Since the debut of my author website, DrJillMurphy.com, I have been asked a few popular questions about me, my practice in the medical field for almost 20 years, and the odd intersect of being both a patient and a Doctor of Physical Therapy. So here are some answers to the first set of burning FAQs.
Why did you write a book about your healthcare experiences?
I’m not sure a typical patient in my shoes would recognize poor healthcare, errors in their medical record, the inattentiveness or unwarranted delays in emergency situations, being dumped as a patient both formally and informally, refusal to modify a plan of care that wasn’t working, the lack of appropriate tests ordered, etc. As a healthcare provider, I have the background needed to recognize good care and to know what should rightfully happen at any given consult. I know what is considered standard of care, and what should happen when a complication, like surgical infection or mal-union occurs. I realize that I have insider knowledge that other patients who are not in healthcare don’t have. As a licensed healthcare professional, I have unique knowledge and experience in a variety of hospital and clinical settings that bestow some responsibility to speak up when there is a major issue in care delivery, so the next unwitting patient isn't treated the same way.
After experiencing a poor healthcare encounter, my first steps were to contact each individual hospital or provider when major errors and concerning events occurred to correct them. However, usually these steps never resulted in the information I provided even being communicated to the provider or providers and other staff who were responsible for the error.. Or, there simply was no action a patient could take to rectify the situation to make sure it didn’t happen again to another patient. After all, if no one dies, there is never a lawsuit. And as someone who worked in hospital systems for ten years, it typically takes an extraordinarily adverse patient event and nearly always a lawsuit for a doctor and/or healthcare system to acknowledge an issue and for change to occur. Even then, I wouldn’t expect an apology.
I love to write about the great and exceoptional healthcare experiences, and what precisely about those visits or procedures that made that physician or other healthcare provider stand out. And while I write about some great experiences, the bad patient experiences kept happening, again, and again, and the some of the ramifications of these errors or simply neglect were life altering for me.. It amazed me the variety of negative experiences, with no one negative consult or hospitalization going down quite like another (although gaslighting reared its ugly head with frightening regularity). And honestly, perhaps none of the bad care experiences were truly targeted at me personally (although I admit it feels awfully personal when you and your family are the one suffering as a direct result of a physician's action or inaction). It's difficult to estimate accurately as sometimes you just don't know, but I could trace many of the issues back to the training process of physicians in the US, where the biases of the attending get handed down to the next generation of providers (like inappropriate sinus tachycardia not being a "real" diagnosis, so it doesn't actually require treatment) over the course of their residencies and fellowships. In one instant, a physician didn't provide the specific treatment and actively blocked my attempts to get the treatment I needed, because he was still emotionally burdened from a complication his previous patient had experienced.
But unfortunately, many of my negative experiences were the result of a wide variety of biases, ego protection, and providers and hospitals placing defense of reputation ahead of the needs of the patient.
It was somewhat fascinating and enlightening, despite the unpleasantness, as to how many different ways healthcare can go wrong. And I will add that not all bad healthcare experiences were from providers who didn't care. Sometimes it was a systems issue in the hospital, or another member of the treatment team who didn't bother to show up when called for a consult. Writing a book filled with stories contrasting excellent, patient-centered care with care that was not is instructive for healthcare professionals on how to improve patient care and for patients to better recognize poor treatment, and what they can do about it.
As patients everywhere can attest, when you are in the midst of a challenging medical condition, the gift of a thoughtful and caring physician is healing in and of itself. And I am thankful to have experienced some truly golden moments along the way. But I imagine that life would be so beautiful if every healthcare provider cared enough about the patient care experience to change their way of interacting with patients in every setting- in-patient, out-patient, emergency, and in every department.
Changes to healthcare systems need to occur as well. While some hospitals are aware and are working to continuiously improve, too many top US healthcare systems and physicians are more concerned with the bottom line and their reputation to actually care about the patient. Their time and attention is research or marketing-based, unconcerned about the actual experience of the patient in front of them. Imagine if healthcare errors and issues were effectively gathered from patients and medical staff every time, and problems, both big and small, were appropriately addressed (I do know of one healthcare system that does this- and the difference is palpable in every patient experience in that hospital!) This simple approach would revolutionize healthcare in the US, saving patients time, money, and emotional distress while reducing the stress on healthcare providers, as fewer visits would be required for patients to receive effective care. And there really is no better antidote to physician and healthcare provider burn-out than the natural product of patient-centered care- grateful patients with excellent outcomes. The truth is, we as healthcare providers can all do better!
On your website you mention that you have always been passionate about providing patient-centered care as a physical therapist. How so?
As a young healthcare professional still quite wet behind the ears, I dove into my first position as physical therapist and licensed athletic trainer head-first, always looking to learn, improve, and grow. One such opportunity came as I studied the posted Press-Ganey results for our out-patient sports medicine physical therapy department. Our results were always quite good, as I worked with a fantastic team. But I couldn't help but wonder about the one or two items where we scored even a tiny bit less than perfect. What caught my eye was respect for patients. What did that even mean? It bothered me, even confused me. While I thought I was delivering care that demonstrated the respect that I had for each patient, I had no idea if I was being successful in my approach. How do I show respect to my patients, and what are patients looking for to feel respected? I wanted a more concrete breakdown of what I could do better, so patients would feel 100% respected by everything I did and said. I asked around, including my supervisors. No one could tell me. So I began and completed an informal yet elaborate research study in my clinic to find the answers. The results were quite the Ah-ha moment, as my interviews with colleagues and surveys with patients showed that we as healthcare professionals really couldn't identify what respect means to patients, even though our sports medicine group was successful in making patients feel respected. I presented the results to my colleagues at our sports medicine clinic, and then introduced the topic to professional healthcare organizations for over a decade now in a presentation entitled, “What Patients Want” and “What Athletes Want.”
You’ve posted a lot of stories already in your blog, on your Facebook page, and on Twitter. How does one patient rack up so many bad healthcare experiences?
Looking back, I’ve traversed a 7-year rather continuous journey as a patient in mainly four different areas of healthcare, but also included primary care, cardiology, neurology, emergency medicine, acute care medicine, radiology, plastic surgery, infectious medicine, and cardiothoracic surgery. There could be more, but you get the idea. Because my heart arrhythmia is the one EP cardiologists are taught in training to avoid taking on, it took 2 years and multiple physicians to even get a diagnosis. Then when I had the mild stroke it took neaerly a decade for neurologists to admit what it was, because the imaging didn’t show it despite my functional loss. In between, pursuing a heart ablation procedure unpopular with physicians, then scoring a complication of constrictive pericarditis which is rare and very elusive to diagnose, let’s just say physicians were not lining up to take my case at any point. Oh, and then the sternum non-union and infection that my treating surgeon refused to acknowledge. Try convincing another cardiothoracic surgeon to clean up the last surgeon’s disaster. But even so, I’m granting no excuses to the physicians at the top academic medical centers in the Midwest who starred in some very ugly healthcare experiences. And a gigantic thank you to the heroic physicians from all over the US who rescued this damsel in distress and put me back together again to allow me to successfully return to treating my own patients!
How did you manage to keep your own physical therapy clinic open through the seven years of medical issues? Did you close for a while?
This is the best question that I'm still trying to figure out! I have no idea. God has a way of working miracles, I guess. It helps to have the most loyal and understanding patients in the world! For about one third of that time, I had no other physical therapists seeing patients at the clinic. A few times I had a fill-in physical therapist, but typically I had very gracious patients who re-scheduled if I could not come in (although I tried to keep those instances very few and far between), and I would schedule any procedures during months that were less busy when possible to delay the procedure without any harm. But a big part of the answer is the wonderful staff I have had working as office managers, at the front desk, scheduling patients, billing, and the PT colleagues at my clinic for the past 6 years who worked as many hours as necessary to meet the needs of our MotionWorks patients. To them I am forever grateful!
I hope that answers the most frequent questions I am asked when peeps find out that I've written a book. If you have more questions for Dr. Jill Murphy for the next FAQs blog post, feel free to submit them to Jill@drjillmurphy.com or message your question on the Dr. Jill Murphy Author Facebook Page, and don't forget I'm on Twitter too @MotionWorksPT.
Jill Murphy is a Doctor of Physical Therapy and founder of MotionWorks Physical Therapy and an advocate for patient-centered care. A Christian wife and mother of three, she survived a seven year journey through the broken American healthcare system in search for an answer to a heart arrhythmia that appeared during pregnancy. A stroke, open heart surgery for constrictive pericarditis, and several other surgeries later, Jill is telling her story of unfailing resilience in her upcoming book, Doctor Heal Thyself. Having grown up on a dairy farm 40 minutes from Lambeau Field, Jill is an avid Green Bay Packers and Wisconsin Badgers fan, and is up for any outdoor activity with her husband Tim and three children, including walking, biking, throwing the football around, hiking in scenic locales, gardening, and coaching a middle school basketball game or two.
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