Do you know what would happen if I let my children leave our yard wearing their wardrobe of choice (which would be no clothes) and walk to Walmart (cause this is something my three year old wanted to do today)? Well, aside from the fact that they would possibly place themselves in grave danger, I would also most likely receive a visit from Child Protective Services. You see, just because my kids want to walk around naked and run out into the road does not mean I should let them. Since I’m the expert on what’s best for them it’s my job to pass that along. In fact if I don’t I get in trouble, or God forbid, something awful happens like my daughter gets hit by a car.
In healthcare patients are under the care of experts in the field of medicine, but if the general patient population doesn’t like “mom and dad’s” suggestions to keep them alive it’s okay. As a matter of fact if the experts on health and safety suggest too sternly what is best, or even worse deny something harmful, they are punished for not keeping the customer happy. Press Ganey speaks and everyone listens.
If your doctor doesn’t want to prescribe antibiotics for a viral infection or more narcotic pain medication than is safe you can always throw a temper tantrum in the way of a satisfaction survey, and your physician will receive a spanking in the form of non-reimbursement.
If my children get into the cookie jar without asking they get punished. But if your dietician tells the diabetic patient to stay away from cookies, and orders a hospital tray as such, poor scores in this area will punish the healthcare team. Subsequently the diabetic will go home and eat a whole box of Ding Dongs. Then when they’re readmitted with DKA again within 30 days guess who doesn’t get paid?
And listen, it’s not that I’m saying patients are like children, but if you can’t follow basic instructions to keep from killing yourself then that’s pretty child-like. When experts in the field of “how not to die” share their knowledge it’s only prudent to take note. Or you can angrily fill out a patient satisfaction survey with low scores. We’ll get the memo.
So what happens? Instead of serving the public with honesty and integrity we are serving the satisfaction of the sick. Instead of increased health and wellness you end up with increased mortality rates. You see an influx of antibiotic resistant infections and narcotic dependency and overdose. Sure you see an overall improvement in patient satisfaction scores, but you also see sicker patients dying before their time.
As a mother if my parenting gig was like my nursing one I could never be blatantly honest with my kids. I wouldn’t parent in their best interest, but rather I would parent in regards to what made them feel good. So in twenty years when I had two daughters instead of four, and one suffered self-entitlement issues, poor hygiene and people skills, and obesity while the other was in jail and dying of AIDS I would wonder if parenting them with rules, limits, and using the word “no” might not have served them to have a more productive future. Hey, at least I’m sure they would have never been angry at me, but in hindsight maybe being pissed at mom is a good thing.
So again, it’s not to say that the general patient population is like a kid that requires being told exactly how to maneuver through life. That’s not my point at all. But we all do have areas of expertise, and also areas where guidance is needed to help us grow happy and healthy in life. I’m all for patient satisfaction in general. I want my patients to be happy, and I strive to achieve quality care every time I’m at the bedside, but when we start allowing “customers” to drive the huge machine of healthcare it’s going to get steered off the road. Again I believe in giving great care to my patients, but sometimes great care doesn’t make people happy. And in these cases where doing what’s best for someone’s health doesn’t make them feel warm, fuzzy, and in control then I do not believe their angst should affect getting paid. When it does we inadvertently risk doing what’s financially best, not what’s needed health-wise.
Most parents agree their children are their number one asset, and as such they will always do what’s in their best interest no matter how painful it may be. Along the same vein of thought, in healthcare our patients are our top asset. Who wouldn’t want to be treated like one? Sometimes being important means not getting your way, but getting the best care possible.