The fate of patient satisfaction

Over coffee each morning, I quickly scan the headlines on my laptop before heading to work. It’s winter in Washington, it’s dark outside, and the medical news headlines are grim.

Healthcare workers are exhausted. Doctors work hard all day and come home to find scathing reviews on online rating sites. Some have their compensation tied to the results of patient surveys. Patients trust Google searches rather than their doctor’s advice. The doctors leave their offices. Should I go too? I could become a dog walker. Dogs cannot write online reviews.

I thought I loved my job, but these daily reminders of how terrible it is to be a doctor make me want to climb back into bed and wait for the sun to come up. “This forced morning person ritual is for the birds anyway,” I thought to myself. Instead, I’ll pour more coffee, turn on my “happy light,” and try to find a reason why I shouldn’t leave today. Yesterday I stayed because I remembered that I get paid to do this.

Today, I don’t leave clinical practice because my patients appreciate what I do.

I know because they told me in person. They say things like, “You saved my life,” when all I did was remove a herniated disc. Others say, “You saved my life,” and they were actually on the verge of death when we met.

Sometimes they are grateful enough to write a note or bring me moose meat, salmon or chocolates. Chocolates are my favorite. I keep a drawer in my office just for warm stuffed animals: notes and gifts from my patients. On top of my desk is a rock engraving that a patient made to show me how much better his hands were working after surgery. When I had a difficult day in the hospital or worked with a more difficult patient in the clinic, I breathe deeply through my nose and flick through some notes. It’s therapeutic.

Of course, I got a negative review, and it stings. I was stunned when someone using a cartoonish pseudonym wrote outrageous comments about me on Google. It probably served me well for googling myself. Egomaniac!

A few years ago I learned that although I thought I was a fairly sensitive doctor, I was 1% less sensitive than necessary. I scored 84% on the key question on my Press-Ganey patient surveys and was expected to score 85%. Anyone in my organization scoring less than 85% had to attend a 3-hour patient experience session. Being obsessed with time, I was outraged to have to devote 3 precious hours to training clearly geared towards those other louts who don’t know how to communicate with their patients.

I went. The doctors leading the session had some clever tricks to get the most out of a patient visit. I made peace with Press-Ganey since he’s not leaving. Looking at the data they collect, my real patients leave great feedback. I have become at least 1% more sensitive.

Today, I’m going to ask my patients if they are happy to have been operated. Most will say, “Yes,” if I do my job well. I will spend time with those who are unsure and listen to their concerns. That’s what I would have liked for Mrs. Cartoon Name if she had come to see me. Often we can resolve simple misunderstandings face to face, like explaining that the term “stroke” is not an accident at all.

Today I will stay.

Barbara Lazio, MDis a neurosurgeon.

This post appeared on Kevin MD.

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