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A Tale of Two Patients

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Written by Andrew Le, MD.
Medically reviewed by
Last updated August 15, 2024

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How uncertainty cost an arm and a leg, and a leg.

Before buoy

Names kept confidential.

Before Buoy, I wanted to wear scrubs, blast music, and do brain surgeries. Specific, I know. But I dreamed about this future for so long and shared it so widely that one day in college, when I sliced my hand on a broken window, my roommates couldn’t help but start with, “Is the dream over?” before realizing, “Oh! He needs a rag!” Luckily, it was only a scratch. I went to med school and did a one-year rotation at Massachusetts General Hospital (MGH), where I could try the various disciplines before planting myself among the neurosurgeons.

For four weeks, I rotated in the ER. My duties mainly consisted in interviewing incoming patients. I asked them about their symptoms and then reported back to a senior resident, who made a diagnosis. Ask, report, repeat. I was an infantryman on the front line.

One late night, a woman appeared in the queue complaining of finger pain. She wore a friendly smile and sat with a large stack of papers in her lap.

“I’m worried my finger might be broken,” she said.

It turned out she had jammed the finger two weeks earlier playing football at a picnic. It showed no swelling or bruising. I asked if she could bend it. She flexed the finger just as freely as the others.

“What makes you think that it’s broken?” I asked. She lifted the stack of paper, a ream of pages printed from the Internet and highlighted neatly in different colors.

“I found this information online,” she said.

More of the story...

After conferring with the senior resident, I assured the woman that her finger was fine, bade her farewell from the ER, and contemplated how much our conversation cost her insurer?—?at least $1000. I rushed on to my next patient.

He had five family members with him, all huddled around his foot, and he was nursing an oozing hole under his big toe.

His chart revealed he had diabetes, left unmanaged. Nerve damage from the diabetes caused numbing in his foot, allowing a small cut to fester and become infected. To save him from a larger complication, the foot needed to be amputated.

“The infection in your toe is major,” the senior resident explained. “And it looks like there’s not enough blood going there to fight the infection. To keep the bacteria from spreading everywhere, which is life-threatening, we’re going to have to amputate your leg.”

“But doctor, what about this?” The patient motioned for his wife to hand him a stack of papers, an opinion from another physician perhaps. It was a pile of printouts from the Internet.

The senior resident combed through the sheets. “Thank you for bringing these, but they won’t change what we need to do.”

The next morning, a team of surgeons removed his leg below the knee.

Making it a reality

For the first time, I second guessed my dream. I wasn’t an infantryman on the front line. Not for these people, at least. I was further back, hidden behind a wall of printouts from health websites. I could only do my part when people decided to get help.

But the Internet misled people. It scared healthy people into the ER and gave unhealthy people an excuse to delay care. For the Internet to work, it needed to do what I was doing in the ER: ask about symptoms, collect data, and narrow the scope.

In recent years, the healthcare industry has increasingly recognized the critical importance of patient experience. Patient experience encompasses the range of interactions that patients have with the healthcare system, including their care from health plans, doctors, nurses, and staff in various healthcare facilities. As defined by The Beryl Institute, it is "the sum of all interactions, shaped by an organization's culture, that influence patient perceptions across the continuum of care." Healthcare providers play a crucial role in shaping this experience, as their communication, empathy, and ability to deliver patient-centered care directly impact how patients perceive their overall healthcare journey. By focusing on improving patient experience, healthcare providers can not only enhance patient satisfaction but also drive better health outcomes, increase patient engagement, and ultimately transform the healthcare landscape for the better.

Rotations ended, and a new dream took hold in me: make a website that would’ve helped the two patients from that night. I hung up my brain surgery ambitions along with my white coat and set out to change the Internet for healthcare with Adam, Nate, and Eddie.

— Andrew, CEO

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Jeff brings to Buoy over 20 years of clinical experience as a physician assistant in urgent care and internal medicine. He also has extensive experience in healthcare administration, most recently as developer and director of an urgent care center. While completing his doctorate in Health Sciences at A.T. Still University, Jeff studied population health, healthcare systems, and evidence-based medi...
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References

  • What Is Patient Experience? | Agency for Healthcare Research and Quality. https://www.ahrq.gov/cahps/about-cahps/patient-experience/index.html</1>
  • Defining Patient Experience - The Beryl Institute. https://theberylinstitute.org/defining-patient-experience/
  • Patient Experience: Your Complete Guide - Qualtrics. https://www.qualtrics.com/experience-management/industry/patient-experience/