"When Doctors Tell Patients What They Don't Want to Hear"
Though the scene marks a bad day for Mindy, I think it also heralds what could turn out to be a bad era for American medicine. Beyond the comedic exaggerations lies an age-old tension: Will our patients still like us if we tell them things they don’t want to hear? The challenge of communicating unpleasant, possibly profoundly upsetting information to patients is timeless. What has changed, however, is that physicians are now being judged, and compensated, based upon their ability to do it....
Second opinion? Okay, you're ugly, too.
Consider, for example, a recent study among patients with chronic kidney disease: the more knowledge patients had about their illness, the less satisfied they were with their doctors’ communication. Another study’s title asks, “How does feeling informed relate to being informed?” The answer: it doesn’t. The investigators surveyed over twenty-five hundred patients about decisions they had made in the previous two years, and found no over-all relationship between how informed patients felt and what they actually knew. ...
But do higher scores on a satisfaction survey translate into better health? So far, the answer seems to be no. A recent study examined patient satisfaction among more than fifty thousand patients over a seven-year period, and two findings were notable. The first was that the most satisfied patients incurred the highest costs. The second was that the most satisfied patients had the highest rates of mortality. While with studies like this one it is always critical to remember that correlation does not equal causation, the data should give us pause. Good medicine, it seems, does not always feel good.
The description of the halo effect and how it influences satisfaction surveys - which is what our students fill out at the end of the semester - was right on.
ReplyDeleteI wonder, is there a training manual that explains how to get high ratings from customers? It might be useful, sadly.
A cable guy came over to pick up a old cable box. He asked if I needed anything else and I told him I did not. He then said, "You'll be getting a survey from my boss. Please let him know if I did a good job. A 9 or 10 out of 10 is considered acceptable. A rating below 9 is not." I've heard this a lot from service workers. How my students would respond to that strategy?
When I worked at Starbucks (during my adjuncting period) we did this too. We were rated on a scale of 1-5 (5 being the best), and anytime we handed out the survey we were instructed to inform customers that anything below a 5 was considered failing by corporate (which it was). It's not good enough to be considered "average," or even "good." It has to be "excellent." Not unlike how many students have been conditioned to believe they need/deserve an A.
DeleteYour cable guy came to pick up your equipment? I have to drop mine off at one their drop-off centers.
ReplyDeleteThat's why he's getting a 10.
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