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an online version of the magazine Fall 2007

The Human Touch

For patients, the bottom line is feeling welcomed and cared for.


By Dean/CEO Edward D. Miller, M.D.


Illustration of doctor comforting patient

I’m looking at the world a bit differently these days—not as an administrator or physician but as a husband whose wife had a brief, dramatic encounter with the health care system.

Thankfully, the biopsy came back negative. We’re all relieved. It’s been an emotional roller coaster—for the patient and her family.

Lynne gave me permission to tell her story because there are important messages here.

Some months ago, she underwent a routine mammogram at Green Spring Station and the radiologists spotted something. The next week, an aspiration cytology identified a ductal papilloma, a wart-like lump that only in rare instances develops into breast cancer.

The initial decision: “Don’t do anything; we’ll just watch it.” But after further reflection, radiologist Cecelia Brennecke recommended surgical excision.

Nagi Khouri, director of breast imaging, concurred and said, “If it were my wife, I would go in and take out the tissue around the site just to make sure.”

We followed his advice. Though I’ve been in medicine a long time, when it comes to a decision like this I’m like most consumers. I listen to the experts. Lynne had the procedure done at the Johns Hopkins Outpatient Center. The experience proved an eye-opener.

When we arrived, the waiting area in ambulatory surgery was as pleasant as the staff members we met. They handled paperwork promptly and after a short wait took Lynne upstairs to the beautiful Avon Foundation Breast Center.

Volunteers at the center provide amazing support for women about to undergo treatment. Lillie Shockney, the administrative director, is spectacular in the way she comforts patients and families.

I noticed that people were taking time to make contact with patients in a very human way—through soothing words or a moment of “touch time.” The nurses couldn’t have been more supportive. Ted Tsangaris, our surgeon and chief of breast surgery, walked by while we were in the Avon Center and rested his hand on Lynne’s shoulder. It had a profound impact on her, and on me.

When we went downstairs for the procedure, anesthesiologist Tracey Stierer carefully explained what would be happening, putting Lynne at ease.

All around us that day, I saw similar scenes unfolding. What impressed me was the extra effort the doctors, nurses and staff took in getting to know the patients, answer their questions and diminish their fears. As Lynne said later, it was this human interaction, these expressions of caring, that mattered most.

Our experience started me thinking: How did we get to the point where the driving force in medicine is the bottom line, improving efficiency, holding down costs and pumping more people through the health care pipeline?

That’s not what matters to patients.  They want to know someone will look after them and tell them what’s going on. They want assurance that their medical team is focused on their well-being. Through words and actions they want to be told, “We care about you.”

It’s ironic that with all the advances we’ve made in medical science, the thing patients remember is the one-on-one, human side of medicine.

Treating people so they feel welcomed and cared-for creates a patient’s comfort and confidence.

It starts at the point of entry. Hotels know that the first seven minutes guests spend with them sets the tone for the entire experience. That’s why hotels emphasize attentive parking attendants and bellhops, an inviting lobby and a friendly yet rapid registration process.

Hospitals need to create the same sort of positive “first impression” that includes a welcoming environment, a one-stop shop for paperwork, waiting rooms that are pleasing to the eye and comfortable, and above all, support personnel who know they are vital to the care team.

Everyone in a hospital helps deliver health care, from the security guard to the registration clerk, cleaning crew and cafeteria staffers. They set the mood. Similarly, physicians and nurses can alleviate patient apprehensions with a few extra moments of personal time. A touch of the hand or pat on the shoulder can ease a worried mind and send a patient’s confidence soaring. If a physician simply sits down in a patient’s room, it makes a big difference. Patients sense you are focused on their problem. You’re not peering down at them.

We’ve got to be more attentive about patient discharges, too. We should make it easy to fill prescriptions before departure—so there’s no extra trip to a drug store later. Paperwork should be handled quickly. And let’s give patients clear instructions, phone numbers to call for problems and a chance to ask questions before leaving.

Above all, we need to rediscover the personal side of hospital health care. Yes, wringing efficiencies from the system is important—but only if we remember that the central focus always must be the needs and feelings of our patients.

 A Silver Bullet for Blake
 Desert Bloom
 'No One Dies Tonight'
 Circling the Dome
 Medical Rounds
 Bench Press
 Annals of Hopkins
Class Notes
 The Stobo Touch
 Learning Curve
Johns Hopkins Medicine

© The Johns Hopkins University 2007