dirty diaper that they notice while assessing the patient. I completely respect how busy and stressful being a doctor is and I would never expect the doctor to do nursing tasks; however, often the best medicine anyone in healthcare can provide is a moment of kindness.
Unfortunately, Doctor's instructions aren't always followed. The last time I was in the hospital, my temperature was high, so the neurosurgeon ordered a battery of tests including a chest X-ray. He clearly said that i should be taken to the X-ray department as he didn't think the portable machines were very good. The next thing I knew, a portable X-ray machine was being wheeled into my room...
If I had a dollar for every time I heard this as a bedside nurse and now from the staff I work with as an NP….it is infuriating to hear this. If you are in front of the patient, it’s your job. 😊
If you can do something to make someone feel like a human being and not a medicalized subject, YOU DO IT. I don't understand the attitude, "it's not my job." Of course, I would not perform an appendectomy (not a surgeon), but if I have an opportunity to take someone's mind off being ill for a few moments, I do that. We are physicians, not shift workers. The patient is a human being, like you. In other words, being compassionate is not beneath anyone's dignity.
There needs to be a new position called "patient advocate. " Patients used to be expected to follow doctors' instructions without hand holding. Sometimes, nurses and ward clerks would help arrange appointments and studies. Pharmacists would be the ones to figure out which formulation of the prescrubed medication was most appropriate. EPIC, especially, has the doctor do all of the above plus inventory control, being their own scibe and billing clerk. It used to be an entire team taking on bits of what needs done so doctor could focus on exam, diagnosis and best plan. Hospital social workers are rare to nonexistent now too! Medicine has changed to abuse doctors' good intentions towards patient care by piling all these hospital cost saving decisions upon them. Its crazy and unsustainable. I still serve patients as needed too though. We are compassionate people.
Thank you so much for saying this. I have been in the hospital twice for major surgery. Both times I was in for two and a half days. Each time despite repeated requests I only received one glass of water. The first time was amusing because they couldn’t release me until they were sure my kidneys were functioning. They had to give me IV fluids.
Operating at peak "left-hemisphere" activity 24/7 will damage your psyche. Being a good person will keep you healthy and productive. Hospital owners be crazy.
Are there other people in the hospital to take care of those needs? Yes. But when you are presented with the opportunity to show an attitude of care and concern for every need you are going to have an unlimited supply of new patients. It’s important that the patient likes you as well as is well served by you healthwise as a doctor. Patients can write reviews these days and other patients will shun you as a doctor. So yes show a softer side.
I definitely think it's a balance, but getting that cup of coffee or water or even just lending an ear to a patient to make them feel heard usually goes a long way in terms of keeping them in the fight for their health. Anything you do for others may come around and even end up benefitting you ultimately.
This is not anything new. As a child,, elementary school age, over 40 years ago, I was in the hospital for surgery. I had to stay over night after surgery. I needed to use the toilet, but I was in a pediatric bed, so essentially a crib. I would press the nurse button and wait and wait and wait. Push it again and wait and wait and so would push again as I was about to soil myself. Finally nurse comes in, bad attitude and wants to know what I want. I tell her and with lots of attitude, lets me out of the crib bed to use the toilet. I also asked for something to drink, but not apple juice as that makes me sick. I got apple juice. I asked for water, but never got it. Being very thirsty, I drank the apple juice and then vomited. When the nurse finally came to check on me, she was very upset that I vomited. I learned that in the hospital, no one cares and no one will come if you need something. Then would not get discharged the next day because I was dehydrated and not producing urine. I wasn't given food because I vomited apple juice, which to this day, I can not drink without vomiting. I had a dozen minor surgeries before I was 18 and the care I got was all the same, which was to be ignored or made very clear that doing anything like get water or allowed to use the toilet was unreasonable request and often had to wait over an hour for someone to respond to the call button.
Not anymore. Each person is no more than a card in the deck they have to shuffle through each day. Get em a prescription be they leave the office or they haven't succeeded. It's gotten worse and Dr Suneel Dhand talks about it on his ch. The public comments tell the tale.
Love your call to duty which you model so exceptionally. Truly you're an inspiration for me and I continue to have hope you're one of many physicians that uphold the same values. I own my patients and their families every day working as a Home Health nurse.
Not so much ‘it’s not my job’, but the attitude of some nurses has become ( especially to female Drs) ‘i’m not your servant’ if you ask them to do something FOR A PATIENT that they should have spotted and done themselves.
Very few doctors are compassionate humans. Most doctors enjoy medicine (and it's compensations) but they LITERALLY hate people. I've come to realize that hospitals and clinics are dangerous places for vulnerable people. Thank you, thank you, Dr. Vinay, for calling him out!
It’s like thinking you’re going to go into Pediatrics but saying “I’m not gonna deal with parents though.” Patient care is a total package and it will always make you a better clinician and person when you see that big picture. Thank you for highlighting this!
It only seems beneath if it’s a resident or an attending is asking but if it’s a patient asking, then you should with HONOR. And I am glad you brought up that they are paying SO MUCH MONEY that if a basic thing isn’t working then it’s not good.
In theory you are right, in practice, kiss time management good-bye. Never underestimate the possibility of a two minute task turning into 10 minutes, now multiply that 10 times a shift…. Now everything else has spiraled out of control, but of course at least the first patient you assisted was pleased for awhile. BTW I applaud any doctor getting a patient water or coffee! lol … (former nurse.)
I agree with you 1000%! I have been a physician for many years & there have always been arrogant doctors, some who look down on their colleagues. The number of self centered MDs today is growing & competence among them is shrinking.
This is a very refreshing take in Medicine and is sorely needed among your colleagues. I cannot tell you how many times as a MRI Tech that I deal with doctors who want our results but absolutely doesn't want to invest anything in achieving those. MRI Techs should not be advocating this hard for anxiolytics or pain therapy for a successful MRI but here we are. "That's the Radiologist's job". Are you kidding me? The Rad is up to his eyeballs in all these CTs the ER orders. They don't have time to order medications for YOUR patient.
I mean honestly they are a paying customer!! If they weren’t needing your service then you wouldn’t get paid!!! I agree 100%!!! Some doctors think that little services like getting water or a cup of coffee is beneath them. I understand we are all busy.
I appreciate your perspective. I had a hospitalist surprise me when he brought my ER patient a cup of water. I asked him about it and he said, "Why not? It's not peanut juice." Made me laugh because my patient was being admitted for an allergic reaction to peanuts. But ultimately, I thought it was really great that he was not above fetching a cup of water for someone. Contrast that with an ER physician I worked with who would walk all over the ER to find a staff member available to check a patient's temperature. He would have saved himself a lot of time had he been willing to grab the thermometer off the wall to check it himself.
This reminds me of when I was on geriatrics placement as a medical student, the geriatricians would often get hot fresh coffee and tea for each patient and one time I got the coffee for the patient. I felt like this was holistic patient care and it was very satsifying to do so, however I agree that the hidden curriculum made me initially marvel at this 'extraordinary' act the doctors were doing, rather than simply realising they were being good humans!
Well said! Every medical student should be required to read the book, "Mountains Beyond Mountains" by Tracy Kidder. The book chronicles the incredible dedication of Dr. Paul Farmer who while enrolled as a medical student at Harvard founded and ran a free clinic in one of the poorest parts of the world. To Paul "everything" connected to a patient's welfare was his job. Sadly Paul passed away on February 22, 2022 but his group Partners In Health still continues to care for patients the world over because they feel it's "their job!"
I am unjabbed and never tested. I live in SF. I was scheduled for August 9 for surgery at CPMC and they required me to test in order to get the surgery. I refused. They cancelled. I went into great detail about how this is absurd and criminal and why anyone is still doing this in 2024. What happened to do no harm? I asked the staff if they believe denying care to patients over colds is acceptable, and if not they should go on strike. I reminded them their insane policies killed many people, like people on the organ transplant lists, or people with cancer, etc. I said if you work in medicine and you refuse to treat people over a cold you should leave the profession. And I pointed out if you’re jabbed up to your gills by now, the fact they’re forcing people to test proves they don’t believe in their clot shots.
As a doctor, at various times I have made tea and coffee for patients, fetched commodes for them, changed their incontinence pads, brought them food and dressed/undressed them. Patients are often more grateful for this sort of thing than the excellent medical care you provide for them.
Exactly. the reason the coffee is cold or whatever is because the nurses and care assistants are understaffed probably due to greedy doctors at management level
this is a core problem. it in part is what hapnd to infectious disease during the gr8 pandemic of 2019. _"i see pts, that my job. world under house arrest, directly related to my field: not my responsibility!"_ . but it is. _JC
I think it depends. If you have so many patients that spending 5-10 minutes to get a patient water or coffee then yes your time should be better spent, but your words to a nurse or other patient care provider weigh a lot more than the patients sadly. If it’s a slow day and you have the time then it definitely helps build a rapport with the patient.
It builds rapport and trust especially if a busy doctor takes the time to get the coffee or whatever with a caring attitude. It goes along with having a servant’s heart.
I’ve been at this for 30 years and we physicians have been turned into data management and entry for the insurers and lawyers, so when I get a chance to do something as simple as get water or a blanket or get an IV to stop beeping or plug in their cell phone or move the food tray from bedside to actually in front of them or help them to the bathroom or bedside commode etc. I just do it. It brings me more pleasure than all the BS clerical and administrative crap that we have to do. As I age, family members get hospitalized, pass, and sick patients are increasingly younger than us, we get a first hand experience of “healthcare.” The little things matter.
I know the power of care and rapport as a psychologist. In my experience, it isn't the doctor that loses care for pts. It's the admins that grind the care out of them with useless busy work or ridiculous mandates and quotas. All stick and no carrot would make me ignore your need for coffee too. Having said that, I still agree 100%.
As a 🇨🇦 I’m in shock. Hospital rooms have showers??? I’ve spent a number of weeks in cdn hospitals and it’s pulling teeth to get permission to use the ONE shower shared by everyone on that floor.
Bravo . These people are suffering. The coffee is symbolic. The Bible speaks about the host of a house washing the feet of guests who visit. A symbol of humility and compassion.
Vinay , did we understand what exactly customer service means .?Firstly patient is not a customer. If any side is behaving as if patient is a customer then we need to understand what it means , before we start becoming preachy
My father's patients were always treated as if they are friends . He would do ward rounds on Sunday mornings, he would go into the wards early and watch how his patients were being treated in the days when the patients got in the way of a well run ward. He would sit there and feed his patients their breakfasts if they needed feeding. He would then gather the entire shift of nurses, matron included, and teach them about the need for a soiled dressing to be changed and then how it should be done. He would also organise things for the patients comfort. He was totally different at home. W e were treated very badly in so many respects. A total Jekyll and Hyde.
This attitude reminds me of some fire in a NY subway years ago. I remember reading about the history of this . Many people died because each job was unionized and those who knew the situation did not react when they could because it wasn't part of their job. Many people died. Wish I could remember more details, but it was years ago I read about this.
