Despite the business world’s best effort to portray medicine as any other business with customers, good business is not good medicine. At the end of the day, a patient is not a customer.
Patient Satisfaction Surveys
If you haven’t been hospitalized recently you may be unaware of a minor change. At the end of your hospitalization, you are sent a satisfaction survey to determine how happy you are with your stay. Press Ganey and HCAHPS are terms that bring doctors and nurses to new levels of annoyance. MBA’s see medicine as any other business that exchanges services for payment so patient satisfaction is the logical means of measuring care given. They couldn’t be more wrong in this assumption.
Imagine you are starving and walk into a restaurant without money. If you try to order food that you can’t pay for, you will be refused even if that meal is necessary for your health and survival. This is the basics of goods for fees. That same restaurant also has a feedback system, through online surveys or verbal complaints. The restaurant takes this information and modifies their services accordingly. They can change their menu, retrain staff, and offer personalized substitutions.
Reconciling Patient Satisfaction
But what do hospitals do when we have a patient satisfaction survey? We can’t change that menu, we are offering mediations ad treatments based on our training and your illness. We are already personalizing your treatment to each individual so that is of no help. So we are left with training staff. And the hospitals like this one! It really is all they are left with. Of course, we can always improve on our patient interactions, but most of this has nothing to do with medicine and everything to do with reimbursement. In an overworked and understaffed hospital, this is not the best use of our resources.
The Business of Medicine
Hospitals will not turn away a sick patient, regardless of a persons ability to pay. This is almost a universal thought, but here in the entitled United States of America, we take this to a whole new level. Not only do our patients expect free medical care, they expect the best medical care for any condition, life-threatening or not. They want the best pain medications and the full workup for a simple cough. They know they can walk into any ER and walk out with a full set of labs, imaging, and a handful of prescriptions. All without dropping a dime. With this mentality, how can you get your patient satisfaction scores up? Give them what they want! But that is bad medicine and bad business.
Patients Are Not Customers
As a paying customer, you expect to be given exactly what you want. It is your decision to make and you can change your mind at any point. In medicine, the clinician decides on the best possible care. Patients can refuse or ask for second opinions, but at the end of the day, the clinician is creating the treatment plan.
My job is to do what is medically best, not to satisfy your every whim. But we have misinformed the patient that they are a customer ordering from a menu of options. If we don’t fulfill that order, there goes the patient satisfaction survey.