Doctoring Reflection

Friday Reflections: Patient Satisfaction?

Recently, while writing a note on a hospital chart, I overheard a patient and their family scolding the nursing staff. Inflammation always peaks my interest. Somehow, it soothes me when I’m not involved.

After the ruckus calmed, I asked the nurse what all that was about.

Oh, Dr Mandrola, this patient is so hard to please; the food isn’t good, we aren’t fast enough answering the call bell, and the doctor didn’t stay long enough.”

The nurse was distraught that they were upset.

(Later, in the course of this patient’s hospital stay, I was asked to look at a rhythm strip, and thus, learned more about what happened.)

It turns out that the dissatisfied patient ‘enjoyed’ life-saving treatment skillfully administered in the wee hours of the morning. If not for the skill and dedication of the health care team involved this patient would have died. What’s more, as an insider, I know the caregivers involved in this case are knowledgeable, generous and of the utmost conscientiousness. They could (and hopefully would) take care of me or my family.

Unfortunately, as CMS finalizes a plan to tie hospital reimbursement to patient satisfaction, stories like this one create even more angst for hospitals. Suddenly, this patient’s life-saving and compassionate care becomes less valuable–but surely not less costly to administer.


Though improving patient-satisfaction is a well-meaning endeavor, it’s inherit unfairness is inflammatory–and thus bad for the heart. Not to mention the obvious: it’s a really dumb idea. Do you want your hospital spending money on its food and lobby? Or, should their your priority be that they buy me the latest mapping system so I can ablate your heart more safely?

I am not suggesting that patients shouldn’t take an active role in their care. By all means, know your disease, question the diagnosis, understand your medicine, and even seek more opinions. But drilling-out the medical staff, or dissing the hospital on a survey because it’s not the Four Seasons is a bad idea.

I’ve been a patient. I don’t expect hospital food to be scrumptious. I know that nurses take care of many patients, have documents to fill out and yesterday’s patients to call and check on. When I was ready for discharge in the morning and the doctor didn’t come until the afternoon, I didn’t hold it against him. That’s because he, like all who toil in the medical field are only human, and thus far, cannot be cloned for the purposes of being in three places simultaneously.

The coolest aspect of modern-day medicine remains the fact that all this ‘fury’ is ultimately delivered by fellow mankind–imperfect and limited as we are.

My advice to patients disgruntled by the little things is the same as my beloved grandmother repeatedly gave me, “you catch more flies with honey than vinegar.”

You might need that nurse, doctor or hospital again.