The Importance of Patience SAVES Patients
Researchers examined death rates of heart attack hospitalizations between the years of 2002-2011 when the top doctors attended national conferences.
The researchers examined the mortality rates of patients who were admitted to the emergency room with a heart attack. They observed patients for thirty-days after admission.
One would logically hope that the top doctors be available and on-call if a loved one were admitted to the hospital for such a high-risk situation.
The results were contrary to our assumptions of top health care (Well, at least mine).
The mortality rate of high-risk patients was 17% when the doctors were away at a national conference, compared to 24.8% of deaths that occurred with the non-conference dates.
The importance of patience revealed that patients admitted to the hospital were more likely to survive a heart attack during cardiology national conference dates.
To help explain decreased mortality rates, the authors of the study offered the “less is more” approach Doing “nothing” resulted in more lives being saved than performing surgery.
On-call cardiologists were reluctant to perform interventions based on a risk-benefit tradeoff. The potential harms of invasive interventions and procedures simply outweighed the benefits. At risk of potential harm of invasive treatment, cardiologists on-call sided with avoiding surgery. And it resulted in more lives being saved.
There was a reduction in specific procedures within the hospitals for these high-risk patients.
Researchers discovered that one of the main barriers for physicians was uncertainty and disagreement about what “not” to do. There exist specific guidelines and routines at the national, regional, and local level of care, which often sadly contradict one another.
Medical doctors do not frequently participate in strikes.
There are ethical concerns and criticism due to strikes adversely affecting patients’ health. So, when they occur, just like other essential service industries, panic and fear can result.
Five notable physicians’ strikes have occurred between the years of 1976 and 2003. These strikes lasted between nine days and seventeen weeks.
However, in every case of physicians’ strikes, the mortality rate stayed the same or decreased, but it never increased.
- For instance, during 1976, doctors in Columbia went on strike for fifty-two days, and mortality rates dropped by 35% during that time.
- When doctors in Los Angeles went on strike over working conditions and wages, mortality rate dropped 18%.
- In 2000, Israeli doctors went on strike. The strike resulted in hundreds of thousands of outpatient visits being canceled along with thousands of elective procedures.
- The Jerusalem Post surveyed the non-profit burial society, which performs over 55% of burial services in Jerusalem. During the strike, the number of funerals performed in the region dropped significantly compared to data from the previous three years.
These results align exactly with the studies of top cardiologists attending conferences. The importance of patience saves lives. Even in health care, there exists an action bias and an inability to wait.
Researchers have even cited that “Physicians are wrong when they tell terminally ill patients ‘doing something’ (in other words, pursuing treatment) is better than doing nothing” (“nothing” usually meaning choosing hospice care instead of treatment).
Clinical uncertainty is a balancing act. And the importance of patience has given way to an action bias that results in doing something.
Doctors have reported a need to do something in order to soothe the emotions of patients. For instance, the global medical community has prompted initiatives to reduce the number of antibiotics prescribed. Nonetheless, research has repeatedly shown that clinicians prefer to “err on the side of caution” and provide the patient antibiotics just to be safe.
Ordering a test, intervention, or medicine is a way of doing something rather than nothing and waiting. These actions supposedly assures patients that everything will be all right.
Doing something occurs way more often than waiting and re-evaluating the symptoms. And whereas, these procedures won’t causes death, it reveals that there exists an action bias, which is the same for top doctors and cardiologists.
However, perhaps, if we can wait, then we can live.
Dr. Rob Bell is a Sport Psychology Coach. DRB & associates coach executives and professional athletes. Some clients have included three different winners on the PGA Tour, Indy Eleven, University of Notre Dame, Marriott, and Walgreens.