Sometimes doctors encounter errors such as missing out a clearly abnormal result in the clinic.
I reflected on my past practice to find prevention tactics before problems arise.
It was my routine to verbally tell each patient at follow-up openly and explicitly each laboratory and imaging result not previously shown to her. I did it in form of a running commentary, whether I gave her a copy or not. The concept is very much like ‘time out’ before an operation. In this way I went 2 miles ahead: first with this time-out concept in everything before anyone in HK said so, and secondly I always involved an awake patient plus family.
I marked each report I myself read in clinic with ‘normal’ or ‘specified_problem’ with a chain of explicit, easy-to-follow instruction to nurses, such as call back and what to say over phone, in simple Chinese or English. If I prescribed drug(s), I always gave a brief explanation so as to empower nurses when they talked to the patients, I went thro the notes esp on allergy, and still I usually instruct nurses to ask allergy again before dispensing.
As explained in paragraphs above, I usually inform patients of results myself at FU. I was also very ready to call patient via phone directly about positive results or important negative results (e.g., I call you just to ‘bo ping on’, or report safety, in my own words; or sometimes I explained that things may be too difficult for nurses to inform you, and I want to be very sure that you understand the matter and it not over-alarmed). I judged the need to call with use of empathy: what would I myself feel about having the result now or later. It is common sense that patients feel warm when they (unexpectedly) receive a call from a busy doctor ‘just to reassure her’. It was also my habit to copy results in computer record and it could be another defense line since I had to do so with active thinking.
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