How Patients See Quality In Health Care
Posted by Mitch Mitchell on Mar 30, 2011
Within the health care industry, lately there's been more talk about quality. Most of the talk involves things such as clinical efficiency, getting people out of the hospital faster, and lowering the costs of care. Only on that last one do patients seem to agree. I've talked to a lot of them over the years, and I've come to the conclusion that there's a great divide between patients and health care professionals, whether they be in the hospital, physicians office, or elsewhere.
You want to start with quality, talk about what people see when they walk into either a hospital or physicians office. They expect clean and we give them clean. What we don't give them is an experience. You walk into a physicians office and you see chairs and a front desk to sign in. Processes are neat and sterile, but not comforting. Same with hospitals, but scarier, as more and more hospitals have stepped up security to the point that patients are wondering if they're going to get a pat down before they have any services performed.
Next, let's talk about the patient's experience. Because I've lost any fear of physicians over the years, I will engage my physician in conversation and I always get it back. Most people don't do that, and thus the physician will say his or her piece then leave, and many times patients leave confused and still scared. The same goes for having procedures done in a hospital; people tell them what to do and what they're going to do, but almost never the reason why, and just as rare no assurances. True, you can't go around telling people things that aren't true, but the whole process is cold and clinical once again; it may be quality in the medical sense, but it's not quality in a patient sense.
Let's talk about the cost of health care and the perception of quality. Medical professionals and patients see costs differently, even if they agree on the initial concept. Hospitals and physicians want to contain costs to help the profit line. Patients want costs, aka prices, to be lower so they can afford to pay for health care. Medical professionals see new technology and pharmaceuticals as a great path towards better health care; patients see it as costing them more. Whereas the perception of quality by patients used to be "if it costs more it should work better", these days it's changed to "if it's better technology it should be able to do it better for less money."
In my opinion, if physicians and hospital executives really want to work on quality initiatives, they need to bring in a few volunteer patients or potential patients and get their opinions as well. Just like I believe if one is going to implement big changes they need to talk to the people expected to do the work, I believe if one is going to try to tackle quality then those that will be most affected by the change need to have a say in it as well.
You wish for a perfect health system, even though there’s one truth behind it. The truth is that the most fundamental a service is, the more people will complain about it, always. It’s like with police, there’s a fundamental need for it and people feel right to complain about it all the time, no matter what.
Healthcare is something so completely fundamental in our society we demand it to be absolutely perfect 100% of the times, which is in my opinion kind of an utopia. I do agree, though, that patients definitely need to have a say on that, and hospitals should probably be a bit more comforting and less sterile in their approach to them.
Gabriele, no hospital, physician or other health care entity will ever be perfect, so from the get-go all you can hope for is very good. But health care professionals and patients often have a different view as to what very good means. I’m thinking that there needs to be these conversations between the two, whether to get it right or at least get a better understanding of each other.