Patient as Customer model of healthcare

  1. Our hospital has in the last couple of years initiated a number of changes. One of them is that in much of our correspondence from upper management the patients are refered to as 'customers'.

    What do you all think? Should we think of our patients as customers? Somehow it has a capitalistic ring to it that I don't like. Ours in a small community hospital, btw, funded by county taxes, in addition to revenue collected from patients. We are also a critical access hospital and this also brings in additional revenue.
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  2. 80 Comments

  3. by   TazziRN
    Hogwash........they're patients!!
  4. by   Medic/Nurse
    This has been a trend in "healthcare" over the past few years and I'm not sure it is the POSITIVE that was envisioned.

    I believe that professional, compassionate care is an absolute right.

    I am committed to patient self direction and determination. Healthcare should not be forced. Patients should be educated on their conditions and should, to the extend possible, direct their care.


    Now, is the "patient as customer model" the best way to achieve this?

    I think the "patient as customer model" has some serious flaws. When this model and the abuses are allowed to proliferate EVERYONE loses. (Including patients)

    With this "model" has come a mentality of:

    "The patient is always right". RIGHT.
    "Service comes first".

    I have found that frequent patients can really learn how to abuse the "system". I have been the "victim" of more verbal abuse from all these customers than I can care to count. I actually had one who told me "I'll just complain about you (in response to MD not ordering more narcs) and how mean and uncaring you are - and then you can just deal with that." I am not kidding.

    I have also found that when patients are "always right" - the system frequently goes WRONG. It can markedly devalue the hospitals most precious resource. NURSES AND NURSING. In these facilities you spend more time kissing patient butt than wiping it. (Both are stinky and messy!)

    I remain out of "nursing" in the traditional sense - and I am not sure I can ever go back and retain my soul. If I wanted to be a waitress, I'd head to Starbucks! If I wanted to try to work at Disney - I'd have applied for the Alice in Wonderland spot there - at least we all know what happened to Alice when she went down the rabbit hole!
  5. by   kitty=^..^=cat
    I posted a response to a similar thread almost a year ago -- and it goes something like this...

    A number of research studies (I don't know specifically which ones - I have the info somewhere from a customer service workshop) have found that most "patients" actually prefer to be referred to as "customers" or "clients", because those are considered neutral terms that don't imply illness.

    I think it's pretty darn funny (and ironic and so unsurprising) that nurses are more offended by the terminology than the "patients" involved.
  6. by   maryloufu
    We were discussing this topic the other night when one of our charge nurses informed us that it was ok for patients to have their infant and small children stay with them at the hospital (critical care here- not OB) because we are viewing the patient holistically. What? So I have grandpa with chest tubes and a PICC line and little toddler running around. What if a small kid goes to another floor to get a soda and gets kidnapped or worse? This is a bad idea.
  7. by   GardenDove
    It does seem as if the pendulum has swung perhaps a little too far in the direction of catering to every whim of pts and their families, sometimes at the expense of order and safety, not to mention the rights of those who would like their hospital stay to be more restful. I try to accomodate families, but sometimes it seems like a free for all.
  8. by   Simplepleasures
    I can hear it now, "Hi my name is Mary, I will be your server today.How may I help you?"
  9. by   jo272wv
    There is a lot of good in striving for "customer satisfaction", my hospital insists on it. The only problem is that if you have a pt that feels you should wait on them hand and foot eventhough they should be capable of performing tasks for themselves, how can you posibly satisfy them when you are the one that has to insist that they at least try doing their own
    adls. Dont think the hospital will back you up when the pt complains you refused to assist them.
  10. by   Tweety
    It's a shame that people just can't treat each other decently, patients, family members, each other, doctors, venders, etc. then hospitals wouldn't have to go to the trouble of teaching us how.

    My facility uses that model as well, but is quick to point out that we "team members" (we aren't employees) are customers too.

    I have no strong feelings about it. It's not all bad.

    I do get aggitated that we are judged by our customer satisfaction surveys. I don't feel they are a true relfection of the care they receive. They could be a good tool, but too much stock is placed in it, IMO.
    Last edit by Tweety on Jan 3, '07
  11. by   P_RN
    What about "Nursing Service Line" The first robot welds the frame together, the second puts a windshield in the Nursing service line hands out meds, the next server puts in the seats and the last says do you want fries with that? Ergo: Customers (oh and be sure you do NOT give them over 3 Ketchup packets)-ketchup costs profits.
  12. by   Antikigirl
    I find when you use terms like client or customer you lessen the reality of the situation! I will always call my patients 'patients' because they are there to be treated in a very serious way for their well being, not like going to a restaurant or store!

    Here is another thing...why not actually take a survey on performance of staff related to the condition...not how quickly a towel was brought in, how fast someone came to show them how to turn the TV volume down, or if a nurse was available every 15 minutes to bring new ice!!! And okay...if you are going to base it all on these issues...why not actually improve the situation by adding nurses or nursing aides instead of complaining to the nurses there to do even more! Obviously we can't do much more!

    When did it become a customer service deal that asks too much from nurses and nurse aides as is versus quality care for the patient on their treatments and conditions (customer service is important, but not the number one deal to me...quality and safe care for the patient condition is!).

    YOu go to the hospital to be treated for a condition...not to badger a nurse and get disgruntled when your Low Fat Latte isn't there in 5 minutes or less!
  13. by   EmerNurse
    I think all this customer service stuff came in so that hospitals can attract patients away from their competitors. By moving away from the age when docs and nurses had authority and patients LISTENED to them, we've gone too far the other way.

    The patient is not ALWAYS right - if they were, they wouldn't need us when their blood sugar is 850, now would they? If they were always RIGHT, they'd have managed it correctly to begin with. They're here, in many cases, because they are NOT always right.

    I have no problem with hospitals wanting to make stays more palatable for the ill. I think it's a good idea. But I do NOT think nurses are the ones to fulfill the "hospitality/hotel" needs every 15 minutes. As someone stated above, if you want to provide that type of service, AS WELL AS great medical and nursing care, then provide the staff to do it. If I have a choice between giving you your antibiotic on time or filling your roommate's ice pitcher for the 15th time, guess which one's going to win?

    And one more rant, which I've expressed before in a Press Ganey thread... customer satisfaction in the ER is a JOKE.... A JOKE! I've had many sick patients express appreciation for my care, however, guess who gets the randomly mailed surveys? The ingrown toenail x6months who can't take it anymore, and who waited for 8 hours and then didn't get narcotics for pain relief. I could cook that one a gourmet meal in my spare time (!), and still get a crappy survey.

    Can you tell this is a huge pet peeve of mine? I'm a nurse... I have PATIENTS (and patience though that wears thin sometimes). I am NOT a hostess!
  14. by   UM Review RN
    The flaw in the customer service model is that patients envision and group together their impressions from retail operations, like hotels. It's comforting to the patient to have some idea of what to expect going in, but it's up to us to refine that perception.

    So IMO, the customer service model can work, but you have to make your terms clear. My biggest customer service complaint is "I can't get any sleep with people waking me up at all hours."

    I now take steps to clearly state what can be expected of us and our hospital RIGHT AT ADMISSION.

    I will say, "You can expect me to come in and get your blood pressure at midnight, and then Lab will be in to draw your morning labs sometime thereafter."

    Some patients angrily respond, "That means I won't get any sleep!!"

    My answer: "Yes, that's right. This is one way that our hospital is helping you keep costs down. You see, the docs check the labs in the morning, and if your labs are OK, you get to go home sooner, thus saving everyone money. You don't want to spend an extra day here, do you?"

    I tell them what I can and cannot do. I usually get reasonable people who really are exhausted from the ER and want some sleep, a couple extra pillows, and some food. In general, the patients who want to go down to smoke (not allowed--I tell them up front) are few and the patients who try to get around that are fewer still, though they do tend to stick in our minds.

    The part of the customer service model that I like the best is that EVERYONE IS INVOLVED and I have rights too. Docs yell at me? Well, as a "customer" I also have a right to be treated appropriately, and docs are no exception.

    The customer is not always right where I work. We work together as much as possible to keep everyone comfortable as well as healing, and folks, that's just a very basic part of holistic nursing, to help our patients get better by creating a safe, comfortable environment for them in addition to the medication and treatment regimen.

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