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Saturday, March 17, 2012

Customer? Consumer? Patient?

How did you feel about your last hospitalization?

Several years ago, the federal Center for Medicare and Medicaid Services began collecting survey data from patients, and publishing hospital report cards on patient experience.  Moreover, CMS began to tie incentives and penalties to performance, helping to drive patient satisfaction to the top of the priority list for hospital leaders.

How did this all come about?  One source was a 2001 report by the prestigious Institute of Medicine which made a compelling argument for the case that American healthcare fell short of meeting the needs of our citizens.  "Between the care we receive and the care we could receive" the authors wrote, "lies not just a gap...but a chasm."  Among those gaps was insufficient attention to "patient centered care."  Healthcare has spent the last decade - and longer - in an effort to understand what that means, why it is sometimes lacking, and what we can do about it.

Hospitals went through a stage where hotels and restaurants were felt to hold the answer.  According to the "Service Excellence" school of thought, if Ritz Carlton can make every guest feel special, why can't a hospital?  Meetings and posters referred to the "voice of the customer" and "exceeding expectations."  There was some merit to this approach: one way to disrupt entrenched thinking is to go outside one's own walls, and no culture is more insular than that of healthcare.  However.

This approach should have alarmed us on its fundamentals, and has by all accounts led to mixed results at best.   And so, from many quarters - purveyors of survey tools, the hospital industry and academia among others - another framework is emerging.  It is new and it is old and it is about one human being caring for another.  It is about recognizing what it is to treat the ill and injured, and what makes the health professional different from the hotelier.  And that is the solemn responsibility, and the unique honor, to care for those who are suffering.  This is a much higher standard, and one which is more authentic to those who provide, as well as those who receive, hospital care.

"Empathy based care" is a new term for an ancient idea.  More about how empathy is regaining our attention next time.

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