The Art of Expectations in the Emergency Room

This article caught my attention as an intern once relayed to me his experience in the Emergency Room wherein the patient, after all that had been done for them, complained and maligned the interns and the staff of the ER. As unfair as it may seem, the disconnect between patient's expectations against hospital protocol may well be the very reason of this incidences. Or I may be wrong... nevertheless, this article is worth reading...


The Art of (Emergency) Medicine

Jeffrey Wonoprabowo, Medical Student

I had seen the patient. I had come up with my assessment and plan. I discussed it with a senior resident and now it was time to present it to the attending. As I wrapped up what I thought was a fairly decent patient presentation, my attending asked me what the patient wanted. I stammered. What the patient wanted? Wasn’t that obvious? They come in to the Emergency Department with a chief complaint and we’re supposed to fix it. Right? My attending went on to talk about the art of Emergency Medicine. The art, he said, involved multiple steps. The first step was to understand our patients’ wants and expectations. The second was in either meeting those expectations or helping our patients adjust their expectations to more realistic goals. In this way, our patients will be more satisfied with their experience in the emergency department.  I nodded my head in agreement. I’d imagine that most people who go into the Emergency Department won’t remember their physician. They see them once and leave. What they do remember is the emotions that they feel. Were they listened to? Did they feel like they mattered? I realized that this is also important outside of the emergency department. This is not necessarily the art of emergency medicine. It is the art of medicine as a whole. This applies to the inpatient setting with patients battling acute conditions as well as in the outpatient setting with patients struggling against chronic conditions. This applies across all specialties and will influence whether or not patients leave the physician encounter satisfied.  It’s not always easy. Anyone who has dealt with patients knows this. There will always be patients who are just impossible to please. Or they will be so set in their ways that no encouragement will lead to an adjustment in expectations. But it is my belief that a good chunk of patients still do place a significant amount of trust in their doctors and will benefit from this type of approach. An artistic, personalized approach that seeks to understand the patient as well as the disease.

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