Patient Care And Customer Service Are Not The Same!
Customer service and patient care are two totally different concepts. Unfortunately, the great divide between the two is only going to clash as we enter this difficult era of reimbursement rates that depend on subjective patient satisfaction surveys. The purpose of this article is to illustrate the differences between patient care and customer service.Patient care and customer service might seem interchangeable to healthcare administrators and members of the public, but they are most certainly not the same. If nurses ignore the differences between the two practices, the outcome could be downright disastrous.
Dorland's Medical Dictionary (2008) defines patient care as the services rendered by members of the health profession and non-professionals under their supervision for the benefit of the patient. On the other hand, customer service is the capability of a business or entity to meet the wants and needs of its customers. While some elements of customer service should be incorporated into patient care, the healthcare industry would be wise to avoid jumping too deeply into the customer service bandwagon. Keep reading to see my point.
Healthcare facilities are expressly designed for patient care; however, they are not made for customer service, regardless of what the powers that be would like the public to believe. Keep in mind that good customer service involves consistently meeting the needs and wants of the people who patronize the business. Conversely, patients often want things that counteract the effects of good patient care. The nurse who gives patients whatever they want (cigarettes, donuts, etc.) is providing great customer service while delivering poor patient care.
The fry cook at McDonald's provides good customer service when he smiles while preparing a Double Quarter Pounder cheeseburger and super sized fries for the patient diagnosed with coronary heart disease. The friendly people at the bakery display great customer service by making an entire dozen of sugary cinnamon rolls per request for the noncompliant type I diabetic patient. The courtesy clerk at the Holiday Inn delivers outstanding customer service when she escorts the oxygen-dependent COPD patient outside to smoke.
Employees in the service industry do these things to ensure a certain level of service because they want those paying clients to return. Who cares if good customer service might be bad for one's health? Health promotion is not the concern of workers in the hotel, restaurant, and hospitality industry. They want the customer's money in exchange for all services rendered, even if the service will lead to patient demise in a few years.
I totally agree that some aspects of customer service belong in healthcare because patients are external customers of the facility, and will refer others to the hospital if they are satisfied with their care. However, what about the patient who refuses to have any vital signs taken during the duration of his or her stay due to not wanting to be bothered? The nurses who honor this request are excelling at customer service for giving the patient what they want, but are practicing poor patient care by not performing a complete assessment.
Customer service and patient care are not synonymous. Unfortunately, the great divide between the two concepts is only going to clash more as we enter this era of reimbursement rates that depend on subjective patient satisfaction surveys. As always, we cannot go wrong with the Golden Rule to treat others in the same manner that we would want to be treated. When faced with the choice between customer service and patient care, I hope that patient care lives on.Last edit by Joe V on Aug 22, '12
About TheCommuter, BSN, RN Moderator
TheCommuter is a moderator of allnurses.com and has varied experiences upon which to draw for her articles. She was an LPN/LVN for more than four years prior to becoming a registered nurse.
Joined: Feb '05; Posts: 38,033; Likes: 69,300
CRRN, now a case management RN; from US
Specialty: 11 year(s) of experience in Case mgmt., rehab, (CRRN), LTC & psychAug 22, '12My nurse manager actually asked the task nurse to wheel a patient outside to smoke yesterday. The poor patient was unable to go out side under their own power to have their cigarette. So sad. The nurse manager went on to tell the nurse to just leave the patient outside and come back into work. As if wheeling a patient under our care outside to smoke, and then leaving them there helpless to come back in was going to be a wonderful story to tell the patients lawyers after this nurse got sued for malpractice, neglect, abandonment, etc. The nurse refused, and I suggested she tell the nurse manager to wheel the patient out herself if she was that intent on providing great customer service-the rest of us were actually taking care of patients.Aug 22, '12AHMEN! well said. I have noticed this trend over the past few years. If the pt doesn't want to get up and walk, that is good customer service, give them what they want. But when their MD comes in, you are giving bad pt care. Puts nurses in a no win situation. Same thing with pain control. I believe that pts should be comfortable, but to what extent, are we going to medicate, medicate, medicate until the pt is in a stupor because that is what they want. As nurses, we can't always take all pain away! IMHO, common sense has taken a back seat to providing great customer service- something that is not always possible in the health care setting.Aug 22, '12Aug 22, '12I truly do not see how they are going to get "reality" feedback from patient care. Most of our patients in hospitals today are very ill and it will be the family who complains. I can't imagine 90 yr olds filling out customer care surveys? Or will more money be spent on telephone calls to patients after discharged? Looks like another way to spend money on being "nice" and not on what patients need......patient care.Aug 22, '12It's all part of the plan, serfs! bankrupt the hospitals, bankrupt the insurance companies, then have big brother step in and take over. You don't like it? Well, we've got plenty of indentured servants who are willing and ready to step in to tow the line. maybe when your family is out on the streets, you'll rethink your ability to provide customer service with a smile.Aug 22, '12Good customer service is not necessarily incompatible with good patient care. For instance, in the NYT article, losing a patient in the radiology department for 8 hours is not great patient care, and it's hideous customer service. There should be some automated way to keep that from happening.
Waking up stable people with stable vitals every few hours for a BP check is not good customer service. Putting patients in semi-private rooms, where they have to deal with the other person's illness, family, and possible, infections, is not good customer service. Hand washing is good customer service for a fry cook. It's also good customer service for medical personnel.
We are in competition with medical tourism destinations. There are top-flight hospitals in India, Thailand, and elsewhere, and it's cheaper to fly to one of those destinations from New York, have a knee replacement in a hotel-like hospital, have physical therapy while staying in a very nice hotel, spend two weeks on vacation, come home, and after paying for everything including the flights, you will have spent a small fraction of what you would have spent at a New York hospital.
That is the competition.
However, it is not up to the nursing staff to provide all that great, non-medical customer care. It is up to the hospital. It does not take an RN to bring someone a magazine or to ensure that the meals are nutritious and edible. That is something the MBAs who seem to be most concerned with cutting every possible corner should figure out.Aug 22, '12Quote from neverbethesameHoly cow.......Aug 22, '12Cold Stethescope I agree 100%. It is not up to the nurse to provide non-essenial non-medical care such as looking for magazines.
As for the person who said the competition is the issue, I disagree. Anyone who has medicare or medical insurance is going to pay less $ to have a knee relplaced in their own country than flying out. Insurance will not pay for air, etc. If it is an elected procedure than yes, may be better to go to Thailand like for cosmetic surgery. I personally would rather pay more and have it here but that is just my opinion.Aug 22, '12As I read the quoted article, I had to laugh to myself. The part about staff having phones and the call bell goes directly to the nurse phone. I can only imagine being in the middle of removing a fecal impaction and having to take a call. Same for other task ie starting an IV, placing a foley or ng tube. I have never felt it was right to take a call about another pt while providing care to your current pt. some hospital use volunteers, others don't. Wouldn't having volunteers pass magazines and general cheer be a help? I just keep working right along, doing the best I can to provide the care I have for many years.Aug 22, '12The patients who receive (in my opinion) the worst care are the ones who are unable to make their needs known. They are the patients that are eventually gotten to. These are the patients who need a family member at the bedside who will advocate for them and also when there is family there the nurse will get into that room for care or to check up on the patient more frequently. Often the patient who needs the least amount of care gets the most. It is what it is and sometimes it plain stinks.Aug 22, '12Quote from Cold StethoscopeActually, the increased focus on non-medical customer service in healthcare facilities would not be problematic if the powers that be were willing to hire hospitality staff or attendants to wait on patients from head to toe by serving meals, transporting people outside to smoke, collecting menus, fetching sodas and snacks, fluffing pillows, dealing with cable TV issues, warming towels, providing prompt room service, and so forth.However, it is not up to the nursing staff to provide all that great, non-medical customer care. It is up to the hospital. It does not take an RN to bring someone a magazine or to ensure that the meals are nutritious and edible. That is something the MBAs who seem to be most concerned with cutting every possible corner should figure out.
However, we all know this will not happen. The main responsibility for providing this non-medical customer service falls squarely upon the shoulders of nursing staff. Why pay two employees if you can get one person to do multiple jobs?Aug 22, '12Quote from needshaldolThere are people who have insurance, but given the deductibles and co-pays, still find it cheaper to have certain large elective surgeries (e.g., joint replacements) in Asia at a top hospital. For people without insurance, it's no contest. For many of them, it's a matter of going overseas (including to such places as Cuba) or going without.As for the person who said the competition is the issue, I disagree. Anyone who has medicare or medical insurance is going to pay less $ to have a knee relplaced in their own country than flying out. Insurance will not pay for air, etc. If it is an elected procedure than yes, may be better to go to Thailand like for cosmetic surgery. I personally would rather pay more and have it here but that is just my opinion.
I had a group insurance plan in the late 90's that would send you to "centers of excellence" if you needed major non-emergency surgery, such as an organ transplant. It's not beyond the realm of possibility that an insurance company would be willing to pay for your trip to Thailand to be cared for at a good hospital, and pick up the tab for transportation and accommodations, if the total cost would be less than that of treatment in the U.S. if outcomes were as good as or better than having the procedure done here.
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