Teaching Doctors the Art of Negotiation

NY Times  |  JANUARY 23, 2014, 12:30 PM  |  By DHRUV KHULLAR  |  By the time I rushed to his room, my patient had already ripped out his I.V., packed his knapsack and was making his way to the door, his hospital gown, on backward, flapping like a cape over the jeans he had hurriedly slipped on. He told me he felt fine now, after coming in feverish and sweating a few nights back, and despite his poorly controlled H.I.V. and the strong possibility that the lump in his neck was lymphoma.  We had been waiting several days for the biopsy results, but now he had had enough.  “I’ve got things to do,” he declared. “Call me when you know.”  “Wait! We, uh, almost…” I stammered. He glared at me and continued his bare-chested charge toward the door.

Just then the attending physician arrived and calmly approached the patient. He offered him a glass of water and asked if they could chat for a few minutes. Patients leaving A.M.A., or against medical advice, were not uncommon on this floor. The attending had practice. It showed.  Read more