Expectations vs. Reality: The Vital Role of Communication Between Patients and Doctors

Date: September 24, 2023

Location: Family Waiting Area, Emergency Department, Peking University Third Hospital

The Family's Background

I had the opportunity to interview a young couple in their 20s, who had rushed overnight from Datong, Shanxi, to Beijing after the woman's younger brother, a 22-year-old, fell critically ill due to an infection. The brother had caught a cold at work, which progressed into septic shock, and the family was now by his side, managing his care as best as they could. Both are farmers, and they’ve been taking turns looking after him.

The Patient's Journey Through the Hospital

Since arriving, the patient's condition was dire. He was diagnosed with septic shock—a severe infection affecting multiple organs. His heart rate was high, blood pressure low, and his fever was persistent. The doctors immediately started him on fluids and antibiotics. By today, his condition had begun to stabilize; his heart rate had dropped, his fever had reduced, although it hadn't fully normalized. The family, although still worried, felt more at ease compared to the previous days when they were overwhelmed with fear.

Insights into Communication with the Doctors

The family had gathered quite a detailed understanding of the brother’s condition. The interviewee attributed this to the transparency of the medical staff. “When the doctor calls us in to sign for medicine or pay the bills, we use the opportunity to ask questions, and the doctors explain things clearly.” They recounted how scary the diagnosis had been at first, with the medical team warning them that all organs were affected, including the kidneys, and that he wasn’t producing urine. This had been a shocking moment, but today, after seeing improvement, the family’s spirits had lifted significantly.

The Cost of Care

For the family, financial concerns were very real. With the brother not being covered by Beijing’s health insurance, most of the emergency care had to be paid out-of-pocket. “It’s about 6,000 to 7,000 yuan a day, and today we’ve spent 4,000 yuan,” the interviewee said. Despite the costs, they felt reassured now that they could see progress.

Challenges in the Care Process

A major challenge was having only two family members to manage everything. “It’s hard—if you go to the bathroom or grab a bite, the doctors might call you in, and you can’t miss that.” With both coming from a farming background, other family members couldn't come to help as they were occupied back home. The added stress was compounded by their need to care for a 4-year-old child who remained in Shanxi.

The interviewee was particularly grateful for the hospital’s waiting area. “We can rent beds here, which is really convenient—only 40 yuan a night, cheaper than staying in a hotel.” This provision allowed them to stay close by in case of emergencies, a service they appreciated, noting that other hospitals they’d been to did not offer this.

Expectations vs Reality

The family’s mindset about treatment was clear: the cost of care comes with the expectation of results. "You spend money, you expect the condition to improve." This outlook was central to their perception of the hospital experience. Had the brother not shown signs of recovery, the family’s emotions and views could have been very different.

While talking, the interviewee reflected on the experience they had at another hospital, Fu Wai, where their brother had previously undergone heart surgery for a ventricular septal defect. That surgery, though successful at first, had complications, with post-operative issues leading to further setbacks. The family wasn’t sure if the problem was due to the doctor or the patient’s health, but there was an underlying assumption that proper surgery should result in full recovery.

Concluding Thoughts

Overall, the family expressed satisfaction with the care provided by Peking University Third Hospital, especially since the patient’s condition was improving. They were impressed with the speed and professionalism of the medical team and noted that the attitude of the doctors and nurses was commendable, particularly compared to their past experience at other hospitals. The availability of rental beds and the frequent updates from the doctors had helped ease the tension and anxiety they initially felt.

However, they also expressed some concerns, particularly about the lack of clear communication regarding what hospitals and emergency services are covered by insurance. The need for greater transparency and communication between healthcare providers and patients' families, especially around complex medical procedures and insurance issues, was apparent throughout the interview.

Takeaways from the Family's Perspective

• Hospital Response Speed: The family was satisfied with the hospital’s prompt actions in the emergency department, noting that doctors were quick to administer treatments.

• Doctor’s Attitude: They appreciated the openness of the medical staff, although noted that doctors sometimes communicated in a direct manner, likely due to the stressful environment.

• Medical Expertise: The family had confidence in the doctors’ abilities, seeing tangible improvements in the patient’s health.

• Hospital Services: They praised the hospital for its system of renting beds, allowing them to stay close by for any sudden changes in the patient’s condition.

• Cost of Care: While acknowledging the high costs, the family seemed to accept it given the improvement in the patient’s condition.