Blog | Friday, January 6, 2017

Health care is incapable of giving 'customers' what they want

The mantra of striving for excellent customer service is a very American concept. I'm reminded whenever I travel around the world and experience general service expectations elsewhere—even in some very advanced nations in Europe—how far ahead we are in the United States. We totally take it for granted that we can expect high levels of customer care almost everywhere we go, and any complaints and feedback we have will be taken very seriously by those in charge.

Health care is, by its very nature, a very caring arena. While I'm not in favor of ever thinking of our patients as “customers” (or worse still, as some in the corporate world advocate for, “clients”), there is still a lot we have learned from the business world in terms of striving for higher standards in a competitive environment. And because the United States health care system is still very privately-oriented compared to most other countries, that places us far ahead of these other nations in maintaining that customer-service mentality. Having said that, we are still pretty bad at giving our patients what they truly want. Here are 5 examples where we fall woefully short:

1. Time

Our patients and their families want nothing more than adequate time with their doctors (and nurses). Time to sit down, talk about things face-to-face, understand, and then make informed decisions. They don't want a doctor who is rushed, distracted by their computer screen, or one whose pager is going off constantly with other issues.

2. Type of doctor

I've written previously about how great “old-school physicians” are, and how every patient is yearning for a doctor like that. A doctor who they trust, knows them thoroughly, and practices good and thorough medicine. The system we work in however, does everything possible to discourage this.

3. False ideals

A huge concept that administrators fail to grasp (maybe because they are partly in denial over something they can never have any control over) is that patients couldn't give a hoot about your shiny corporate logo, swanky office building, or bumper-sticker slogans. Patients come to clinics and hospitals, because they like and want to see their chosen doctor. If you have a good caring doctor with happy and well-treated nurses around them (assuming the medical care is right)—patients could be seen in a middle of a power plant, and they couldn't care less!

4. Computers

The health care information technology train, which has enriched so many, spawned a whole new industry, and served so many different agendas—has been a disaster for the practice of good medicine. Statistics suggest that new doctors spend as little as 10 percent of their day in direct patient care, with the majority of the rest staring at a screen and ticking boxes. While information technology represents the future in all aspects of our lives, health care IT has not lived up to anywhere near its promise, and is the biggest daily frustration for doctors (and nurses) all across America. We need a revolution with health care IT, and need to make it more seamless, efficient and quick to use—so that doctors can get back to where they should be: with their patients.

5. First do no harm

It's the motto of medicine, but we lose the forest for the trees when it comes to simple common-sense things that make life so much better for our patients. These include measures such as allowing our patients a restful nights' sleep, getting them up and moving earlier, and even feeding them more palatable food!

You may notice a contraindication above. While praising the business-oriented customer service mentality, we are also saying that the big-business mentality is what gets health care into trouble. Note the words: Big Business. Small business is fine, and encourages closeness with our “customers”. It's when a large corporate cookie-cutter mentality prevails, that we find ourselves stuck in a top heavy administrator-led health care system. One which views patients as numbers in an assembly line—an unacceptable mentality when we are talking about real human lives. This philosophy is rarely compatible with the practice of the good and thorough medicine which our patients demand. Therefore, while we must bring the best of business in certain ways, we must also realize how different we are to business at the same time.

Finally, we mustn't forget the influence that big government regulations and mandates are having on the ability to give our patients what they truly want from us. Any health care system that fails to take into account the effects that all top-down directives have on the frontlines is going to eventually collapse under its own weight.

In all industries nothing matters more than the final “product” and how it's perceived by the people who are using it. So let's start listening more to our long suffering patients and giving them the type of health care they've been asking for.

Suneel Dhand, MD, ACP Member, is a practicing physician in Massachusetts. He has published numerous articles in clinical medicine, covering a wide range of specialty areas including; pulmonology, cardiology, endocrinology, hematology, and infectious disease. He has also authored chapters in the prestigious "5-Minute Clinical Consult" medical textbook. His other clinical interests include quality improvement, hospital safety, hospital utilization, and the use of technology in health care. This post originally appeared at his blog.