The delivery of healthcare is a strange business. It is a unique business because of a number of factors. These factors include: the patient (or customer) is receiving a service but most of the time is not the one paying the bill; the expectations of the patient for an encounter may differ from those of the provider; the provider of the service cannot guarantee results even when everything was done right; and the provider of the service may provide quality care yet have a dissatisfied customer. The patient is technically a customer but it is rare that they get to choose what they are purchasing or to even know what the service they are receiving really costs.
I have provided services to patients for a number of years. I can speak for the great majority of providers when I say we do what we do because we want to help the people we see. We want to have satisfied patients. However, sometimes patient expectations can be unrealistic and it is not possible to please everyone. Sometimes the knowledge and experience of the provider dictates that what the patient is seeking is not what is best for them.
Every time I walk into a room I ask myself “How can I help this person?” Sometimes the question is easy to answer. For example, if they have a fish hook stuck in their head, I know I can solve the problem and they will be happy. However, if someone has a chronic problem that has been already addressed by other providers, I am worried I may not have much to offer. That person may leave with the same problem they came in with and be dissatisfied. It is not because I did not want to help them; it is largely because I cannot solve every problem.
Healthcare systems track patient satisfaction and more recently have been tracking quality measures. The quality of care is not as easy to measure as one might think. I support quality measures that are meaningful and valid. But quality care does not always produce a satisfied customer. Quality measures and patient satisfaction measures are different. The provider may be tempted to provide treatment that will satisfy the patient even though they know it is not the best care. If patients do not trust the provider, there will always be a disconnect between patient satisfaction and quality of care.
It seems to me the most satisfied patients are ones who have a healthcare provider they can trust and that have faith in the expertise of their provider to try to do what is best for them. This requires building relationships with providers. Sometimes the provider has to earn the trust of their patient. Also patients who are willing to do their part to take care of themselves, seem more satisfied with the care they receive.
On the other hand, it seems the most dissatisfied patients are ones who have unrealistic expectations, seek care for chronic problems in the emergency room or walk in clinic, expect quick fixes for symptoms, are unwilling to make lifestyle changes, and are seeking specific treatments or medications that are not warranted. Also, some patients have a hard time accepting results of testing and evaluations and are convinced that something is being missed.
Healthcare providers are people too. They are not perfect. Their goal is to provide quality care that will create satisfied patients. This will require teamwork toward the goal of staying healthy my friends.
By: P. Michael Shattuck, M.D. – Community Health Network Family Physician
