Teaching Hospitals: My Thoughts as an IBD Patient
Since I was diagnosed with ulcerative colitis, a form of inflammatory bowel disease, I was always treated at a teaching hospital. I know every hospital operates differently when it comes to their medical students, residents, fellows, etc but these are just some of my experiences and thoughts related to this topic:
When I was initially diagnosed and hospitalized at 13, I was all for letting everyone come in and learn from me. Ask questions, take their time, try to take blood but not get it on the first try, whatever they wanted to do for the most part, I was on board. And then as the years went on and I had way too many negative experiences with people in the medical profession, I started not allowing anyone but an attending doctor talk to me or do anything to me. As I continued to have to endure so many surgeries, hospitalizations, and procedures, I developed PTSD. This caused me to have a huge issue with literally anyone touching me besides my surgeon whom I love.
Fast forward a bit and I started to try and think about things from the other side. Given my most recent health issues have been a puzzle until recently, I found that allowing residents and medical students who seem intelligent, caring and genuinely interested in helping me gave me a little more hope. Maybe I will say something that might spark an idea in one of their minds? Maybe something they recently learned ties into something that no one thought about? I am not sure, but all I knew was the more people working on my case, the better. It is different when all these doctors or soon to be doctors are doing is touching you when you are already in pain and/or are uncomfortable, asking you to repeat the same exact things constantly, and it just doesn’t seem like their presence is worthwhile.
During my most recent hospitalization, a medical student came in with one of the doctors when I first got there. He then proceeded to come back about 20 times over the course of a few hours with follow up questions. I found him to be incredibly intelligent, respectful, warm and really interested in what was going on with me. I know his interest was also for schooling purposes as he even told me he never met anyone with pyoderma gangrenosum before (an extraintestinal manifestation of inflammatory bowel disease) but I also felt like his brain working on my case was a good thing. He obviously was taking the things I said and comparing it to my history that he was able to view from the computer system given his follow up questions were very on point and referenced past things I had either taken or had done.
You do get a vibe from doctors (or medical students) just as you do with anyone.
A different kind of example…
During my last procedure a week ago, I needed an ultrasound machine in order for them to have IV access. The person putting the IV in was teaching the entire time. I was already anxious beyond words and had to sit there with my head turned away listening to him talk about how if he pushed on this spot he could blow a blood vessel and arteries and just all of these things. He kept pressing on my arm too in order to make his point. Meanwhile, when he finally went in, he not only didn’t get the IV in, but also caused enormous pain and my arm to swell so much it looked like I had a golf ball underneath from bleeding.
His response: “Oh wow. I guess I should be choosy when I stick you.”
Um, let me get this straight. You have a patient who has such terrible veins they need an ultrasound guided intravenous line…. How could you even think for a second you should NOT be choosy?
Once it was just him, he got my IV in the second time, but it was just ridiculous to me. I wanted to ask him to stop teaching but I didn’t want to sound rude.
Anyway, I know we all have different experiences with these types of things and so many stories. Most teaching hospitals are more on the cutting edge of things since they are actively shaping future physicians who need to learn. After my last hospitalization, my “go to” person was a resident I met while I was there and she couldn’t have made me feel more at ease about everything. She made me feel like I was cared about even though I was relatively new to their healthcare system.
I am definitely not for or against teaching hospitals if done properly. If someone is in the emergency room or hospital, I believe any more than four people in the room should require permission from the patient. It becomes very overwhelming. I do understand that while in the hospital setting, people have roles and need to do what they have to do for the most part. A patient should always have a say though. In terms of office visits, I believe a patient should always be asked if it is okay if someone else sit in and listen. Often conversations are of a personal nature and it does take a lot to form a bond with a doctor. I think you are setting the patient up for possibly being too uncomfortable to share everything that is going on if there is someone else in there whom they don’t know and therefore feel awkward sharing vulnerable information with.
As a long time patient, being respectful goes a long way in my book. Asking for permission is a huge sign of showing respect and will likely get you a “yes” as opposed to if a doctor took it upon him/herself to do what he/she thinks is best to my body. The more a person is treated like a human being, in my opinion, the more they will feel like they are working with their healthcare team as a partnership. To me, that is such a big deal! Knowing I have full control is also a huge thing for me seeing as suffering from a chronic illness like Crohn’s Disease or ulcerative colitis can cause so much unpredictability in a person’s life. I need to control the things I am able to so just feeling like I have a real say in what happens to my body makes it mentally a lot easier to cope with what is going on.
Are you being treated at a teaching hospital? Do you notice a difference between teaching hospitals and non-teaching hospitals in terms of the quality of care? Do you always let residents and other hospital staff treat you or do you try and stick with your physician only? Share your experience with us in the comments or on our Facebook page!