Poor Doctor-Patient Communication in the E.R. Equals Poor Patient Care at Home: Proposed Changes to Medicare Policy Can Help

Mike Ferrara

Attorney
(866) 735-1102 Ext 650

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A new online study tracking patients after they have left the emergency room shows that a gross majority of patients are not getting the help they need to give themselves proper home care. Because most hospitals do not have the infrastructure in place to instruct patients fully on self-care procedures such as administering medication and caring for wounds, and to then follow up to make sure patients understand and are capable of carrying out the instructions they receive, more and more patients are returning to the emergency room with complications and worsened conditions.

Unacceptably high rates of re-admittance to the hospital are causing agencies such as the Medicare Payment Advisory Commission, which influences Congress on health care policy, to make significant changes to Medicare. Proposed policy changes include reducing Medicare payments to hospitals whose re-admittance rates are particularly high, and rewarding physicians who are helping their hospitals lower re-admittance rates.

Experts say that better doctor-patient communication techniques are the key to patient understanding. In a typical E.R., doctors doll out many of their instructions verbally and quickly. E.R. patients, who are typically vulnerable, anxious and upset, are often not in the best state to receive and process complicated information. A “teach back” approach, in which the patient repeats his or her instructions slowly and carefully back to the doctor, is widely accepted as one of the most effective methods of preventing self-care errors once the patient leaves the E.R.

If implemented, the proposed changes to Medicare will encourage our hospitals to take more responsibility for the long-term well-being of their patients. Please call your Congressperson to voice your support for the Medicare Payment Advisory Commission’s recommendations.