Picture the patient Harold as a long-haired, straggly-bearded street man in Salt Lake City. That’s how the staff at Intermountain Healthcare’s emergency department, where Harold presented regularly, saw him. And then some: alcoholic, intimidating and abusive. 

Intermountain’s corporate director of patient and clinical engagement Tammy Richards did not specifically state that doctors and nurses were afraid of the homeless man, but the implication was palpable.

Until one day a nurse sat down with Harold and talked to him as a person — before having him shed his own clothes to don a hospital gown for a cold, prodding examination — and learned that Harold is an Afghanistan war veteran wherein he both witnessed and participated in violent acts, including some against women and children, that have had haunted him ever since.

“That day when he told his story, Harold changed,” Richards recounted here at the Healthcare IT News Patient Engagement Summit. “And so did we.”

Forgotten history
Harold’s is just one of literally countless stories about caregivers who do not fully understand the patient as a whole person.

Indeed, it may even be becoming more common as hospitals shorten time spent with patients from what Patricia Salber, MD evoked as “the tyranny of the 15-minute office visit,” down to 8 minutes or fewer.

“I think one of the things we’ve dropped is the social history, the personal story of a patient,” said Salber, CEO of Health Tech Hatch and The Doctor Weighs In.

Yet that personal past is perhaps more important now than ever — as is, of course, the present.

“People really, really prefer the present over the future,” said Douglas Hough, associate director of the Master of Healthcare Administration program within Johns Hopkins University’s Health Policy and Management Department.

That rationale figures prominently in what Hough discussed as the fast-brain vs. slow-brain modes few people have mastered. As in: the fast brain just lights up a cigarette even though the slow brain doesn’t actually want a smoke because it understands the body will likely live longer without one. Same goes for sugar cookies.