Tuesday, February 17, 2015
Money back guarantee on medical care?
How many times each week do we hear the phrase, “If you're not completely satisfied, we'll refund the purchase price, no questions asked.”
This is more often a marketing ploy than a true money-back guarantee. I have a sense that trying to obtain a promised refund on an item that dissatisfied us is about as easy and carefree as changing an airline ticket reservation or reaching a live human when our home internet service is down. So, when the weight loss pills don't really melt the pounds off, don't be shocked if the check isn't in the mail when you mail back the placebo pills to a post office box several states away. And, of course, you won't recover the shipping and handling costs.
This is my opportunity to ask for help from my erudite readership. What exactly is shipping and handling? Doesn't postage already cover the shipping? $8.95 seems pricey for a “handling” charge for anti-wrinkle cream or a set of steak knives endorsed by make-believe chefs. I don't really want strangers handling my stuff anyway. Are they wearing gloves, I hope?
I hear a commercial often for a zinc product that promises a full refund if the product does not shorten the course of the common cold. I do have some medical training, as readers know. Readers who are smart enough to understand “shipping and handling” are asked now to explain how an individual can assert that the zinc product was not effective.
“Please give me a full refund. My cold lasted 6 days. Usually, I feel better by the fifth day. Your zinc stinks.”
“Thank you so much for your input. All of us at Zinc Jinx, Inc. welcome customer feedback. Please send urine samples for days 4, 5 and 6 packed in dry ice at your own expense so we can verify that you were taking the product as directed. Include all packaging including the shrink wrap around the bottle that you should have retained had you consulted our customer service website prior to opening. Expect a response in 6 weeks. Even if your urine drug content is deemed to be sufficient, our onsite cold and flu experts may conclude after impartial study that your cold would have lasted 9 days without our product.”
I'm not offering an opinion on zinc's effectiveness in fighting the common cold. I'm suggesting that it is not possible for a zinc swallower to really know if zinc expedited his recovery. Belief is not evidence. If we recover on day 6, perhaps, zinc was an innocent bystander receiving credit for a favorable outcome that it did not contribute to.
Sometimes, we physicians are lucky in the same way. Our patients get better, as they usually do, and we get the credit. As we know, the converse is sometimes true. We get blamed when we don't deserve it.
Should doctors offer a money back guarantee if our patients are not fully satisfied? The zinc scenario illustrates how difficult it can be in medicine to assign credit or the blame for the outcome. The only secure guarantee in medicine is that there are no guarantees.
If any reader is not fully satisfied with this post, the full purchase price will be promptly refunded, no questions asked.
This post by Michael Kirsch, MD, FACP, appeared at MD Whistleblower. Dr. Kirsch is a full time practicing physician and writer who addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.
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Ira S. Nash, MD, FACP, is the senior vice president and executive director of the North Shore-LIJ Medical Group, and a professor of Cardiology and Population Health at Hofstra North Shore-LIJ School of Medicine. He is Board Certified in Internal Medicine and Cardiovascular Diseases and was in the private practice of cardiology before joining the full-time faculty of Massachusetts General Hospital.
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