As I'm in my 60s, I have elderly friends and relatives who have spent time in hospitals and rehab facilities. The patient needs to have an advocate who is informed of their situation and is present when the doctor makes their brief daily or weekly visit. I've seen decisions made, that contradicted the information in their "chart" such as exercise sessions for a person with a documented broken spine, treated as inviolable by the nurses and other clinical staff. Only the doctor can change the facts of the case.

What I suggest is that if you have a friend or relative visiting you, they should bring a "flip chart" -- the old fashioned 2 x 3 foot pad of paper -- and write down in huge letters the most important details of the case. Ask the doctor to help you fill it in.

Wow. Fascinating article. I am an engineer in a family that is otherwise purely medical (mom nurse, dad pediatrician, sister veterinarian).

Over the years I hear a lot of their pain points, and EMR's are consistently very painful for my boomer parents who are not tech savvy (my understanding is that it's not an age thing, though).

I have personal experience with pt. 8: Doctors know who's good, they just won't tell you. When I had a meniscectomy with poor results, none of the orthopedists I visited after the surgery would comment even lightly on the appropriateness of that procedure given my symptoms and MRI. This isn't different to other professions, where you generally have nothing to gain from badmouthing colleagues, but its incredibly painful that thousands of people are prevented from good care because of this meritocratic breakdown.

As a totally separate point-- this format of shadowing notes in incredibly compelling! I've been shadowing chemistry and biology wet-labs lately, and I wonder if making similar writeups would be interesting to others?

Is 'Hospitalist' an American thing? I'm afraid the word grates on my European ears.