Patients Don't Fail

The patient had done everything right. Yet the surgeon, after evaluating the worrisome infection, explained the situation this way: You failed out-patient antibiotics. We will open the wound and admit you to the hospital for IV antibiotics.

The surgeon was expert and caring, but (Dang it!) the patient hadn’t failed anything! I can attest that she was an ideal patient who had succeeded at doing everything perfectly. She had gone to an ER in a timely manner. After receiving a dose of IV antibiotics, she had taken the prescribed oral antibiotics exactly on schedule. She had returned to the ER at the first hint of worsening.

I can’t believe I’m still talking about this language problem in 2023. Decades ago, many patient advocates became vocal, begging clinicians to stop blaming patients and change the vernacular to The treatments failed.

It seems The patient failed treatment continues to be the accepted phrasing in medical settings. Even if few clinicians today think patients are to blame when proper treatment doesn’t work, that language is not acceptable. Patients are vulnerable and feeling a loss of control. It’s unhealing to put blame on them. It adds an unfair burden of responsibility for the outcome—even if only subliminal. If anything, clinicians should take a moment to reassure patients: This is not your fault. This is something that sometimes happens even when patients do everything right.

Until we make it standard to talk about “treatment failures,” patients do well to take the “you failed” as an archaic language glitch…and to the correct the phrase in their head, if not aloud: The treatments failed me.

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