Physicians Office Resource Volume 12 Issue 6 - Page 17

The Problem with “Customers.” Words, and their various denotations and connotations have more power than we realize. Trite-isms and clichés like “the customer is always right” have been bandied about since the dawn of time (or maybe since the advent of "customer service"), but it's the essential M.O. for anyone working in the service or retail industries. And “the customer is always right” is absolutely true in some very specific instances. Many of us know the struggle of keeping an inconsolable customer happy, often at the sake of speaking our minds, so as to make the sale or get the tip. Think about the cranky customer sending back the well done steak, burnt to a charcoal crisp, and still proclaiming it “too rare.” In these scenarios, the customer may be objectively incorrect, but because of the structure of retail, the server’s job must keep them happy, accommodating them in the face of ludicrous demands. It’s how retail and business operate, and I don’t see “the customer is always right” going anywhere any time soon. The problem is when that mentality migrates to health care. Indeed, modern patients do have many similarities to customers. They can “shop around” in their treatment. They can use their knowledge to bargain for the treatment they’d most prefer. They can post negative reviews on Vitals or Healthgrade and warn other prospective patients of making the same mistake. Where "customer" breaks down is this: receiving medical treatment isn’t quite like buying a car. It's sometimes a matter of literal life and death and in these scenarios, it’s up to the physician to make the absolute best judgment call possible for the sake of the patient...not to acquiesce to the patient’s demands. Can We Turn Back? One common thread in the health care discussion is the metric of patient satisfaction and its relationship to funding and reimbursement. Like any business performing simple customer satisfaction surveys, these metrics help in determining a health care systems efficiency or a particular practice's strengths and weaknesses. It’s also indicative of how a “ Essentially Shared Decision Making (SDM) encourages clinicians and patients to communicate with one another using the best available evidence when making a treatment decision.” Dylan Chadwick physician is doing (generally) in terms of their patient relationships. However, the problem with depending entirely on patient satisfaction metrics is that the data can skew very heavily in one direction based on a few arbitrary factors. Tanya Feke cites a study in the British Journal of General Practice in which more than 980,000 patients were surveyed across 7,800 practices. The results indicated that physicians who prescribed more antibiotics were perceived more favorably than family doctors who weren’t as willing to prescribe. When such arbitrary factors can swing such a huge door, the idea that these surveys so heavily control a physician’s level of compensation become somewhat alarming. Also one must take into account that individuals are far more likely to post reviews about their experience when they’ve had an “extreme” one, either good or bad. When they've got an axe to grind or absolutely HAVE to let the world know about that transcendent colonoscopy…but rarely for anything average. This means that many 4-5 star reviews aren’t being written simply because the patient doesn’t feel the incentive because who wants to review their experience when it was completely average and unremarkable? (in a good way). Of course, one way to curb this dilemma is for physicians to regularly encourage their patients to review them after each visit. This can produce more realistic satisfaction metrics for the physician as they're getting more well- rounded patient satisfaction metrics from a variety of sources. While patient satisfaction surveys will always be around, as well as comparisons between patients and customers, we can still curb the negative aspects of these developments, simply by expounding on the positive ones. SDM is in itself, a great way to bridge that precarious gap between “patients as customers” and “patients as patients.” Because the goal really isn’t to restrict patient power or patient capability. It’s to channel that capability into something mutually beneficial for both the physician and the patient. Bringing patients fully into the decision making process, really bringing them in and not just creating the illusion of it, should only increase patient satisfaction. They’re brought onto the same page as the physician and any perceived walls of secrecy or agenda (on both parties) disintegrates. It encourages participants to share knowledge and experience,  creates a system of trust, evidence and mutual understanding and celebrates the... Read the rest of this and other articles at 17