ArchivDeutsches Ärzteblatt39/2002Krankenhaus: Empfehlung an deutsche Kollegen

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Krankenhaus: Empfehlung an deutsche Kollegen

Dtsch Arztebl 2002; 99(39): A-2541 / B-2172 / C-2035

Wurm, W. Heinrich

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LNSLNS After practising anesthesiology for 25 years at a university hospital on the East Coast, I recently returned to visit my aging mother following minor gastrointestinal surgery performed in a large city hospital in Germany.
I feel compelled to comment on the one single most remarkable difference between US and German surgical practice: communication. This was the 4th time my mother was admitted to a private surgical service in a German hospital and I have yet to find a surgeon who would even attempt to contact a member of my family in Germany or in the US. At one point, at age 85, my mother was scheduled for an excision of a solitary hepatic lesion at a small suburban hospital. No calls were made. Why is it that German surgeons are so incommunicado? And why are surgeons in the US so tuned into their patient’s families needs and anxieties. Why do they direct nurses to contact family intermittently during surgery, visit them immediately thereafter and are regularly available for conferences and feedback at least once a day? Excessive, perhaps, but not inappropriate if one looks at the patient-physician relationship as a contract or a bond built on trust and understanding between two parties. In the US the patient is very much looked at as the client or the customer and the physician or surgeon as the service provider. Patients value bedside manner and the ability to explain and build trust almost as highly as technical know-how and professional reputation.
Why the difference? Is it fear of litigation or competition in a lucrative marketplace? Are US patients more demanding, more knowledgeable, more critical and more consumer oriented? Whatever it may be, it serves patients well and does not harm physicians or surgeons either. I can only recommend it warmly to my German colleagues.
W. Heinrich Wurm, M.D.,
Tufts-New England Medical Center,
750 Washington Street, Box 298, Boston, MA 02111, USA
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