Today would’ve been my wee brother’s birthday. He taught me a lot of things, including much about healthcare and the relationships between patients and the professionals caring for them.

Sharing today to remember him. He died in 1989. https://blogs.bmj.com/bmj/2018/03/14/patricia-cantley-we-must-remember-how-scary-hospitals-can-be-for-our-patients/

There are lots of imbalances between doctors (and other healthcare professionals) and their patients...

I was a patient again this year & was well looked after, but the three “gaps” remained:

- the knowledge gap
- the power gap
- the “arousal” gap.

The knowledge gap is the easiest to address, though still tricky. Do you trust Google? Or your friend who works in a related specialty? Or the friend who says they had a friend who had the same...
Leaflets help, but only a bit.

The power gap is a tricky one. It is simultaneously reassuring & terrifying to be on the “conveyor belt” of an efficient department. Suddenly you find yourself completely out of control of what the next step is. You are swept along as part of the process, with or without consent.

The “arousal” gap is one I’ve noticed for a long time.
For the clinician, it’s just another Thursday. For the patient, this is a potentially life changing event.
It’s hard to take anything in, or make rational decisions. Taking someone with you can help, not just to fetch coffee.

My latest episode was resolved satisfactorily and I’ve written my thank you letter.

It reminded me of the imbalances though... and I continue to teach trainees about the importance of recognising them.

And back to my brother Iain...

If a family or patient want to discharge themselves from hospital, we must listen to them & try to help. They will have good reasons for their actions and plans. We might not agree with them, but we should respect them.

They might be right!