Internal Medicine – Day 22

Expectations are a huge part of medicine. Whether you’re are a provider, a patient, a student, a family member, or in any other role your expectations and whether or not they are met is a major deciding factor in whether or not your healthcare experience is a good one. In many cases, it seems like it’s the physician’s role to help manage expectations for the care team and for the patient. As a student, I’ve noticed it can be easy to get caught up in chasing lab values as an objective marker of a patient’s health improving. So much conversation and decision making occurs in the workrooms, unbeknownst to patients. Orders get signed, patients get sent of for diagnostics, or get their blood drawn without much shared decision making or conversation. I’m not necessarily saying that the patients need should be consulted before making every single decision, that would be impractical, but they deserve at the very least to know the plan before it happens or as it happens if possible. We need to set expectation so they don’t think we are poking them just for nothing, and when we think about it this way I think we become more mindful as to whether or not certain things are necessary. On multiple occasions, patient’s were getting their blood sugars checked unnecessarily, just because the order was placed in the ED and never canceled as they are transferred, until I point it out to my seniors or attending. Often times the patients have not expectations, so they just go along with it because they assume we are doing what’s best. Having conversations with patient about their care should be the standard. Managing patient expectations should be a part of their care, not an afterthought.

Costco pizza, good public radio programming, innovative alarm clocks


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