I had lasertripsy for a kidney stone last week and was intimately immersed in our health care system and my physiological responses. I am not recovered and can look forward to more procedures. During the process I grew a bit frustrated and in my head starting working up a lecture on customer service that would I give to the various medical personnel that I encountered. Part of my idea was that hospital and doctor compensation should be partially based on patient satisfaction surveys. My lecture would begin, “We are in customer service and …” It dawned on me – I don’t like that my pay depends on student surveys. The surveys are crude tools that can be manipulated in various ways and affected by a lot of exogenous variables.
But part of teaching is customer service. I look my students in the eye everyday. I feel their humanness and must response as a caring responsible human being. If they phone me, I call back. If they email me, I respond. If they have a problem, I listen and then come up with a plan of action. If an unusual situation comes up, I deal with it fairly, openly and then change my procedures to reflect what I have learned. To me this is just basic human consideration and part of the job.
You can see where I am going with this. Our health care system has lost its humanity. Patients and procedures are profit centers to be dealt with as efficiently and quickly as possible according to the latest metrics and statistical studies. Calls are not answered or answered belatedly. Questions are not asked. Patients can be left in a bewildering miasma of pain and ignorance. I am all for outpatient care. The less time in a hospital the better but where is the follow-up call the next day and the day after that. The use of checklists is, amazingly, a recent innovation in medical care and has lead to improvements. Where is the checklist for aftercare followup? Questions like What is your temperature?, Have you gained weight?, What meds are you taking at what frequency?, What is your level of pain? Questions tailored to my surgery might have saved me a trip to the emergency room or was that trip just the cost of doing business.
In my experience a doctor’s office is organized to maximize the efficiency of the doctor and only that. The doctor is in a protective web, is doing well financially, and gets little feedback. The impact of a medical care organization on a patient, the entire patient, seems to be seldom assessed and substantive changes rarely made. This is the healthcare system I want fixed. Obamacare may help with medical coverage and costs but for all I can tell it doesn’t address the most important quality issue – healthcare’s increasing inhumanity.