This Is Why Patients Are Not Customers

patients are not customers

First published on KevinMD on January 7, 2016

The customer is always right or so the saying goes. Not when it comes to medicine.

The Customer Is Always Right

If you work in retail, buyers who ransack neatly folded tables of sweaters and leave them strewn about like tornado wreckage frustrate you. If you work in the food industry, diners who complain their soup is cold even as you see steam rising from the bowl annoy you.

It can be hard to bite your tongue but you do what you can to make the sale, to get the tip. The customer is always right, not because he is technically correct, but because to call him otherwise would cause you to lose business.

What about health care? Are patients customers too?

Why Patients Cannot Be Customers

Customer: A person who purchases goods or services from another; buyer; patron.

Dictionary.com

Customers are people you serve but more than that they are consumers. Patients consume health care. Literally, they ingest medication but they also utilize services from lab tests, imaging, consultations to procedures. In the eyes of hospitals, administrators, and even the government, this qualifies them as customers.

This is why patient satisfaction surveys have taken over the healthcare industry. Patient satisfaction measures a clinician’s performance and even affects how much they get paid. Like Amazon reviews for books and other goods, patients rate a doctor’s visit as good or bad based on how long they sat in the waiting room or what they thought about the receptionist’s mood. The sad truth is this does not necessarily reflect on the quality of care.

A study in the British Journal of General Practice showed how patient satisfaction surveys can be skewed. It surveyed more than 980,000 patients across 7,800 practices. Doctors who prescribed more antibiotics were perceived more favorably than family doctors who doled out fewer antibiotics. When you consider the UK’s National Institute for Health and Care Excellence estimates more than 10 million antibiotic prescriptions are inappropriately prescribed every year (antibiotics do not treat colds and other viral infections), there is a serious disconnect.

Feedback Matters

That does not mean there is not value to patient satisfaction surveys. Of course, there is. Feedback is important if it is constructive and there may be times when a negative review is exactly what the doctor ordered.

The trouble is many people have a tendency to report only on extremes of experience. When they don’t get what they want or when they have a bad experience, they are more apt to complain. It takes an even higher proportion of positive vibes to encourage someone to take the time to fill a survey. Most clinic encounters fall somewhere in between. Without all data points, surveys do not give the full picture. How does this help patients get better care?

What doctors know is that patients are not merely customers. They are people, individuals, and they make mistakes like all people do. If the customer is always right, patients cannot be customers when it comes to matters of health. Patients want things that may not always coincide with the best, evidence-based care.

Health is our most valuable asset, not comparable to a sweater or a bowl of soup. A patient deserves to be treated not as a customer or as a commodity but as a whole person. Opening up a dialogue between the doctor and the patient, rather than a survey, is what makes the real difference.

 

References

Ashworth M, White P, Jongsma H, Schofield P, Armstrong D. Antibiotic prescribing and patient satisfaction in primary care in England: cross-sectional analysis of national patient survey data and prescribing data. Br J Gen Pract. 2015 Dec 6. https://doi.org/10.3399/bjgp15X688105

Calls for NHS to curb inappropriate antibiotic prescribing. (2015). National Institute for Health and Care Excellence. https://www.nice.org.uk/news/article/calls-for-nhs-to-curb-inappropriate-antibiotic-prescribing

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