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Thanks, Doc, And By The Way—Who Are You?

Jay Moore, for HealthLeaders Media, February 5, 2009

As a physician, if you provide quality care to your patients, does it really matter if they don't know who the heck you are?

Researchers at the University of Chicago Medical Center talked to 2,807 patients who were admitted to the hospital during a 15-month period. The patients had been seen by teams of caregivers, including attending physicians, resident physicians, interns, and medical students, were admitted by a night resident, and handed off to other caregivers the following morning. Researchers asked the patients to name the physicians who cared for them and to characterize their understanding of each doctor's role.

Some of you may have seen this study published last week in the Archives of Internal Medicine, but even if you haven't, you can probably guess where this is headed. Seventy-five percent of patients couldn't name a single physician on their care team. What's more, of the 25% who did offer a name, only 40% were correct. Which means, if my questionable math skills aren't failing me, that roughly 90% of the total respondent pool couldn't offer a correct name.

Now, such findings conceivably could be attributed to several different factors. Insufficient patient education processes. Lackluster communication efforts by caregivers. Faulty research methods. Dumb patients.

I'm leaning toward the first two explanations, since there's no reason to believe the research is anything but sound and the patients are anything but smart—especially given another statistic from the study. Fifty-six percent of participants rated their understanding of their physicians' roles as very good or excellent. In other words, although only a small minority of patients knew their physicians' names, a majority said they understood their various caregivers' roles.

That said, isn't it more important that patients understand the various steps of their care and the function of each provider than it is for patients to remember names? "Do you really need to know who your doctor is, or is it more important to know some processes that will help you get at the information you need?" said Ernest Moy, MD, medical officer at the Agency for Healthcare Research and Quality, in a New York Times piece on this subject.

Debatable, of course. I do think these kinds of findings can be symptomatic of a deeper problem: a lack of interventions by providers to ensure patient awareness when multiple handoffs occur. As a patient, I guess I'd like to understand care processes and know my doctor's name. But then again, if I'm a patient who is sick, nervous, and not thinking clearly, a physician could tell me his name three times and tape a photo ID badge to his forehead and I still might not remember his name when asked about it later. Ultimately, if I have a team of physicians caring for me, I would like to know their names—but what I really want to know is that they're good.


Jay Moore is managing editor for HealthLeaders magazine. He can be reached at jmoore@healthleadersmedia.com.
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