The consumer is always right…right?
At PT Haven, many of our writers tend to share ideas and thoughts with each other that spark debate and conversation. Fellow writer Mark Shepherd shared an article that spoke deeply to me based on the healthcare environment that we all live and practice in today. The article is entitled, “The Problem With Satisfied Patients”, written by Alexandra Robbins.
The article speaks to the decisions made by the Department of Health and Human Services and the Centers for Medicare and Medicaid Services. In October of 2012, the Affordable Care Act implemented a plan in which hospitals would have a portion of the money owed to them withheld, and would only receive that money back (or receive bonuses) based on high patient satisfaction scores and basic care standards. Patients take a 32 question survey (Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)) addressing communication with doctors, communication with nurses, responsiveness of hospital staff, pain management, communication about medicines, discharge information, cleanliness of the hospital environment, quietness of the hospital environment, and transition of care.
It begs the question: is our main goal to have happy consumers or to have healthy consumers? Often, we can have those two things live in harmony, and when it does we feel great about the accomplishment. But what happens when what is medically necessary isn’t what the patient believes should happen? Do we then choose to abandon having a satisfied patient? Or do we choose to work around our medical knowledge because we need the consumer to feel satisfied? Do we decide to avoid having the hard discussions with patients about their lifestyle that might help prevent further health issues? It would be hard for me to have an open discussion with a patient about things like smoking cessation or weight management without feeling like the patient would leave less satisfied.
The articles goes on to talk about how many hospitals are now promoting amenities and perks to enhance the customer experience, rather than training staff with medical knowledge. Things such as valet parking, custom-order room service, flat screen TVs, and VIP perks are now making regular appearances. Nursing and therapy are undergoing training to help script interactions to enhance the consumer’s feelings of inclusion and power, such as motivational interviewing. But are subjective patient satisfaction surveys going to really change how we deliver healthcare, to make it more efficient and beneficial? Or does it change how we script our everyday interactions with patients so that they believe they are receiving high quality healthcare, regardless of what is actually being delivered?
My hope is that we can find a way to best include patient satisfaction in with delivery of high quality medical care. That should be the gold standard. However, the healthcare field continues to find it harder and harder to deliver on both fronts. It begs the questions---is the consumer always right?
Daniel graduated with his Doctorate in Physical Therapy in 2011 from Armstrong Atlantic State University. He currently works in the Day Program rehab unit at the Shepherd Center, a model center for spinal cord and brain injury rehabilitation, located in Atlanta, GA. Daniel currently serves as Recording Secretary for the Physical Therapy Association of Georgia, and has served as a Delegate and Chief Delegate in 2014 representing Georgia at the APTA House of Delegates. Daniel has presented multiple times since 2011 at both Combined Sections Meeting and Annual Conference, directed towards leadership and engagement for Early Career Individuals. Daniel also has served on multiple task forces for the Physical Therapy Association of Georgia, the American Physical Therapy Association, and the Federation of State Boards of Physical Therapy. Daniel is a current APTA Credentialed Clinical Instructor, as well as a member of the APTA Perspectives Editorial Advisory Group. Recently, Daniel was named an APTA Emerging Leader for the state of Georgia in 2013.