Patients are more frequently being referred to as “customers” by medical providers as the U.S. healthcare system undergoes a massive redesign that includes an increased focus on consumer experience. But use of the term customer is being questioned by some physicians who note that in the consumer world, “the customer is always right.” It doesn't work that way in healthcare, they say.
Though critics agree medicine is a service industry—and, therefore, satisfaction and experience should remain in the forefront—they also note that patients are not customers in the traditional sense of the word.
“It implies that this is like buying a wastebasket at Target. But it's much more than that. What is coming out of the experience can be a matter of life or death,” said Dr. Patricia Gabow, a former Denver Health CEO who led successful performance improvement efforts there. Caring for people is a partnership between the provider, the patient and the family, she says, “so, right away it's not a customer relationship.”
Others say focusing too narrowly on whether a patient is happy can also lead to potential harms. The role of a physician is to make appropriate medical decisions, and sometimes those decisions conflict with patient requests, said a New England pediatrician who blogs under the pseudonym Dr. Russell Saunders.
It's not uncommon for people to ask for medications, expensive or invasive tests and other care they don't ultimately need. Acquiescing to those demands can put patients at risk for unnecessary harm, Saunders said. “When the primary focus is customer satisfaction, you may overlook the fact that sometimes appropriate medical care can mean the patient will leave unhappy with the decision.”
The focus on patient experience continues to increase as the healthcare industry faces government surveys, such as the CMS' HCAHPS, which links poor patient satisfaction results to financial penalties. Providers also are subject to public-facing online reviews and the watchful eyes of consumer groups. Some are turning to the hospitality industry for improvement tips, and more hospitals and health systems are bringing in chief experience officers to address the concerns that drive negative experiences and outcomes.
Whether they are called patients, consumers, partners or clients may really just be a matter of semantics, said Lisa Suennen, managing partner at Venture Valkyrie Consulting, a firm providing advisory services to those in the healthcare field. She, Saunders and Gabow all agree the true focus should be on providing optimal patient-centered care.
“It doesn't mean patients have to be right with respect to the science, it means they have to be treated as a human being, and feel like they've had a respectful, personalized experience that is convenient and financially reasonable,” she said. “I just can't imagine why anybody should disagree with that.”