The Customer is NEVER Right - A Nurse Practitioner's Perspective
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...more unsolicited "food for thought"

While viewing the previously mentioned video about Disney running your hospital, about nine blogs ago, I clicked on this other video screaming at me to click on it, so I did.  The video is titled Patient Satisfaction. To my surprise. NOT! It was a patient satisfaction recruitment propaganda video.
 
 
Within the first 30 seconds the message was “If [patients] are not happy they are going to tell everybody they know.” An ideology I call the greatest paranoia of healthcare administrators. My argument is that administrators need to rely on patients who are happy rather than try to reel in the 20% USA Today found to report discontent regardless of industry. The video went on to mention, “A customer [rather a patient] who has a good experience will tell an average of five people.”
 
 
The video also points out another common use of customer surveys are for marketing strategies or as they say in the video, “To promote why you are better.” I ask, “Better than whom?” As I discourage pinning healthcare workers against one another as a marketing strategy. Healthcare is not take-out food.
 
 
The video goes no to share some attention getting propaganda. “It’s a great tool [Press Ganey customer surveys] because it gives me objective data. In general physicians are very smart people and they really like to make data driven decisions. When you present them data about how to proceed and how to proceed in comparison to standards in the industry that Press Ganey gives us they are more willing to make changes.” Really!?!
 
 
I call it propaganda as my experience has been that Press Ganey assessments have not moved the needle on patient satisfaction yet the ideology continues to be pushed on to healthcare. Almost confirming that, although Lee did not mention Press Ganey specifically in the Disney discussion of nine blogs ago, he did say, nothing in the past decade had moved the needle.
 
 
Lee now claims he has another great idea, although he was one of those pundits who contributed unsuccessfully to moving the customer service needle before he went to work for Disney, I call his ideas more of the same. Remember, Lee said it himself, that the customer service needle had not moved in the past decade. He also introduced himself as a healthcare administrator before going to Disney. Is anyone paying attention?
 
 
One healthcare CEO even described Press Ganey as “the numbers they publish up the street” after agreeing Press Ganey numbers were unreliable. Likely an attitude throughout healthcare as the surveys are inconsistent and unreliable yet published because the competition is publishing the same inconsistent and unreliable data. Of course, in the recruitment video they use just the right words to convince very smart people who like to make data driven decisions that Press Ganey is for them.
 
 
In the same video someone states, “It is difficult to bring on new patients” More paranoia, as they just mentioned above that when a patient has a good experience they will tell an average of five people. So why is it so difficult to bring on new patient? Here is the formula, provide good medical care and the word will get out. As for emergency departments, no one at any emergency department across the nation will tell you there is a shortage of patients.
 
More purposeful chosen words to convince very smart people who like to make data driven decisions, “In order to make smart decision you have to have data.” I agree, however, the wrong data, clean bathrooms, smiling staff, call bells answered, yada, yada, yada, is not as valuable as, Did we get the diagnosis right? Did the treatments help? Are you feeling better? Were you able to follow up? Would you trust us to care for you again?
 
 
By this point in the video they have captured your attention so they throw in the consequences of having dissatisfied patients. “Of those patients who do complain, 50-70% will do business again if their complaint is resolved and 95% will return if their issue is resolved quickly.” Looks like fussy math to me.
 
 
As if those numbers were not altered enough, more propaganda, “Compared to physicians with top patient satisfaction survey ratings, those in the bottom third of Press Ganey data base were 110% more likely to have malpractice lawsuits brought against them.” Unfortunately, in my experience those healthcare workers are labeled a risk rather an access and so the nail in the coffin. Yet, the video does not mention the outcome of those malpractice lawsuits and as I referenced in the book, studies and even emergency department directors have noted, there was no correlation between a happy customer and good healthcare. So although those claims sound horrendous, that the bottom third acquire 110% more lawsuits, who is to say those lawsuits, were not dismissed versus the top patient satisfaction performers were all found negligent?
 
 
Do not get lost in the words, as the propaganda continues in the video, “With the growth of malpractice premiums and malpractice claims it’s best to understand what the patient thinks.” Why don’t we just ask patients, “Are you going to sue me for me trying to help you?” Because that is what it boils down to.
 
 
The melodramatic propaganda in the video continues, “When the patient feels that the physician cares about them as an individual they form that bond and when there is that strong patient physician relationship the possibility of having a malpractice suit brought is extremely low.” A comment I found curious because I thought bonding would lead to better medical care but instead its purpose is to avoid malpractice suits. I wonder if patients know that. Must be part of the calling healthcare pundits so much talk about, like a secret code patients are not conscious to.
 
 
So then let me see if I got it right, all this customer service gibberish is not really about patient care then but instead to avoid malpractice suits. Again, I wonder if patients know that. Are we in the business of helping others with good healthcare or are we just keeping patients happy to avoid malpractice law suits while we take their money. The theme of avoiding litigation seems to be common when it comes to customer satisfaction. So then it’s not really about customer service but instead about avoiding litigation. Got it!
 
 
Wait, more propaganda in the video, “Finding and correcting the weak points in your practice is one benefit of electronic surveys. But positive reinforcement can go a long way and finding the stars among your employees and reciprocating and recognizing their achievements can really move a practice forward.” Bonuses! But only for those willing to submit to idiotologies.
 
 
Wait, just when you thought they could not fit more propaganda into a FIVE MINUTE VIDEO, “A practice can also use the information for marketing. To help differentiate and promote what they are doing really well. We have clients who’ve used it in advertising, in signs in their waiting rooms. They’ve taken out billboards and they promote their commitment to patient satisfaction.” Interesting, because rather than promote their commitment to provide good healthcare they chose to promote their commitment to patient satisfaction.
 
 
The feature video discussed in this blog has been viewed 2,232 times since posted on 24 Sep 2010 and had one like and one dislike and comes from a company that has 171 posted videos.
 
 
The internet is inundated with these videos on both side of the fence. My best Press Ganey scores, a video that depicts what healthcare has become in order to keep customers satisfied is one that should not be missed, although administrators may get ideas to incorporate the “Discharge Hugs!” seen at the end of the video.
 
 
It’s not about patient complaints but that administrators take those complaints at face value over vetted healthcare workers.
 
 
Ironically, this satire video  titled Patient Satisfaction Training Video uploaded to YouTube on 27 Dec 2010 has 2,441 views and it is an example of how the conversation with complaining patients goes when exaggerated unrealistic emotional expectations are not being met and those patients  ask to see others who may cater to them. However, few complaining patients are drug seeker and although drug seekers rate the healthcare poorly if they were denied their vise, most drug seeking patients do not complain, even after a melt down were they verbally or physically abuse healthcare workers.
 

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