'Do You Know Who I Am?'

Assembly Speaker Urges FPs to Make Connections With Patients

October 27, 2014 11:20 am David Mitchell Washington –

Anna Quindlen was in the hospital, getting prepped for surgery, and she was furious.

Her anger was not prompted by the fact that she had already had the same surgery just six months earlier and now had to go through it again. She was mad because the anesthesiologists had not listened to her or respected her wishes.

Journalist and author Anna Quindlen offers family physicians a patient's perspective on health care. Quindlen was the featured general session speaker Oct. 23 during the AAFP Assembly in Washington.

Six months earlier, different anesthesiologists had met with her, talked with her -- listened to her -- and allowed her to explain that she did not like the idea of being unconscious and had, in fact, picked her surgeon based, in part, on the fact that the doctor had agreed to let her have a local anesthetic rather than a general.

Speaking to a packed ballroom during the Oct. 23 general session at the 2014 AAFP Assembly here, Quindlen said that because those anesthesiologists administered the epidural she had requested, she felt that she had been acknowledged and respected. She also noted that one of them had held her hand during the procedure.

But this second time around, the epidural wasn't working, so one of the anesthesiologists suggested a general anesthetic. Quindlen protested and -- eventually -- got the epidural she wanted. When it finally worked after multiple attempts, that same anesthesiologist patted her leg on his way out of the room.

"Next time," he said, "you'll take the general."

That patronizing gesture and dismissive comment is what angered Quindlen. The Pulitzer Prize winning journalist and author of nearly two dozen books -- including five best sellers -- said she had to fight the urge to bark the retort of many a disgruntled celebrity: "Do you know who I am?"

But in retrospect, she said it is a question more patients should be asking -- not because of fame or a desire for special treatment, but because patients should be questioning whether their physicians know them and care enough to make a real connection.

Quindlen said family physicians can, and should, make those connections, especially in this era of retail clinics. Those who don't, she said, might see an exodus of patients.

"Isn't that why patients would be just as happy to have someone listen to their heart at Walmart?" she said. "If no one knows her name at the doctor's office, she can go somewhere cheaper that doesn't know her name and pick up T-shirts for the kids at the same time. You should be able to answer the question, 'Do you know who I am?'"

With abundant medical information on the Internet and smartphone apps that can diagnose some illnesses and conditions, patients still go to their physicians because they want a connection with their trusted health care expert, she said.

"People come to you when they already have diagnosed themselves on Web M.D., and that's a best-case scenario," said Quindlen, noting that other patients first turn to "new-age misinformation and half-baked homeotherapies."

Physicians, she said, can validate a patient's need for information without validating the information itself. Sometimes, she said, the connection patients and families make with a physician is just as important as the care they receive.

Last fall, Quindlen's father suffered third-degree burns and was taken to a burn unit. At 83 and in poor health, she knew his likely outcome. When she asked his physicians hard questions about the realistic benefits of aggressive treatments, Quindlen said, "They made me feel like a good daughter, and not the opposite, for asking those questions. They made me feel like I had power and control in a situation where I could have felt powerless."

Quindlen said she was impressed not only by the life-saving care the nurses and physicians gave to other patients in that burn unit but by the care, and kindness, they provided to her dying father. After he died, the staff sent her a sympathy card.

Her advice to physicians? Be present, look people in the eye, and be kind.

Quindlen said that while her father was in the burn unit, none of the physicians or nurses mentioned her books or columns or gave any hint that they knew who she was in her professional life.

"They acted like I was the daughter of a man with a poor prognosis who was doing the best she could in a horrible situation," she said. "In other words, they knew exactly who I was, and that made all the difference."