The Customer is NEVER Right - A Nurse Practitioner's Perspective
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Patient Satisfaction is Overrated (Letter)

This article, and the referenced Forbes article, and the referenced UC Davis research, and the Emergency Medicine News article by Edwin Leap all are synopsizes to a book titled “The Customer is NEVER Right: A Nurse Practitioner’s Perspective”.

Except for one component, it’s not possible to point to the one thing patients complain about. It’s not the antibiotic or the Dilaudid they did not get. It’s not the MRI that was not ordered or the work/school note that was not signed. It’s not the long wait time or the lack of 200+ TV channels in their room.

In the book, I summed up patient complaints to being no more than “exaggerated unrealistic emotional expectations”. Although many have told me it took courage to have written the book no one has committed to taking healthcare, the ONLY industry dedicated to helping others, back from special interest groups who have taken it down the wrong tracks. Just to be clear, I do not have a problem with making a profit—my motto being, “I work for FREE or I work for FULL price BUT I do not work for CHEAP!

Nonetheless, this article may be an eye opener for some; however, none of it is new and unfortunately it’s not news to many. I have made a number of attempts to present the gist of my book, what I call “Our nation’s ‘Silent National Crisis’”, at a number of national healthcare conferences only to be rejected by gatekeepers who claim, “…the objectives and content [of the book] were not relevant to our audience.”

“The Customer is NEVER Right” has resonated with healthcare workers everywhere, them saying it is not relevant to healthcare makes no sense. However, working in healthcare since 1984, I am very aware of healthcare’s unspoken idiosyncrasies and knew healthcare pundits and gatekeepers would shun the book, saying it is “not relevant”, was something I expected. Yet, the book’s website has had over 15,000 hits in the 1-1/2 years it has been up and of that 52% corresponds to the blog regarding this same topic, “Patient Satisfaction is Overrated”. However, like this article, and the ones before, and likely the ones in future as well, we are preaching to the choir.

Unfortunately, the media is only interested in stories with wings, no pun intended, which will make their ratings skyrocket, like chasing after ONE! plane that fell out of the sky, or the courtroom drama of a girlfriend killing her boyfriend, or a mother accused of killing her daughter, or even that Hulk Hogan is making a comeback to WrestleMania. Yet, the increase in healthcare directed violence, one of much collateral debris left behind by accommodating patient’s every whim, that accounted for 38 deaths between 2002-Jan 2011 is not covered anywhere in the media. Nor was the UC Davis research that pointed out that “…rating your doctor is bad for your health” as the Forbes article tried to unearth, only to get 183,639 views since published in Jan 2013 and likely why the topic was not pursued by Forbes.

Now, the lone “Health Business/Administrator” (KM) commenting here claims, “This article is littered with personal opinions and little to no data to support any of the ‘claims’ made by the author.” However, that is not only this healthcare administrators or pundits’ defense but the rehearsed answer to administrators being caught with drinking the Kool-Aide of special interest group. A healthcare administrator who challenged me said, “How dare you paint healthcare with one brush?” Really? Ma’am. Sir. The data, the facts, the overwhelming evidence is out there! To include your very own, Fred Lee, one of the pioneers of getting healthcare to where we are today, will tell you, “We have not moved the needle with regard to customer satisfaction.” So now, Mr. Lee is repacking his idiotology [sic] and selling it to those desperate to beat “the competition up the street”.

Are healthcare administrators that naïve or ignorant or they just not interested in the collateral damage healthcare customer service, satisfaction, or as the lone administrator wrote here, “patient experience”, has left behind? By the way, jargon like “patient experience”, “looking out for the patient’s best interest”, “patient advocacy”, “service excellence”, “working closely with hospital administrators [first] as well as physicians [second or an afterthought]”, “active, educated consumer of healthcare”, “healthcare can not go back…we have a NEW system”, “‘consumers’ of medicine [and] the best consumers they can”, “ALL patients”, “administrators using themselves and their family as ‘patient’ examples”, “work[ing] together…everyone win[s] in the end”, “step back to take a look at the bigger picture”, “walk in their shoes”, “see it from all sides” is no more than rhetoric.

Why rhetoric? No one, not even the patient, and much less business idiotology [sic], has the patient’s best interest in mind than the healthcare worker caring for the patient. The healthcare worker, and the healthcare worker alone, is who will have to face a jury of their peers if they get it wrong. If administrators do not believe the desire to help others is sufficient interest in patient advocacy and service; I will tell you that facing a jury of one’s peers is sufficient check and balances. Having said that, facing a jury is not what drives us to suit up every shift to help others. Instead, it is helping others alone that drives us. One more on the rhetoric, only because limited by time, healthcare workers are patients too and have families who are patients as well. So an administrator using themselves and “theirs” as patient examples in these discussions is repugnant!

To administrators, “Denying a patient a medication, let it be an antibiotic, a narcotic, a gender specific medicine over a coupon or any other medicine for that matter is NOT a lack of bedside manners. Nor is denying a diagnostic, an admission or a work/school note. Neither is telling a patient there is no benefit to smoking or that diet and exercise would benefit them a lack of bedside manners either. Instead, that is healthcare! A time-honored profession, responsible to care for the sick, promote health, and prevent illness and injury and maintain levels of health for others. Rinse and repeat. Day after day, shift after shift and patient after patient!”

Deeds and NOT words! NOT surveys! NOT regulations! NOT certifications! NOT registrations! NOT benchmarks! And definitely NOT business/administrative blah blah blah [rate G version]! ...define our practice!

By the way administrators, those you consider and call “the competition up the street” to healthcare workers they are colleagues helping others. It just happens those colleagues work at different organizations but we all have the same interest—to help others.



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