The Customer is NEVER Right - A Nurse Practitioner's Perspective
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My mother. A patient's perception.

Lee’s talk about what the patient perceives reminded me of a recent experience with my mother when I accompanied her to an appointment she had with her endocrinologist. Her physician was extremely pleasant. However, when he offered to take my mother’s shoe off to look at her feet I thought he had jumped off the deep end, head first, into an empty pool.
Here is why, not an hour before, my father had offered to buckle my mother’s shoes at their home before the appointment. Although I thought it could be seen as my father being cute to help his bride of 53yrs I said to my mother, “Why can’t you put on your own shoes?” “I can,” she replied, “but it takes me a little longer to fasten the buckle.” “Then wear shoes with buckles,” I said.
My father then joined in the conversation by saying, “I don’t mind. Your mother has helped me when I couldn’t get dressed.” “Oh my God, is this what I have to look forward to when I get old,” I said. My mother answering back, “This is nothing. Don’t get old.” So after my father buckled my mother’s shoes we left for the appointment.
Not only did her physician remove her shoes he help her to put them back on and even buckled them for her as I watched in awe. Why? I thought that was really going above and beyond yet it never occurred to me that my mother’s physician was buckling her shoes for customer service points. Instead, I thought that was his practice and likely did that for all his patients he thought needed help with taking off or putting on their shoes or any other article of clothing if needed.
The physician’s actions must have been what Lee mentioned in his previously mentioned video, “That difference between being perfectly satisfied and wanting the person back again cannot be measured, scripted, reduced variation, or standardized. It comes only from the heart. It can be physical or emotional.” Although I accompanied my mother to the appointment I was there to be her translator and no more than that as I do not introduce myself outside of work as a Nurse Practitioner. Nonetheless, the physician included me in my mother’s visit in a manner I do not include family of patients I see while at work. I mention this not because I intent to change my practice but because I felt the physician was genuine with his practice, to include helping his patients with removing and donning their shoes.
Having said that, and although I think the world of my parents and love them both dearly, we were not there because my mother was Cinderella (a Disney story I believe) and her physician was trying on the glass slipper. Instead, we were there because my mother is an insulin-dependent diabetic and she was seeing her physician for her three month checkup after started on insulin.
For the past three months my mother had been recording her “blood sugar” as directed by her physician and she would record those values in a log provided by her physician that he asked her to bring with her to her appointments. Once in the examination room my mother asked me to ask the nurse for a new log book as the current one was full and the nurse did just that.
During the physician’s visit with my mother he asked for the log book and after thumbing through it quickly he asked her if she had brought in her glucometer to which my mother said, “No.” After asking my mother about her numbers, the highs, the lows, the average, etc., he returned the log book back to her and asked her to bring in the glucometer for the next visit in three months.
Later that evening, at my parents’ home, while watching television, after dinner, my mother says to me, “I guess the doctor today thought I was lying about the numbers I wrote in the book.” A bit confused I said, “What?” My mother repeating her statement. “What makes you think that?” I asked. “Well he barely looked at the numbers in the book and asked me if I had brought in the glucometer,” she answered.
Are you kidding me? Although not something I would say out loud to my mother. However, I did say, “Mom, as healthcare workers we have nothing but the patient’s best interest in mind. As it is only us who pay the price if we get it wrong. I will tell you, I have never seen a more concerning healthcare worker than your doctor today. He not only took off your shoes by unfastening the buckle but he put them back on and fastened the buckle. I would never do that. When I need to remove a shoe I pull it off and rarely put them back on and would never tie, snap, fasten, or buckle a patient’s shoe back on either. I believe your doctor is an exception and he is an expert when it comes to diabetes and it is likely he is an expert with those glucometers too. The likely reason he asked for the glucometer rather than looking through your log book was because with the glucometer he can work its memory to find the highs, the lows, the averages, and whatever other information he needs. I doubt it very much he wanted to look through your glucometer because he thought you faked the numbers on the log book. The book is to get you accustomed to checking your glucose and recording the results in the book helps you with that process. Having said that, the book is not for you doctor to thumb through it and see if you did your homework. That is why he looks through the glucometer for the same information but much more simplified. Can you imagine going through that book of ninety days, four numbers for each day, and trying to decipher all those numbers? That is why he asked you for the glucometer and not because he thinks you were lying.
Hard to believe but that was my mother’s perception. I can see how she got there but she was wrong. Yet patient’s perception is what healthcare workers need to cater to today according to Lee and the new and innovative Disney fantasy idiotology [sic] administrators have come up with as a result of breaking up into small working ad-hoc groups and brainstorming while at resort conventions.
Making matters worse are not the bad ideas throughout healthcare or that those bad ideas go unchallenged. What makes matters worse is the fact that those bad ideas are rarely of a single individual’s thoughts but instead thoughts of so-called subject matter experts getting together to brainstorm and these were the best ideas they came up. Not good.

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