18 Comments
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R. Chad Swanson's avatar

ER physician here. Thanks for the thoughtful, insightful post. We all inherited a system driven by episodes of care, profits, and elitism, largely formed over 100 years ago. While my colleagues in healthcare are some of the most brilliant and caring people that I know, systems and structures too often drive behavior. we can do much better.

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Sylvie Leotin's avatar

So glad to connect with you here! You've captured it perfectly – it's the system design that's the culprit, not the brilliant and caring people working within it. That's exactly what I'm trying to highlight with 'Ask the Patient' – those inherited structural flaws and how they drive behaviors that harm patients despite everyone's best intentions.

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R. Chad Swanson's avatar

Looking forward to learning from you!

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Beverly Zavaleta MD's avatar

Per usual, Sylvie is spot on in her analysis. Bravo!

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Sylvie Leotin's avatar

Thank you so much, Dr. Zavaleta! Coming from someone who brings both clinical expertise and personal cancer experience to this conversation, it means everything. I'm also thrilled to have you as a new subscriber. Thank you for your support!

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Ali's avatar

Terrific

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Daniel Flora, MD, PharmD's avatar

Excellent article.

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Sylvie Leotin's avatar

Thank you so much, Dr. Flora! Coming from a physician who understands both sides of this equation, that means a great deal. I really appreciate you being part of this conversation.

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Ahmed Elaraby's avatar

Thank you, Sylvie, for this. As someone who has both worked within healthcare and navigated it as a patient, I couldn’t agree more: the system’s design assumes resilience and privilege exactly when patients have the least capacity to provide either.

It’s time we stop teaching patients to endure dysfunctional systems and instead reimagine those systems to meet patients where they truly are—vulnerable, exhausted, and deserving of dignity.

I look forward to following this series. Voices like yours are vital for pushing healthcare toward, human-centered transformation.

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Sylvie Leotin's avatar

Thank you for reading and for validating these insights! You know you wrote a good post when someone comments and repeats your key points. 🏆 It's encouraging to hear from a doctor who has experienced both sides of this reality. Looking forward to continuing this important conversation through the series.

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David Price's avatar

Great post, highlighting differences between assumptions and patient experiences. In the post, you are educating readers on human- centered design. Thanks!

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Sylvie Leotin's avatar

Thank you so much, Dr Price! You captured exactly what I'm doing: bridging true human-centered design with healthcare.

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Brian OKelley's avatar

Damn. Too much truth for one post! What’s so crazy is that the patient is sick and all the sudden has to learn all these ropes. It would be one thing if they weren’t already in a state of high stress, fear and disorientation. There are no ready, patient/human friendly on ramps into specialized medicine. From my own experience, I found that practitioners, administrator, call centers just assume that you know their ropes and we’ll just have the patience to endure long hold times, indifference, and poor navigation.

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Sylvie Leotin's avatar

Thank you for your comment, Brian! As a design leader, you understand exactly the lack of "patient-friendly on ramps." Your point about practitioners assuming patients know "their ropes" while we're in crisis perfectly captures the gap I write about. This is exactly why "Ask the Patient" is so important; we need patient expertise informing healthcare design.

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Alfred Sadler's avatar

Sylvie - very well done - Fred

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Sylvie Leotin's avatar

Thank you, Dr Sadler! Your endorsement as a respected physician executive means a lot to me. It gives me hope that healthcare professionals can appreciate the value of patient expertise. This is precisely the type of partnership 'Ask the Patient' aims to foster.

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Manny Katz's avatar

Well, you found one paltry example of an acknowledgement of "patient expertise." Usually, physicians are often demeaning, disrespectful, and dismissive of anything that resembles patient research and patient expertise, because it contradicts physician experience and knowledge. Or they become noticeably silent. Physicians are sometimes resentful of even being asked questions, which they often interpret as challenges to their own authority, knowledge, experience, and expertise--who are WE to question any of their conclusions?! Stop being so uppity! One of my friends was severely criticized for asking even one "normal" question by her surgeon.

Sometimes they have a point in that we, the patients, demonstrate the validity of that old saying, "A little knowledge is a dangerous thing." We might have read some internet blog or article which then gives us the feeling that we know something they don't, but in truth much of medical knowledge has to be qualified in ways we, as layman, could not comprehend. I've had many examples of this in expressing my views to doctors. Often I reiterate something I heard from a nurse in a hospital. Then I am told not to take the nurses opinion at face value because....Or my objections about medical procedures/treatments have failed to consider this, that, or some the other fact, as is to be expected of an untrained layman. I've noticed that medical personnel don't like to talk about the system's failings, or have their "well-established" protocols challenged. Again, who are WE to question their well-thought-through procedures and protocols? And who has the time in a typical, compressed appointment to discuss "theory?" Everyone is overbooked and running late! Get out of the way!

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Sylvie Leotin's avatar

Manny, this is EXACTLY why I started "Ask the Patient"! Your insights are spot-on. I think you'll appreciate my upcoming posts, which delve deeper into these dynamics. Would love to have you subscribe. I have a feeling my analysis will resonate strongly with your experience.

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