I work in an ED that sees 400 patients daily, 24/7/365. Probably 20 a day are narcotics seekers. We detect them and refuse their scams with about 98% success. Out of the 12K patients we see a month, our Press-Ganey scores are typically based on <50 responses returned, or 1/3 of 1%. A common caveat in opinion polling is that the dissatisfied respond at rates 10 to 20 times that of the satisfied. So when we infuriate 600 douchebags a month sponging for narcotics, like ethics, policy, and the law require us to do, what're the chances they're making up a significant percentage, if not the bulk of the responses? If surveys get mailed to 5% of all patients, that means 30 went to drug seekers refused their fix. And we get, once again, fewer than 50 responses/month, going back several years.

This process is as asinine as basing police salaries on the opinions of those they ticket and arrest.

And don't wave the customer service ethos of other professions in our faces. Call me when the government mandates that you have to serve the people in your business that you'd currently throw out the door, and THEN you'll be comparing apples to apples. When was the last time McDonald's was mandated to feed homeless people regardless of ability to pay, and then receive government compensation at 2 cents on the dollar based on how satisfied those who hadn't paid were with the product? (Hint: never. And neither is any other business known to man.) And if they were, they'd be out of business in a week.

So either clue into how retarded that entire idea is, or save your uninformed opinions for a Press Ganey survey, so at least we can properly discount them as such.

A customer in health care requires several items
1. Be given the information they need to make an informed decision. In a professional and respectful way.
2. Be listened to – their concerns and questions answered.
3. Be given what they need to improve their health care situation if medically necessary.
4. Medically necessary = after study what was found to be the underlying medical problem that needs to be addressed.
5. Be treated timely when they arrive and informed that they may be treated out of order of arrival depending on their level of medical need.

What really needs to happen is our health care system revamped. The reason so many people are seen in the ER – is that hospitals “have” to see them wether they can pay or not. Private physicians wont see a patient unless they can pay.

With the possible cuts to the medi-cal and medi-caid programs of the state of CA. This will lead to many people not being seen by private physicians because they will stop taking these kind of patients because they wont even get paid enough to recoop the costs for basic services.

Many Rural hospitals may close their doors, because you cant give from an empty cup. Resources are finite. If the facility isnt even being paid to replace the resources they have to use on these types of patients, they will not have any to use for anyone else.

Essentially – health care for everyone – Obama Care just went down the comode.

There is no quick fix.

Just remember doctors – documentation is your friend, it should be: Dated timed and signed. legible,complete and detailed.

Good Luck – because good doctors are hard to find.

Couple of things to point out. The study states that “”higher satisfaction was associated with less emergency department use but with greater inpatient use, higher overall health care and prescription drug expenditures, and increased mortality.”

The keyword here, boys and girls, is “associated”.
Can you say “asociated”? I knew you could.

In fact, the final paragraph of the study goes so far as to say “These associations warrant cautious interpretation and further evaluation.” But I guess that didn’t help make your point, huh?

Moving on, the study goes on to say “regardless of physician actions, patients may also have fundamental tendencies to be more or less satisfied that are associated with distinct care-seeking patterns.” In other words, the guy who visits the ED 5 times a month, wanting nothing more than attention, may be more likely to score his visit low, regardless of the outcome. Likewise, a patient that sees his doctor once a year, and is in generally good helth, may be more likely to score his visit highly, regardless of the outcome.

With that in mind, let’s take a look at the “associations” this study mentioned again. Higher satisfaction is associated with less ED visits, more inpatient admissions, higher prescription expenditure, and higher mortality. Could it be, perhaps, that people who only go to the doctor when it is important are more likely to be happy with their visit, being as their health is, by association to their frequency of visits, higher? And while they do visit the ED less, and score their visit higher, could it be that they are admitted to inpatient more often because, when they do visit, it turns out to be for something serious that calls for being admitted? And when we admit patients, isn’t it generally because they have a serious issue, one that could, I don’t know, kill them. That would raise their mortality rate, wouldn’t it? And when they are admitted for something serious that could kill them, isn’t their visit, by nature, going to call for more meds, procedures, and stays, which would, maybe, cost more?

Notice I asked a lot of questions, instead of stating facts from mere associations, since that would make me look quite silly. Instead, I would suggest that readers look at the 5th paragraph under the “COmment” section, which states:

“While patient satisfaction correlates with the extent to which physicians fulfill patients’ requests, patient satisfaction can be maintained in the absence of request fulfillment IF PHYSICIANS ADDRESS PATIENT CONCERNS IN A PATIEN-CENTERD WAY.” It goes on to say, “patient-centered communication requires longer visits and may be challenging for many physicians to implement.”

So, this study that you used to make a non-existing claim basically says customer satisfaction is important, but it will take hard work on the part of physicians to make it work.

Don’t worry, though, if your job is too tough for you, there are plenty of other jobs available out there.

RN’s are certainly not in it for the money. I also don’t think the physicians that I work with it are in it for profit. We all work very hard to keep our patients alive and to resolve their critical health issues.

Saw a bumper sticker which stated “Paid to save your ass,not kiss it” – unfortunately, now we are told to do both and the patients and their families know it.