Patient Perspective: What They Need to Know to Improve Their Safety

Drawing from his personal experiences, Bertil Damato, MD, PhD, Professor of Ophthalmology, University of California, San Francisco, elaborated on what patients must understand about how they can improve their own safety. Patients need to know whether their informed consent is truly informative and directly applicable to their personal condition.

Patients often worry about whether they have comprehended everything the doctor has explained. Another concern patients have is about the doctor’s experience and expertise. Does the doctor have the necessary training, and will the procedure be performed by the doctor or by a student or resident? If the procedure is being performed by a resident, is the resident being supervised adequately? Patients also want to know whether the hospital or clinic has the necessary equipment and staff to safeguard patient safety.

One of the major concerns that patients have about seeking a second opinion is whether their original doctor will accept them back after seeking one. Dr. Damato argued that second opinions can be a win-win situation for everyone, because the patient will either return to accept the primary doctor’s advice reassured or they may choose to receive better treatment elsewhere.

It is often difficult for patients to find meaningful information about doctors and hospitals and to know whether they are receiving the best possible care. Patients worry about repercussions if they complain about the quality of care, whereas complaints and suggestions should, in fact, be encouraged. A nurse who acts as a patient advocate can help to safeguard patients’ interests and improve patient safety.

Patients enthusiastically support Dr. Damato’s proposal of a “bill of rights” specific to their particular condition, which would help them to know what to expect when they see their doctor and to check whether the care they are receiving is adequate. For example, patients should always be informed of any pigmented fundus lesions that are detected on routine examination, and if there is diagnostic uncertainty, the merit of surveillance should be emphasized because the lesions could represent possible malignant melanoma. This would ensure that patients do not default from follow up.