Would you speak up if a waiter brought you a hamburger, but you ordered fish? Would you speak up if the bagger at the grocery store put cans of soup on top of a loaf of bread in your bag? I am guessing that most of us would speak up in these circumstances. After all, we deserve to get quality services and products that we pay for. But what about in healthcare settings? Are you comfortable telling a nurse that you won’t take an unfamiliar pill without confirmation that it is indeed correct? How would you feel about telling a doctor you don’t agree with his/her diagnosis? Should you speak up if you think your doctor is wrong?
Speaking up in healthcare settings is one of the most important things you can do to get the best healthcare and the best outcomes possible. That shouldn’t be too hard, right? After all, your health, or the health of your loved one, is much more important than squished bread. However, research shows that many people don’t feel comfortable speaking up. Why are some people reluctant? Your willingness to speak up depends on how your doctor (or nurse) interacts with you, your past experiences and your personality.
Patient-centered care relies on patients speaking up.
The core of patient-centered care is an emphasis on deep respect for patients as “unique living beings” and an obligation to care for patients on their own terms. Therefore, doctors practicing patient-centered care must respect, inform, listen to and involve patients in every aspect of care. Patients’ wishes must be honored, instead of routinely following medical guidelines and treatment norms. Doctors must make sure patients understand the risks and benefits of care, and include them in decision-making. In order for this model to work, patients must feel comfortable voicing concerns and desires.
In what other ways is speaking up important?
An analysis of research on doctor-patient communication found that “speaking up is one of the critical behaviors of patient safety”. Speaking up about care-related concerns can improve patient safety and can reduce an individual’s risk of being a victim of medical errors. Patients and families may be the first to notice changes in health and may detect errors even before medical staff can identify issues. Additionally, being actively engaged allows you to convey key information to all medical team members and help maintain a continuity of care. This is not only important for hospitalized patients, it’s also crucial to speak up in outpatient settings.
What’s the research show?
Until recently, there was little research on how patients and families feel about speaking up, and what barriers prevent some from expressing their concerns. A recent study at a Boston teaching hospital surveyed patients/families in the ICU, and conducted online surveys among patients/families with past ICU experiences. The results show that unfortunately, most people are reluctant to voice concerns in a medical setting. Interestingly, older, female participants and those with personal or family employment in healthcare were more likely to report feeling comfortable voicing their concerns.
How comfortable are people when it comes to voicing concerns in medical settings?
The findings suggest that the majority of patients/families feel comfortable speaking up about medications, but most do not feel comfortable voicing other concerns:
- 69% were very comfortable discussing medications
- Only 31% were very comfortable discussing hand hygiene
- About 1/3 were very comfortable discussing mismatched care goals, including disagreements about wanting care that was:
- more aggressive than the team proposed (31%)
- less aggressive than proposed (35%)
- 52% felt very comfortable asking for clarification of confusing or conflicting information
- 46% felt very comfortable discussing a possible mistake in care
What’s stopping people form voicing their concerns?
Half of all respondents reported at least one barrier to voicing concerns. The 5 top reasons people are reluctant to speak up:
- 34% did not want to be seen as a troublemaker
- 32% were concerned the team was too busy
- 32% stated they didn’t know how to raise a concern, or didn’t know who to speak to
- 23% expressed fear of seeming like they don’t understand medical concepts
- 21% reported they didn’t want to harm their relationship with their medical team
Additionally, some respondents reported they were hesitant to voice concerns because:
- Nothing would be done about their concerns
- They felt it isn’t their place to question the team
Are you voicing your concerns?
Now is a good time to take a few moments to think about how you have handled situations where you felt something wasn’t right or your doctor was making a mistake. Have you felt comfortable speaking up? What has stopped you? Whatever issues that may have held you back from speaking up in the past, it’s time to let go of your fears and worries. Speaking up when something doesn’t seem right, or you think your doctor isn’t listening to you, is a key to getting the best healthcare, and the best outcome, possible. Like anything else in life, the more you do it, the easier it gets. And keep in mind that speaking up assertively, but politely, is the best way to get the attention you deserve and need.
For more information on the importance of being engaged in your care, read my recent blog posts:
- Learn a Lesson From Serena Williams: Trust Your Instincts When it Comes to Your Health
- Advocating for Your Loved Ones: Caregivers Speak Up!
- How Can You Get the Best Healthcare? Actively Participate!
- Being an Engaged Patient Can Help You Get the Best Medical Care Possible.