Emergency Medicine News . 35(9A) Supplement 1Page #], 10 September 2013.
Horana, Lasanta S. MD
Once upon a time, no one cared about the patient's opinion, and he had little ability to negotiate his physician encounter. What the physician said was near-absolute, and the patient had no recourse. And so the patient bill of rights was born.That was taken a step further when we didn't just empower the patient but asked, is he satisfied? This innocent question made the pendulum swing completely to the opposite direction. Now, as an emergency physician, I stand with no recourse and await the day when the physician's bill of rights comes out. When will someone empower physicians?...
...The problem as I see it is that we mislabeled the process as patient satisfaction. The problem is inherent in the term. It implies that our job is to satisfy the patient. If a patient was not satisfied, we failed. This is quite contrary to our training in emergency medicine....
...Satisfaction is an obligation or even a promise we make that means we will deliver satisfaction. This is not realistic when we consider all the moving parts that go into one ED encounter. This is not Disney, and I am not selling vacuum cleaners. No matter how much the patient satisfaction guru wants us to adopt the customer service model of Disney, the ED is not Magic Kingdom. We should label these surveys "Patient Feedback Surveys." Feedback does not imply a pre-expectation; it implies a process that already occurred and now seeks constructive criticism or suggestions for improvement, not a rant about how I never should have been licensed to practice medicine...
..We need our leaders in emergency medicine to advocate for the physicians, and the Emergency Nurses Association should do the same for the nurses. We need to draft a bill of rights that is supported by hospital administration saying that we will not tolerate frank disrespect, foul language, or threats! Once in a while, it would be nice if administration and medical leadership actually sided with us and defended us. Once in a while, it's OK to say that someone was out of line, that this kind of behavior will not be tolerated. Our job security is not based on three complaints and disregard for the other 397 patients I served and satisfied this month. Let's get some perspective that two of my 15 surveys were negative, making me fall out of the 95% patient satisfaction expectation although my other 350 satisfied patients failed to fill out a survey. Let's change the surveys. Empower me, give me some recourse, and defend me! After all, the oath that I took was first, do no harm, not first, do not disappoint.
