Wednesday, April 30, 2014

The focus on patient satisfaction is enough to make you sick

All patients should be treated with professionalism and respect.  We all want our patients leaving our care happy, healthy and satisfied, if at all possible.  However, sometimes patients don’t leave an emergency department very happy or satisfied.  Sometimes the doctor could have prevented it, but many if not most times, such dissatisfaction has little if anything to do with what the treating physician did, or didn’t, do.
The reasons for a patient being dissatisfied with a particular healthcare encounter can be very complex.  It’s not so simple as to just include a line in a survey such as, “Were you satisfied with your doctor?”
Who should be held responsible for the results of these surveys, is where the crux of this debate lies.
So why are hospitals obsessed with patient satisfaction?
It’s the same reason Walmart puts greeters at the front door (the ED), not the back door (inpatient floors), and the same reason the government collects taxes and not sea shells: money.  The question we really need to be asking is: Why is the obsession with patient satisfaction in the ED so soul-crushing to those that work there?
Sometimes a patient voices frustration in a survey despite your best efforts to be nice, helpful, professional and clinically astute.  This may be due to factors out of your control regarding ER wait times, a large hospital bill, dirt on the waiting room floor, or a rude staffer that wasn’t you.  If the results are used against you, it is very difficult to smile and say, “It’ll never happen again.  I’ll do better next time.”
You didn’t make it happen, and you have little if any ability to make it better next time.  You’re already nice to your patients, do your best to help them and treat them with respect.  There’s tremendous cognitive and emotional dissonance there.  Things like this can end careers and fuel burnout in a big way.  Such things are the undercurrents that cause doctors to go work for insurance companies, as non-clinical consultants, or just plain move on.

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