Healthcare reform is a hot topic these days and everybody has an opinion.  It seems that no two people have the same opinions, though, which makes a wildly complex issue even more so.  And it’s a quite frustrating issue, too.

ABC News recently posted two articles online, one identifying the six things patients do that frustrates doctors the most and one identifying the six things doctors do that frustrates patients the most.  The doctors’ frustrations, first published in the February issue of the Archives of Internal Medicine, were addressed in a survey of 449 family practitioners and internists.  Patients’ frustrations were gleaned from the online comments posted to that story.

Here’s a view from both sides of the issue.

Doctors felt the most frustration when their patients seemed to be dissatisfied with the care they’re getting or when they have unrealistic expectations.  Their top six frustrations:

• Family members in the exam room.  Doctors often find themselves settling family squabbles, speaking to the concerns and confusion of too many people at once, and trying to overcome unwanted distractions when trying to address just the patient.
• No word on supplements, herbal remedies, and alternative treatments.  These substances or practices are not officially recognized as drugs or scientifically proven practices so doctors don’t always give them credence but patients don’t always tell their doctors what they’re doing, in addition to the therapies he or she is prescribing.  They may not be drugs but they often do produce interactions with prescription drugs that affect patient outcomes.
• Patients discontinuing medications without alerting their doctors.  Sometimes the reason is adverse side effects, sometimes it’s money.  Either way, every time a doctor prescribes a medication, the prescription is written with an expected outcome.  When the prescription is stopped or dosage altered without the doctor’s knowledge or guidance, serious and unanticipated consequences can occur.  Some of these unexpected consequences can be life threatening but difficult to diagnose under a veil of secrecy.
• Patients prefer pills, surgery, and medical devices when simple lifestyle changes would eliminate or ease the condition more appropriately.  Obesity, bad diet, smoking, lack of exercise, and excess alcohol intake are just some of the lifestyle choices that produce very clear but unwanted consequences to our health.  They involve work and personal commitment but making changes to these habits is more effective than anything in a doctor’s pharmacopeia or medicine bag.  In many cases, the doctor is faced not with disease and a known treatment regimen but with a self-induced lack of health.
• Patients asking for prescriptions based on the advertising they’ve seen.  Some patients are so insistent on leaving the doctor’s office with the desired prescription in hand they pay no attention to the advise of their doctor, even when warned the medication will have no effect or will only add to the patient’s problems.
• Demands for unnecessary tests or procedures.  These don’t come as often as requests for highly advertised drugs but they are not uncommon, either.  Satisfying these demands can be costly but the demands themselves may be masking underlying fears of past bad experiences, life stressors, or even psychological issues.

On the other hand, the top six frustrations expressed by patients against their doctors include:

• Doctors who value their own time over the value of the patient’s time.  No one likes to arrive on time to an appointment - any appointment, anywhere - only to be left waiting half an hour or longer.  Patient frustrations only grow stronger when the doctor finally sees them but rushes through the appointment so fast the patient feels overlooked or invisible.
• Not being heard.  Appointments are too rushed, leaving too little time for constructive conversation.  Doctors often don’t listen to patient questions, cut the patient off in mid-sentence, or ignore the patient almost entirely, relying on charts instead of preferred person-to-person communications.
• Hearing the problem is all in the head.  Most patients have no mental problems but some of them do have ailments that are uncharacteristic of their medical history, age, or gender.  These patients want to feel their doctor is making the effort to see them as the unique individuals they are instead of lumping them with the very few psycho cases that should be getting treatment elsewhere.
• Never learning test results.  In some cases, no news is good news but that’s never the case where one’s health is concerned.  If a patient undergoes a test ordered by a physician, the physician simply must report the outcome of the test to the patient.  Every test, every patient, every time.  Period.
• Doctors who won’t consult the patient’s other doctors.  Some people have a primary care physician but special medical needs require specialists.  When doctors don’t communicate with each other and share their knowledge of a given patient, the patient often pays for multiple copies of expensive tests or medical histories, undergoes unneeded uncomfortable procedures, and gets too many prescription drugs that may produce devastating interactions.  Coordinated care eases patient fears and frustrations and leads to more desirable outcomes for everyone.
• Doctors who belittle patients for turning to alternative remedies.  The soaring cost of traditional medical care and the patient frustrations listed above lead more and more Americans to look for something they have more control over.  Sometimes that means alternative therapies.  Full disclosure is required to avoid harmful interactions but patients don’t want to be ridiculed because of the measures they’ve gone to to take care of themselves when traditional medicine falls short.  Doctors say they want full disclosure from their patients but they frequently insult the patient when full disclosure is made.  The cycle of silence, and frustration, repeats.

Healthcare reform doesn’t involve just doctors and patients.  Surely nurses, caregivers, and administrators have their own list of doctor-patient frustrations, too.  ABC News has yet to tackle the issue from those angles but they’re all a part of improving the nation’s current healthcare system.