Years ago I was reading HealthLeaders Magazine, where they were talking about all the different things hospitals across the country are trying to do to make the hospital experience better for patients. Some of the things were pretty good while others were more for the benefit of the hospital than the patient, no matter how much some hospitals tried to sugar coat the processes.


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I've been in health care almost 35 years, and I've seen a lot of things. I've talked to a lot of patients and a lot of hospital personnel, including non-managers, directors or administrative staff. I've also talked to a lot of physicians, both in hospitals and those in private practice, in professional and personal settings. I've done a lot of thinking on this subject, and believe I've come up with 5 things that patients really want. Here they are, with a caveat; for some of these there's nothing that can be done.

1. Patients want to know what's going on.

They want to know what's contained in their medical record. They want their physicians to tell them what's wrong with them, no matter how small it might be. They want someone to explain to them why they're having certain tests done, what those tests actually are and what those tests will tell the doctor about their condition. They want to know what information of theirs is shared with other doctors or nurses. Overall, they just want to know why they have to do things they're told they have to do, no matter what.

2. Patients hate having to continuously fill out all this paperwork.

I go through this all the time different physicians groups that are affiliated with each other. Most of them share the same electronic interface and are affiliated with the same hospital. They set up the appointments; they have the same groups doing their billing. Why aren't they sharing my information so I don't have to keep writing out the same information time and time again? Why do I have to keep pulling out my insurance cards for someone to scan when the system already contains all that information? Why is it that when I copy one sheet for all of them that contains the same information they have to have it on their own sheet? And why, when I ask to see the procedure telling them I'm supposed to keep filling this stuff out do they balk instead of just showing me (okay, this last one's for me since I'm in the field)?

Going further, why are there so many forms patients have to fill out for hospitals and physicians? Some of this I know is because both state and federal governments require this information. Medicare's the worst for patients; there are tons of forms they have to have completed at least once a year. You fill out all this paperwork for the government, and for the protection of the hospitals and the physicians, and so hospitals and physicians can get paid and patients can be tracked; who's benefiting more?

3. Patients want extraordinary customer service.

Unlike going to Macy's, no one willingly walks into a hospital or physician's office and asks for care; not even hypochondriacs. No matter what level of care you're getting or from whom, it's stressful. As someone who's had phlebotomists have trouble getting blood out of my hard to find veins, I know this can be quite irritating.


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If a patient is an inpatient, they want to see a nurse on a more regular basis than twice in 8 hours. They don't care that there are other patients, they care that they're stuck in a room and no one is stopping in to check on them. They want to see a physician more than once a day. They want better TV choices or enough outlets so they can plugin their technology and amuse themselves better. They want to have at least a couple of choices in their meals; tasting good would be nice. And, of course, you remember point number one, right?

4. Patients want a better understanding of hospital charges.

Although this is geared mainly towards hospitals, patients have the same issues when they're dealing with physicians or clinics. True, patients are bad at asking what things costs before visiting providers, but it often hurts more when people go to the hospital... though not always.

Iive written a few articles about hospital charges. I've written about what's known as price transparency; what it was, when it's practiced, and the results shown by those facilities that actually gave it a shot. Turns out patients don't really care even when they say they do. It's like not caring about all the intricacies concerning their insurance; they just want to know if what they're about to have done is going to be covered or not and how much they're going to be responsible for out of pocket.

I tend to believe that if patients are told what the costs of services are, estimated of course (since things can, and often do change), and how much insurance is going to cover, and possibly talk about the relationship between what's actually billed, allowances, and actual cash paid, along with charity care options for those that needed it, that it would make more patients understand the process better, or at least feel more comfortable with it all.

This will cost a lot of money to hire and train people to do it right. It'll also take a lot of work figuring all of these things out in advance (unless they have skilled people who understand their charge masters). If a hospital or physician's office really cared about their patients they'd do it. No one likes being caught off guard when a medical bill shows up and the amount they owe is much higher than what they expected, especially if they have insurance coverage.

5. Patients want to know where and who to go to for any questions or concerns they have, and they want it to be easy.

On this front, I know hospitals have tried many things, some that work and some that don't. In the magazine article, there was mention of the CEO of the UCLA Health System who actually makes rounds himself, being a physician, and will drop his card off to many patients telling them they can call him at any time, 24/7, if they have any issue at all with their care. How many hospital CEOs would dare take the time to do this in hospitals larger than 50 beds?

Years ago when I was still working as a hospital employee, we instituted a program where the person who registered a patient for an inpatient stay gave them their card and said that if there were any concerns over financial obligations that they could contact that person at any time. I wanted to extend it to any questions or complaints in general, but I couldn't push that one through. However, at a different hospital I was at we had it set up so that clinical coordinators would try to do all follow up with patients to try to address their concerns. Our issue was that no clinical coordinators worked on the weekends, so there was a deficiency that we continued to miss. Still, we gave it a shot; no one took us up on it.

Patients want a lot of things, hospitals should think about giving more, but there needs to be a balance between want, need and actual use. Every time I meet someone and tell them what I do they start asking me about hospital charges they got on a bill they received. Whenever I ask them if they called to ask any questions, they say no. Whenever I ask if they called to ask how much their services would be almost all of them say no. I also know that many times only physicians will disclose how much procedures will cost, but only if someone needs surgery.

I don't have full answers on how to symbiotically merge both sides on some of these, but I do have recommendations. All someone needs to do is ask. 🙂