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.'"

Comments

Easy solution

[Anonymous Coward]

Write, "Please stop sucking cock and do these blood tests, bitch!" :-) That includes the word please!

Re:Easy solution

[illumnatLA]

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.

Re:Easy solution

[jellomizer]

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.

Re:Easy solution

[Ritchie70]

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.

Re:Easy solution

[natehoy]

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.

Re:Easy solution

[Bakkster]

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.

While it may not give them the right to act like a prick about it, a technician's job is to do menial tasks so that a doctor or nurse (or engineer, in other fields) doesn't need to. There are plenty of reasons for this, not least of which is that it keeps costs down. Not only does it cost more to pay a doctor to do so (and keep him from his other duties), but the technicians are certainly better at getting lab work done. And, since technicians can't provide patient care, it's best to give each task to those who specialize in it (nurse draws the blood, lab tech runs tests, doctor diagnoses and prescribes treatment).

It's similar in engineering (electrical in this example, since it's what I do). The engineer designs the circuit, a draftsman lays it out physically, and a technician lays out and solders the parts. Yes, the engineer can do it, but it's not their specialty, and it's much more expensive and slower to have them do it.

One could certainly make an argument that such jobs are 'below' engineers/doctors, but I wouldn't direct that kind of sentiment to a tech. It's certainly valuable work that they do that saves me a hell of a lot of time, and I try to show my appreciation (lots of 'please' and 'thank you'). It doesn't give me or anyone else the right to shit on a tech, but it is their job to assist the doctor/engineer by doing menial tasks that they don't have time to do.

Re:Easy solution

[cowscows]

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.

Just wanna say

[Barrinmw]

Forced gratitude has zero meaning.

Re:Just wanna say

[Farmer Tim]

Thanks for that.

Re:Just wanna say

[Anonymous Coward]

We're all very funny today aren't we, all of you folks that haven't worked E&R. Let me tell you something you will never experience yourself, but hospital doctors can be some of the biggest ego-centric pricks you will never meet - really, you have no idea the sense of self importance they carry with them. It's a God complex - "I save lives, so get out of my FUCKING way, you worthless turd". Even though the E&R and post-op nurses save way more lives than they do, the nurse is relegated to a personal slave who OWES limitless respect to his lordliness. I think this is an EXCELLENT response - yes, it's puerile, but it's exactly that level of childish egotism that we deal with every day, and even if it's FORCING them to be civil when they're really not at heart, it still puts the bastards in their place. Just a little bit.

With BOFH and PHB stereotypes well-known to /. , I would have thought a little more understanding would be forthcoming. But no, the "IT boys" long for such parity with their medical counterparts, and make jokes about us "bitches" and "lowly technicians". You know what - I hope one of our doctorly lords fucks up your med prescriptions next time you're in recovery - see how much you appreciate the attentiveness of us "weenie slaves" then. And, yes, go suck your own cock, you humourless, anonymous waste of breathing space.

Re:Just wanna say

[xmundt]

Greetings and Salutations;
          While I sense a certain amount of repressed anger in this post, my recent experience of spending four days in hospital tend to re-enforce the overall view of the ER doctors. While I have no complaints about the technical competency of the doctor who sealed off the seven ulcers in my esophagus, trying to get him to discuss my illness and ways that I could deal with it was like trying to pull up a manhole on the road with a screwdriver! I was left with the impression that he considered talking to me to be a waste of time, both because I was obviously too old and stupid to understand anything he said about the state of my body, and, that it would be a waste of time to discuss long-term treatment with me.
            I will say, though, that the nurses and technicians that I interacted with over that four day period were top notch. They provided excellent care, and, interacted with me as if I was actually a valuable human, and, dealt with the terribly chaotic schedule of an intensive care wing with good humor and a positive attitude. Actually, the only problem I had was that I have terrible veins in my hands and arms (small, buried deep, and, with a huge tendency to slither away or go flat when a needle gets near them), so, the techs that came in to get blood samples had QUITE a challenge. I was fairly sure that after the first day, they were down there drawing straws, to see who got the short one and had to come poke me.

Re:Just wanna say

[Jedi Alec]

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.

Re:Just wanna say

[AVryhof]

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.

Re:Just wanna say

[Qzukk]

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.

Re:Just wanna say

[u17]

No, but it would help if you said "plz".

Re:Just wanna say

[chooks]

As someone in the medical profession, when you get tired/rushed/etc... you lose one of two things:

1. Compassion
2. Ability

Guess which one kills people or gets you sued when lost?

Not credible

[Anonymous Coward]

The source for this is an "odd news" blog, whose source is a "newspaper" called The Sun. You may have heard of it. National Enquirer anyone?

Re:Not credible

[TouchAndGo]

Agreed, I can't find any other source for this news, and it's pretty bizarre to be quoting a tabloid as a source. Unless you're the Men in Black.

Oh Please!

[iamhassi]

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?"

Re:Fire them

[icegreentea]

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.

Next one

[kikito]

Planes will not be allowed to move until the pilots say "Engage".

Doctors caused it, admin enforcing it...

[Wyatt Earp]

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".

Rubber stamp

[Itninja]

They should just get self-inking rubber stamps that say 'Please'.

The administrators need to get a clue

[mark-t]

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.

Re:The administrators need to get a clue

[Anonymous Coward]

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.

Re:Liability Issues?

[Lawbeefaroni]

If a patient refuses to write "please" as they die, the death will be refused.

In extreme cases, the Lazarus Engine will be employed.

How could there be any liability issues?

Re:Fire them

[Z34107]

Or for opening a door for a lady. Depending on which day it is

Very true. I err on the side of caution when it comes to holding the door open for people, but some manage to be offended by such a gesture.

I held the door to my dorm for some chick late one night. After hours the doors require you to swipe your student ID to get in. It's a pain, so decent folk don't let the door swing shut after getting the reader to take their ID.

She yelled something about "I can get it myself!" but she was kind of drunk, so I couldn't really understand her. She was angry, though, so I shut the door, and it locked.

Turns out she forgot her ID. I have no idea how long she was standing outside. I think there's a moral in there somewhere.

Not sure if this is a true story, but...

[GodfatherofSoul]

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

Re:Fire them

[plover]

Yes, the administrators are requiring it, but likely at the behest of the technicians. And the techs are enforcing it by not performing unless the order says "please". Kind of makes a mockery of the term "order" there, too.

I imagine this is going on today.

Original order: "Draw Mr. Smith's blood."
Technician: "Denied, you didn't write the magic word."
Revised order: "Draw Mr. Smith's blood by 9:00, and if you ever question my orders again I'll have your arse sacked."
Technician: "Those are magic words. Here's your lab results."

Solutions

[DynaSoar]

1. Instead, write "This is an order, not a request."

2. Put "Please tell me where you're going to be working next week if these are not done."

3. Write "One of these id for a relative of yours, I believe."

4. Approach both techs and admin and ask them, if they had gotten hurt on the grounds and were taken to their ER, would they expect to be treated in this way. Would they expect to not receive treatment after they came to Research.

5. Circulate a memo stating that very soon all employees would be required to say please when asking for their salary check. ANd if it's not sincere or strong enough, they don't get paid. The eception is administration. They have to beg for theirs

Story is from The Sun

[xaxa]

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

Re:Story is from The Sun

[openfrog]

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?

Re:Story is from The Sun

[xaxa]

The sun is affiliated with Faux News?

Yes. They are both owned by News Corporation.

Re:Story is from The Sun

[Anonymous Coward]

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.

Re:Story is from The Sun

[MiniMike]

The editors must have been told to 'check their sources before posting', not to 'Please check their sources before posting'.

Re:Story is from The Sun

[tsalmark]

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.

Re:Story is from The Sun

[Camann]

Recommended reading for anyone who'd mod 'Faux News' troll.

Re:Story is from The Sun

[billcopc]

"Most balanced" in the news industry is like "least retarded" in the special olympics. It's all relative...