Patients are not Customers

I witnessed one of the scariest, saddest, and disappointing things recently at a departmental meeting. We were shown the results of a survey, on how patients viewed our service in our Emergency Department. While I’m not disputing the need or desire to make sure patients have an pleasant and satisfactory visit, I am worried about what satisfaction surveys may turn medicine and treatment into. The Ministry of Health and Long Term Care is leaning heavily on funding distribution based on results compiled from such surveys.

A survey asking how long someone waited in the waiting room is all relative. 3 hours waiting in one hospital might be short, whereas 2 hours in another might seem long. How can hospitals be compared against each other like this? What is more worrisome, is how surveys such as these are now driving funding and directives for hospitals. The danger is that the desire to achieve “standards” set forth by the results of these surveys, the physicians and nurses tending to the care of the new patients will be pressured to get things done “faster”, and “more polite”. Again, not to dispel the importance to ensure satisfactory experiences, the fear is that quality and safety will suffer at the hands of making sure survey results are favourable in order to secure funding.

Of course you might be thinking that this rant is due to my hospital receiving poor results and unsatisfied patients. In reality, our hospital did quite well, ranking above average in the majority of areas and our Emergency Department was ranked near the top in our province. We are very proud of the quality we provide and the service we provide to our community. What we don’t want is for quality and safety to be at risk just to satisfy what politicians want in order for them to be able to tell the public how they’re fixing health care. Good health care in the Emergency Department should not be measured by happy people who were seen faster when they have a cough; it’s having timely access to tests and specialists to help people when a serious condition arises. Let’s not jeopardize access to health care based on measurements that risk quality and safety.

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2 Responses to Patients are not Customers

  1. aptate says:

    Great post. We are facing the same type of pressure in the ERs I work at in Las Vegas. Healthcare providers in most countries are expected to not only provide excellent patient treatment and care, but also do it all with a fast food drive thru pace. It’s providers, like you, that notice that thinking of satisfaction scores above patient medical care will lead to an increase in rushed assessments, missed diagnoses, and lack of quality medical care. I always remember that as a Healthcare provider I am my patients strongest advocate for their healthcare and well being, even if the patient doesn’t give me 5 stars. I take pride that I can walk away every morning, and know that if I’m questioned by a superior on my performance, that I wouldn’t change the way I cared for my patients and feel confident in the treatment I provided. After all isn’t that what we are hired to do, to help and heal, not to ensure they enjoy their stay.

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