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Doctor Slams Hospital's "Please" Policy

Administrators at England's Worthing Hospital are insisting that doctors say the magic word when writing orders for blood tests on weekends. If a doctor refuses to write "please" on the order, the test will be refused. From the article: "However, a doctor at the hospital said on condition of anonymity that he sees the policy as a money-saving measure that could prove dangerous for patients. 'I was shocked to come in on Sunday and find none of my bloods had been done from the night before because I'd not written "please,"' the doctor said. 'I had no results to guide treatment of patients. Myself and a senior nurse had to take the bloods ourselves, which added hours to our 12-hour shifts. This system puts patients' lives at risk. Doctors are wasting time doing the job of the technicians.'"

32 of 572 comments (clear)

  1. Just wanna say by Barrinmw · · Score: 4, Insightful

    Forced gratitude has zero meaning.

    1. Re:Just wanna say by somersault · · Score: 3, Insightful

      Agree. Yes, a lot of Doctors - especially surgeons apparently - have "God complexes" (source: a good friend who's been a Doctor for 2 or 3 years now). While it can be a negative thing, it's also good for these guys to actually have confidence in their abilities.

      You need good skills and confidence to perform a difficult operation. I'm not saying that they should be justified in treating everyone else like shit, but forcing them to write "please" on a form is just being puerile. It serves absolutely no purpose other than to waste time and endanger patients. If you don't like the type of person that tends to become a Doctor, or perhaps how being a Doctor affects a person's ego (I'm guessing it's a bit of both), then don't work in a hospital..

      I have to admit that in my IT support role I'm probably as guilty as the aforementioned Doctors sometimes with the way I think of people who know nothing about computers. I do often try to explain things to people though, and answer even "stupid" questions.

      --
      which is totally what she said
    2. Re:Just wanna say by Jedi+Alec · · Score: 4, Insightful

      Nah, that is not how it works. Being able to tell the difference between someone just blurting out the usual or someone trying to make a genuine effort to be courteous is something almost all human beings are capable of, and I can say from personal experience that it both works and is very rewarding. Who cares if you don't know the girl ringing up your groceries? Make her smile, brighten her day for a few seconds and your own will be that much better for it.

      Doesn't cost anything and massively improves the mood of both yourself and all those around you.

      --

      People replying to my sig annoy me. That's why I change it all the time.
    3. Re:Just wanna say by stonewallred · · Score: 3, Insightful

      Agreed. Just a few seconds of your time and it costs nothing. And the next time you come in, your bread won't be placed in the bottom of the bag with a gallon of milk on top of it to hold it in place. Or the waitress will make sure you coffee cup stays full and your order is hot and right. Or the salesman will point you away from the expensive "x" and towards the equal quality "y" which is a lot cheaper. Funny what a kind word will get you.

    4. Re:Just wanna say by AVryhof · · Score: 5, Insightful

      I would imagine being an ER doctor is a lot like being an Emergency Repair technician. The best at getting the job done quick and moving on to the next, but not the best to explain what happened. I bet the reason most ER doctors don't want to talk to you is because they want to finish the job and get to the next patient. (I'm always hearing about the ERs around here being packed solid from people waiting 8-10 hours to get in)

      On the other hand, the nurses probably have a little more time to talk a bit and tell you what might help. If you want to talk to a doctor, schedule a regular visit with your family doctor. Chances are though, that they will tell you the same things a nurse will.

    5. Re:Just wanna say by arielCo · · Score: 3, Insightful

      Oh, where are my mod points now. RIght, they're waiting for the next high ratio of Apple and Idle stories.

      Yes, so often they are rude out of haste. They tend to be overworked and have a sense of "get the important done, delegate the rest" floating inside their skull the whole time.

      --
      This post contains no rudeness or derision of any kind. All arguments are friendly. Terms and exclusions may apply.
    6. Re:Just wanna say by Qzukk · · Score: 5, Insightful

      I was left with the impression that he considered talking to me to be a waste of time

      This is probably because there's another dozen patients literally dying to see him, and stuff like "what should I do about my disease" is best left to your primary care doctor who should ideally know all the drugs you're on and all your allergies and your complete medical history and have 15 minutes to discuss this stuff with you without being pre-empted by some guy getting hit by a car.

      --
      If I have been able to see further than others, it is because I bought a pair of binoculars.
    7. Re:Just wanna say by c6gunner · · Score: 3, Insightful

      The amazing thing for those of us outside America is not how the US healthcare industry has so successfully lobbied government over the years so that they can continue to squeeze profits out of the sick. It's how they've managed to lobby so many of the population to believe it's best too.

      Well, as someone "outside of America", I can say that the amazing thing to me is how governments have successfully lobbied so much of the population into believing that 6 hour lineups and the emergency room and 8 month waits for a specialist are a GOOD thing.

  2. Oh Please! by iamhassi · · Score: 4, Insightful

    while I'm all for manners, refusing vital blood tests when doctors forget to put the word "please" on weekend requests just seems damn right stupid and dangerous. How can any manager sit there and support this measure?

    This sounds like something out of a Dilbert cartoon or from Office Space, I could just see him saying "Yeah... you didn't put please on your TPS reports... so I'm going to need you to come in Saturday, m'kay?"

    --
    my karma will be here long after I'm gone
  3. Liability Issues? by ricree · · Score: 3, Insightful

    I have to imagine that this would open the hospital up to some liability issues. The first time someone dies because a test wasn't run in time, I have a hard time seeing a jury accepting "the doctor didn't ask me nice enough" as an excuse for not running the test the doctor ordered.

  4. Re:Fire them by icegreentea · · Score: 4, Insightful

    It doesn't seem like its the technicians who are forcing this through. TFA says it was the management who decided it was a good idea to "ease pressure". Which probably meant that the techies were feeling overworked (they probably are overworked) and complained (not really expecting something like THIS to happen). And instead of doing anything constructive (or maybe they're just all out of money), the management went for some crazy ass stupid idea that somehow past muster.

    Pointy Head Boss eh? IT isn't the only place where they exist.

  5. Doctors caused it, admin enforcing it... by Wyatt+Earp · · Score: 5, Insightful

    Having done alot of chemo and hospital over the years and having a number of doctors in my immediate family (1 heart, 1 gastro, 1 family practice, 1 abdominal) and a doctor turned administrator, I bet the doctors have been jackasses and the hospital administrators pushed this down the throats of the doctors because they'd treated the lab folks like cattle.

    I bet there were a ton of meetings about how to balance out increased workload with less staffing and the administrator's solution was "please".

  6. The administrators need to get a clue by mark-t · · Score: 4, Insightful

    They're called written _orders_ for a reason... that is, they have all the justification that is required to simply be followed. While it's all very well and good to want people to be polite, it is no more required that a doctor remember to say please than it is required that air traffic controllers say "please" when directing airplanes.

    1. Re:The administrators need to get a clue by Anonymous Coward · · Score: 4, Insightful

      You are familiar with Van Halen's condition that a bowl of green M&M's be present back stage for them to perform?

      Do you really think it was Van Halen acting out their rockstar egos, or their assurance that someone actually read the specifications (weight limit of stage, total power, etc.) needed for them to perform safely?

      This is a simple case of doctors not following policy (even if I agree the policy is kind of idiotic) of numerous other polices I've seen MDs fail at, which include wash your hands between patents, write legibly, write legal orders, etc. I could point you to a study done on incorporating checklists for procedures, with _anyone_ able to stop the procedure immediately and correct the (typically, but not necessarily) MD if the correct steps were not being taken. MDs complained about that has well, but it did reduce errors by over 50%, and hopefully impressed upon others the importance of working as a team.

      You are not House. You require the services of numerous disciplines in order to care for the patient. If I can't trust you to follow a simple, one word policy, or better yet, not act like a complete jerk; you should be fired.

  7. Re:Would it kill you to be civil? by horatio · · Score: 3, Insightful

    Would it kill you to do your fucking job without having to be coddled, you whiny little bitch?

    No? Clean out your desk, because I'll find someone else who will. It doesn't mean the doctors treat the staff like shit, but a minimum of doing the tasks you were hired to do is absolutely expected, demanded in exchange for your paycheck. What next? Should the doctor have slip a $5 note with the request? Bullshit. Do. your. fucking. job.

    --
    There is very little future in being right when your boss is wrong.
  8. Reminds me of INTERCAL. by RyanFenton · · Score: 3, Insightful

    INTERCAL is an esoteric programming language meant as a parody of stuffy, arcane programming language requirements. One of its more interesting requirements involves the "PLEASE" statement. As an undocumented feature of the language, the compiler will fail if programs are either too polite, or insufficiently polite - which involves placing the PLEASE keyword in front of statements the correct number of times.

    Kind of like here - if the Doctor just peppers all of his written requests with too many PLEASE statements, that's condescending right there - too polite. But insufficient politeness is equally worthy of wrath - all completely nonsensical requirements, dehumanizing the interaction even as they demand for a confusingly artificial subset of human interaction.

    Ryan Fenton

  9. Not sure if this is a true story, but... by GodfatherofSoul · · Score: 4, Insightful

    This makes me wonder how big of an asshole the doctors had been to force this kind of a policy on them.

    --
    I swear to God...I swear to God! That is NOT how you treat your human!
  10. Re:Fire them by mandolin · · Score: 3, Insightful

    One of the good things about living in Texas is that it is always acceptable to hold the door open for anybody, and more generally than that, it's never impolite to be polite.

  11. Story is from The Sun by xaxa · · Score: 5, Insightful

    The story is from The Sun. It would be worth checking if the story was true before getting worked up about it...

    1. Re:Story is from The Sun by openfrog · · Score: 5, Insightful

      Excellent observation... If we checked sources more systematically, and early in a discussion, I guess we would leave perhaps one or two out of ten stories nearly comment-less. Perhaps this would get the message across to Slashdot editors?

    2. Re:Story is from The Sun by bluefoxlucid · · Score: 3, Insightful

      Funny enough the Sun is horribly liberally biased (like CNN, you know, the TV station everyone says is "unbiased" after the ENTIRE news crew came in wearing all-black and speaking as if at a funeral... the day Bush was re-elected), while Fox is seen as highly conservative-biased. (Note: To me, Fox's political leanings seem clear; they have one highly liberal-biased anchor they use explicitly for political debates, and they have to bring in others to do debates. They do, however, give them a voice for consideration. Most of the time I care to discuss Fox, I'll call them "Balanced" for this reason; I'm not ignorant of their political leanings).

    3. Re:Story is from The Sun by Anonymous Coward · · Score: 4, Insightful

      To say CNN is "horribly liberally biased" while Fox News is merely "seen as highly conservative-biased" is a little silly. CNN _and_ MSNBC have been far harder on Obama than Fox News was towards Bush.

    4. Re:Story is from The Sun by tsalmark · · Score: 4, Insightful

      To the moderator: Given Fox News earned the moniker Faux News after going to court to defend it's right to literally lie in it's news casts, I fail to see how Troll is an appropriate moderation.

    5. Re:Story is from The Sun by ccady · · Score: 3, Insightful

      Do you read these things at all? This study does nothing to further your assertion that "Fox [is] the most balanced in straight reporting".

      The study covered *only* 2008 Election stories during the prime time evening news shows for a period of 3 1/2 months in late 2007.

      The methodology was to look for "positive" and "negative" comments about candidates. Suppose we had a story about a serial killer. By this methodology, if the news program called him a thug twice, and a blessing once, then we'd have an "unbalanced" news report which was 66% negative and 33% positive.

      (Interesting to note that by these measures, the Fox news was close to 50+/50- for democratic candidates, but the others averaged 47+/53- for those democratic candidates.)

      If you wish to learn more, go to SourceWatch.com (http://www.sourcewatch.org/index.php?title=Center_for_Media_and_Public_Affairs) and find out who funds the Center for Media and Public Affairs (http://www.cmpa.com/). At the time of the report, the president of the CMPA, S. Robert Lichter, was a paid Fox News contributor.

      --
      J'aime mieux les méchants que les imbéciles, parce qu'ils se reposent. -- Alexandre Dumas
  12. Re:Easy solution by illumnatLA · · Score: 4, Insightful

    You shouldn't have to say 'please' for someone to do the job they were hired to do... it's not a bloody favor you're asking them to do, it's what they're paid for.

    --
    Web hosting that doesn't suck!Dreamhost
  13. Re:Easy solution by jellomizer · · Score: 4, Insightful

    I like this rule.
    You probably have never worked with MDs before. But let me tell you they are the worst people to deal with. Because they have a Dr. for a prefix and a MD for a suffix to their name they act like they are the smartest person in the world. So when they encounter something new to them, and out of their main scope they get very offensive, rude and makes everyones lives a little bit more stressful.

    They will often treat non-MDs who work with them as underlings, who job is purely to aid the doctor from doing those little jobs that they don't like to do. They often hide the fact that they are jerks under the catch phrase "lives are at stake". Which is a medical term for "Think of the children" which also means "I want to do it the way I want to".

    Forcing them to be polite while seems like just a silly step is actually quite powerful. Saying please before hand means that the work being done is done for the doctors benefit at the expense of someone elses time. Vs. Just shooting out orders that says you are here for me and just me.

    At work we have a policy if a doctor is calling and is cursing and yelling at us without giving us any useful information we can tell them to call back after they have calmed down then we can help you. It isn't about restricting free speech is is about keeping things professional and trying to keep things running orderly.

    Yes there is a cost savings by making the Dr. think twice, as well it can help keep the load down for the labs for a while.

    --
    If something is so important that you feel the need to post it on the internet... It probably isn't that important.
  14. Re:Easy solution by Ritchie70 · · Score: 4, Insightful

    In general, I totally disagree.

    If I'm dining out and a waitress brings me a drink, I say "Thank you." If they ask if I'd like something, I say "yes, please" or "no, thank you." Maybe my mother just beat it into me (not literally) but I can't help myself and I think it's appropriate.

    If I were a doctor, I'd probably ask the techs to "get Mrs. Jones's blood to the lab ASAP please" unless I was distracted with trying to keep Mrs. Jones alive, and even then I might well out of habit.

    If you read the article, the goal of the "Please" isn't actually civility, it's to make the doctors think if the test is necessary. I assume there's some higher cost to weekend testing than week-day testing as it's a weekend policy.

    To require it in a medical concept is nuts. If a doctor orders a test, he should expect it to happen without having to write some "magic word" on the order.

    --
    The preferred solution is to not have a problem.
  15. Re:Easy solution by SanityInAnarchy · · Score: 3, Insightful

    Because they have a Dr. for a prefix and a MD for a suffix to their name they act like they are the smartest person in the world.

    They've been through medical school, so yeah, I'd say they are some of the smartest people in the world. I'm not saying they have the right to be assholes, but it seems like elitism is justified here.

    They often hide the fact that they are jerks under the catch phrase "lives are at stake". Which is a medical term for "Think of the children" which also means "I want to do it the way I want to".

    Except that "lives are at stake" is likely to actually be true. Do you have a specific example of where "the way I want to" is actually arbitrary?

    Forcing them to be polite while seems like just a silly step is actually quite powerful.

    I don't think it's likely to accomplish what you're suggesting. At best, it'd get them to grudgingly start saying please and thank you -- and would you really rather have a sarcastic "please" than none at all?

    the work being done is done for the doctors benefit at the expense of someone elses time. Vs. Just shooting out orders that says you are here for me and just me.

    Versus, say, you're all there for me, the patient.

    At work we have a policy if a doctor is calling and is cursing and yelling at us without giving us any useful information we can tell them to call back after they have calmed down then we can help you.

    That part is key. Also, "cursing and yelling" is something you might actually complain about, compared to "not saying please."

    --
    Don't thank God, thank a doctor!
  16. Re:Easy solution by natehoy · · Score: 4, Insightful

    Given the source of this story, I doubt it's true or complete, but assuming it is...

    I like this rule, except that the failure to write "please" should not prevent the actual test from being performed when the doctor orders it to be done.

    Maybe fine the doctor $10 every time they fail to say "please" on a form, put the doctor's names up on a wall of shame, or make them buy the next round of flowers for the office.

    But anyone in the medical field should know that you do not withhold medical information that is possibly vital to a patient's health because the doc forgot to say "pweddy pweaze wiff sugar on top" on the form. Ever.

    I'm not saying courtesy is unimportant, or that doctors have the right to be rude, only that the patient shouldn't suffer because their doctor is a dickhead to the support staff.

    --
    "This post contains words, known to the State of California to cause thought. Wash brain thoroughly after reading."
  17. Re:Easy solution by hduff · · Score: 3, Insightful

    And interfering with medical care is OK with you? Please get your panties in a bunch in another line of work.

    --
    "I believe in Karma. That means I can do bad things to people all day long and I assume they deserve it." : Dogbert
  18. Re:Easy solution by cowscows · · Score: 4, Insightful

    Just because someone hasn't been through medical school doesn't mean that they couldn't have gone to medical school. Am I automatically less intelligent because I chose a career that isn't in the field of medicine, or that doesn't require a few extra years of school? It's not like the day I got my bachelor's degree I stopped learning new things. I learn more every day while working.

    I'm sure there are plenty of doctors out there that are smarter than me. I'm also sure there are plenty of doctors out there that are dumber than me. I hope that all doctors out there know more about medicine than me, but I'm willing to bet that very few of them know more about my profession than I do.

    The fact that someone spent more time in school than someone else doesn't automatically means that they're smarter than them, it probably just means that their priorities were different. And it certainly doesn't give them the right to be an elitist asshole. Cure cancer, and then you've earned the right to be an elitist asshole. But even then, you're still an asshole, and you should expect people to respond accordingly.

    --

    One time I threw a brick at a duck.

  19. Re:Easy solution by abigsmurf · · Score: 3, Insightful

    Perhaps they find it insulting because it IS insulting?

    They wish to be called Doctor and they've earnt the right to be called doctor. If someone named Richard says "please call me Rich, not Dick", do you then go around calling him Dick? Do you address important business clients you're meeting for the first time just by their first name?

    You are deliberately choosing not to address them by their title against their wishes. That is a calculated insult.