There is a quite interesting article in the current Time magazine about Doctors’ experiences of the American health system from the recieving end, either as patients, or a patient’s relative.
It’s quite interesting, as many of the issues raised are the same that I suspect you would experience in Australian or New Zealand hospitals.
It is also interesting though, the startling differences in the way the American health system operates, and most of the differences cast a very very negative light on how the Americans do things. They think that limiting junior doctors to “only” working 80 hour weeks is reasonable and healthy for their professional development, and that junior doctors working with minimal supervision doesn’t adversely affect patient safety (one senior doctor comments in the article “The only thing wrong with 1 in 2 on call is that you miss 50% of the good cases”). It’s frankly terrifying, not to mention blindingly stupid when you consider not only the patient safety issues but also the social and psychological fallout of those practices on doctors lives and health.
There is however a good little sub section entitled “What makes a good patient?” which I think everyone should read. It uses the case of a patient with multiple chronic diseases and conditions, who is medically really difficult, but who listens, ask questions, looks things up, and has reasonable expectations.
A quote I love from the TV show House goes “There you are. The mystery of medicine. Everyone wants your opinion, but nobody wants to listen to what you have to say”. It unfortunately rather nicely sums up most of our interactions with patients, and so when you see on the ward a medically difficult patient who actually listens you know you’re going to have to work really hard, but that it’s going to be a satisfying effort, and one that will ultimately be beneficial for both parties. The doctor will feel satisfied because their efforts are appreciated, and subsequently they will go the extra mile for that patient. The patient will also feel greater satisfaction with the relationship because of the more personal interactions, and will probably ultimately get better medical care.