Why is there so much hostility toward the patient experience?

by Dr. Trina E. Dorrah

Whenever I talk about the patient experience, I notice a general hostility from my colleagues toward the subject. Recently, since I’ve started blogging about the patient experience, the angry opinions have become even more noticeable. The other day, I was discussing the different comments I’ve received from my blog posts with my friend, who is also a physician. He noted that he understood the hostility, because that is also how he feels. He asked me why he should have to change his practice to pander to the ridiculous whims of patients?

That got me thinking. I asked him if he thought it was OK for doctors to explain a diagnosis or treatment plan to a patient without using medical lingo? After all, how many patients can be expected to know what metabolic acidosis is? I then asked him if he thought it was fine for doctors to give patients the results of their procedure in the recovery room while they are still altered from the drugs used for sedation? I chose these two examples because they are both things I have seen providers do throughout my career as a doctor. In both instances, my friend answered no. He said of course doctors should explain things in ways patients can understand, and of course doctors should treat patients with courtesy and respect by discussing test results when their patients are coherent.

Interesting. I didn’t tell him this, but guess what? He just advocated for providing a good patient experience. Given that most physicians feel as he does, why have we turned the conversation about the patient experience from providing thoughtful care for our patients to catering to their unreasonable demands? When I hear this, I always ask, “What is so unreasonable about wanting to understand what your doctor is saying?” “What is so unreasonable about wanting to know your test results?” In fact, when we all eventually become patients, we will all want to know these same things.

I think the issue is that instead of focusing on what it truly means to have a good patient experience, we’ve allowed ourselves to be swayed by people who equate the patient experience with patient dictatorship. In reality, the two were never meant to be the same thing. I agree that we should advocate against any movement whose goal is to create a culture where the patient is always right. As physicians, we know that simply is not in the best interest of our patients. In fact, if patients truly understood how dangerous the patient is always right mantra is to their health, they would abandon it. Thus, instead of trying to discredit the patient experience, I would challenge us as health care professionals to return the patient experience movement back to what it was intended to be. It was never supposed to be about patients threatening doctors or making unreasonable demands. Nor was it ever intended to be about doctors prescribing unnecessary medications, tests, or treatments.

The patient experience movement was and still should be about showing kindness, empathy, respect, listening, explaining, and doing what’s in the best interest of our patients. As health care providers, we need to reeducate our patients, administrators, and the general public on what providing a good patient experience is truly about. The public needs to know it is not about the patient always being right. It is not about making doctors feel as if their jobs or salaries are on the line unless their survey scores are always high, regardless of the possible unintended consequences. Both of these positions take away from what focusing on the patient experience is truly about – empowering doctors to work collaboratively with their patients to do what is right for the patient each and every time.

We all went into medicine to help our patients, and focusing on the patient experience does exactly that. In the end, it’s not the patient experience that’s the problem…it’s the way in which it’s often interpreted and implemented. The next time you hear your colleague mention the patient experience, instead of showering him or her with cynicism, remember what it’s truly about. When doctors are able to collaborate with patients to do what’s right for the patient, the patient experience flourishes. Who can argue with that?

Dr. Trina E. Dorrah (@drtrinadorrah) is an internal medicine physician/hospitalist and the author of Physician's Guide to Surviving CGCAHPS & HCAHPS. She can be reached through www.drtrinadorrah.com.