An open letter to the medical profession
Dear medical office:
I’d like to thank you for sending me a survey about my recent experience at your medical office. You are extremely consistent. Every time I visit a doctor or interact with anyone at your office or any other, I get a survey.
I’m sure you’re using those surveys to learn ways you can do better, and not to evaluate and punish medical and administrative staff for doing their best and sometimes failing in the obscenely oversubscribed and stressful environment you have created for them.
To save time, I will share what my response would be to every one of these surveys:
- Did the medical professional listen to and respond to your medical issue? Yes, they did the most professional, insightful, and empathetic job they could given the conditions they were working under.
- Did they address your problem? If it was a simple problem, sure. If it was more complicated, they referred me to someone else who is probably not available for another month or two.
- Did the administrative staff handle you with appropriate care and discretion? Yes. Although their workload sometimes seemed a bit EPIC, to be honest.
Somehow you never seem to ask the questions I want to answer:
- Were you able to get an appointment in a timely way given the urgency of your problem? Of course not.
- Were you satisfied with the clarity of the insurance and billing that happened after the appointment? No. The financial followup was both impossibly expensive and incomprehensible given that I have decent and costly medical insurance.
- Did we follow up regarding the recommended treatments? Probably not.
What the medical office should be contacting me about
By sending me a survey, you are requesting uncompensated labor from me without clarifying how you will use the results.
So instead of consistently surveying me about “my experience,” how about following up with me in a way that actually might help me?
Why not send me a message including these questions?
- Did the suggested treatment resolve your problem, or are you still having it?
- Did you have any side effects or interactions with your other medications?
- Have there been any other changes since we spoke that would potentially require a different treatment?
- Would you like us to follow up in a month, three months, or six months to check on how you are doing?
- How have the delays in treatment affected your health?
- Would you support legislation to prohibit private equity firms from owning medical offices, a trend that has driven costs up and the quality of work experience for dedicated medical professionals down to the point where many are leaving the profession and creating staffing shortages?
Do that consistently. Then let’s talk.
Signed, your patient (until one of these conditions finally does me in, that is)
Somewhere in the holding company that owns your clinic or hospital, someone is being paid generously to gather and interpret Net Promoter Score results.
Applies to many other situations as well. I get these surveys from everyone. They are designed to enable managers to report / boast about customer satisfaction without risking actually asking about satisfaction in any real way. As you say, they are “experience” disconnected from end results. I’ve gotten airline air surveys cheerfully asking about how they did on flights that were four hours late.
The medical system in this country is run for profit and not for patients. Patients are merely the way to generate profit, not cure anything. Doctors squeeze as many patients into each hour, rarely read a chart before they see you, and, as you observe, they push you off to specialists who, more often than not, shuffle you off to another specialist since no one wants to be a medical diagnostic detective anymore. And we are a “developed” country.
I travel outside the United States with some frequency. I invite host country citizens to opine on the quality of their healthcare, typically state run. With regard to “Medicine 2.0” (see/read Dr. Peter Attia) no one, to date, has convinced me their local healthcare is superior.
America falls well short in regards to “Medicine 3.0” – health and wellness preservation, disease prevention.
You can not look at what medicine can and cannot do in isolation.
Medicine needs to treat full patients, not just the illness within them.
Yep, you have to be your own best medical consultant these days. The medical “professionals” sure won’t do it for or with you. They aren’t interested in listening to us, about the reason for our visit. They ignore the fact that we know more than they do about what’s going well or what’s going wrong in our bodies. We live 24/7 inside ourselves, after all.
My husband and I have been trying for several years now, without success, to find a physician who is not woke, who doesn’t push drugs and injections at every visit, who will actually look at our physical bodies, who will give us complete physicals every year. The pseudo-physicals I’ve had in the past four years are not physicals – they are merely a consultation at the computer screen: no urine samples, no physical palpitation of abdomen, no breast exam, no gynecological exam, no proctology or prostate exam – height, weight, blood pressure only, maybe listening to the heart. Otherwise, no touching at all. Yabba yabba yabba, that’s all, folks!)
Then my husband is inconvenient one when he has to call repeatedly, and for the pharmacy to call repeatedly, to get prescriptions renewed – it often takes weeks – and the doctor says she can’t hire good help. That shouldn’t be OUR problem. And then the online portals never work, so my husband insists that he get answers and printouts in person, at the doctor’s office, which angers what staff they do have.
Neither of us is willing to be dehumanized by being forced to live in our computers and cell phones. We are not digital creatures, we are of flesh and blood. When we have an ailment, we want it assessed – in person – analyzed, identified, and treated – by a human, not by a computer or AI.
And we don’t need insurance companies to dictate to doctors how to treat us, which is exactly what has been going on in the medical profession for at least two decades. No wonder so many people ail, what with the incredible stress we are all under because we have to tangle with the insurance entities for the coverage we have paid through the nose for. It’s bad enough to deal with pain of recovery and adverse drug reactions; nobody needs corrupt insurance companies compounding that pain.
Well, Josh, I’m afraid you may have opened an artery here … I’ll close here before I bleed out. (Got billable work to do.)
This is really a good take on the issue of “satisfaction surveys” and it has reminded me of the importance of finding the correct question, not just trying to get the correct answers.
I find it “weird” that companies do not seem to really want to actually improve things, but to have what in social media we would call “vanity measures”.
As usual, a very enjoyable read, thank you :-).