Why radiology should become more like McDonald’s

For years, I have been progressively beating a louder and louder drum — one where my colleagues know that I liken radiology to McDonald’s.

Most of the bad press out there, it seems to me, has to do with poor customer service. Our health care system is often inefficient, and delivers limited, incomplete care. The root of the problem, in my opinion, is that there aren’t enough doctors or hours in the day and many doctors may not have fully developed “customer service skills.” Doctors tend to be over-worked so that they often can only spend, at best, 15 minutes communicating vital information to each patient.

But when it comes to telling patients about major ailments such as cancer diagnoses, sometimes doctors fail miserably. I think we doctors can do a better job of communicating effectively and empathizing appropriately.

Why does McDonald’s succeed so well for so long? The hamburgers? The french fries? Perhaps. But they also uniformly deliver a product of similar quality with speed and efficiency, no matter where in the world you are. I’m always impressed that I can go into a McDonald’s in Paris, Rome or Chicago and get the same tasting hamburger and fries in about the same amount of time and with a friendly smile from the person handing them to me. Health care should do the same.

Physicians should deliver a product that is safe, clean, and similar with speed and accuracy. As a radiologist, I feel that our product can be delivered in this fashion with relative ease. In my field, turnaround times are key. Accuracy and quality of dictations are close seconds. It seems straight-forward to me, therefore, that my field will be best served if we deliver a product as accurately and rapidly as possible.

What happens then? Is this a money making commentary? No, though following the above recipe should yield more cookies, so to speak. But delivering quality radiology reports, in a timely and efficient manner, can only result in an improvement in health care delivery to patients.

In my radiology group, we pride ourselves on turnaround times of less than two hours for most reports. In this manner, the requesting physician will have the findings of the patient’s study and can quickly take any necessary action for their care. Communicating important, critical findings by calling the physician is also one aspect of customer service that I (and the American College of Radiology) feel is essential to offering and delivering good service.

Overall, good customer service in the medical field comes down to good communication, empathy and understanding. It’s not that difficult. It’s just that very few physicians receive any training in their early years to foster and develop those skills. It’s time that we focus on this aspect of health care delivery for the health and satisfaction of our patients.

Paul Dorio is an interventional radiologist who blogs at his self-titled site, Paul J Dorio, MD.

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  • joe

    Paul:
    I guess I am an old timer here but I miss the older radiologists I used to confer with during radiology rounds. With the computerization of radiology with PACS and the retirement of my older radiology collegues I find the younger radiologists in general less willing to discuss scans with clinicians. If I hear one more smarmy comment of “did you read the scan”, I am going to throwup. Yes, as a matter of fact I did read the scan and I looked at the scan, but I still have a question which is why I am talking with you. Frankly the neuroradiologists at my hospital are well-known for being a$$holes frankly so they don’t have to talk with the cliinicians. I wish some of the radiologists who graduated in the last decade or so would remember they are the consultant for the clinician.

    • http://drpauldorio.com Paul Dorio

      Thanks for the comment, joe. That sentiment is exactly why I try to promote a sense of “hello may i help you” mentality. My customer service commentary is purely about deliverinig a quality product with a smile. (A friend pointed out that other aspects of McDonald’s are not as favorable to use as an example of good quality medical care.)

    • http://fertilityfile.com IVF-MD

      Is it a monopoly there? What about sending your patients to the OTHER radiology group instead?

  • Rob

    I’m all for standardization and everything, but I can tell you that the applicability of the “McDonald’s model” to medicine depends heavily on the specialty. Radiology and pathology might be perfect analogues for McDonald’s service model, but other fields, such as, say pain medicine, are not.

    Doctors (and police officers, and judges, and, in the old days, bankers) differ from other professions in that we have the responsibility to say “no” to our clients, when it is not in their best interest. McDonald’s will gladly serve their big mac to any half-ton behemoth who comes into their store, no questions asked. Imagine what would happen if doctors gave out Oxycontin with fries and a smile just as easily. In fact, we don’t have to imagine: a few years ago, bankers and mortgage lenders decided to adopt the McDonald’s model, and we all know what catastrophe happened next.

    Comparing Radiology with McDonalds may be a fair (and attention-grabbing) comparison, but much would be lost if the rest of medicine adopted such a model.

    • http://drpauldorio.com Paul Dorio

      Of course, which is why, as a radiologist, I only commented upon the service with a smile aspect of radiology/radiologists towards other doctors and patients. It was not meant to be a system comment.

      Thanks for the the input.

  • http://www.pacificpsych.com/ pacificpsych

    McDeath is your model of excellence? You mean that chain that fattened up the populace while killing the rainforest and fostering generations of low paid illiterate workers who can’t even pay their living expenses?

    That’s your model? Why not Google circa 2007, before it started becoming evil? Why not Apple circa 2007, same? Why not strive for a high quality, patient and doctor friendly environment that promotes individualism, collegiality, thinking and empathy?

    I’ll be impressed the day I can stop at any highway stop and get fresh baked hard crust bread. Or the day I can call up a colleague and they’ll have the time, willingness and knowledge to explain things. Like in the old days. When doctors were doctors, not good little admin servants. I still remember when a doctor could sit by the patient’s bed and hold their hand. Now, you’re lucky if the second assistant to the assistant of the doctor’s NP will give you the time of day.

    Yes, let’s dehumanize everything even more. That’s the answer to all our woes.

    • rezmed09

      In areas where the work ethic is flawed, where there is no real capitalism, much can be learned from MacD’s. They do sell unhealthy food, but they also teach efficiency, product quality control – taste, and customer satisfaction. Like it or not, there are valuable lessons to be learned from successful corporations.

      Medicine in the USA is often devoid of efficiency, cost control, customer satisfaction, quality control, and most importantly it is devoid of real meaningful competition. The only similarity we have now with MacDonalds is the reduction of primary care to the burger flippers in corporate medicine.

      • AnnR

        Been to McD’s in Baltimore lately?

        They may try to teach efficiency, product quality control, customer satisfaction, but the help isn’t buying it.

        You’ll get your order when it’s ready so just stand over there and wait….

        • Vox Rusticus

          So if I ask for an MR of the brain and orbits without and with contrast, I might get that, or just as likely something completely different and other?

          McDonalds is an example of how to apply uniform standards of preparing bad food at all hours by low-standard workers who can be trained to operate machines that have been designed for those with no skill. We have an epidemic of obesity, lifelong poor eating habits, diabetes and premature morbidity to show for it.

          Just like McDonalds? No thanks.

  • Alice

    This is thought-provoking on a customer service level. With two children who received radiation for cancer treatment I can share the workers there have been caring (the doctors are batting 50% as far as care , empathy, and information).

    McDonalds…hmmmm……….quick, unhappy workers under strict management serving mostly junk food with a toy……..good marketing to be sure because it is so corporately profitable to a few. Maybe they could give us a geiger meter badge? Ack! In truth watching my daughter drink radiation made my knees weak…every ounce of my mother’s heart wanted to grab her and run away…..and now I live with the regret of knowing I harmed her and the radiation didn’t work.

  • Sandra

    Awesome concept, Dr Dorio. It would be so great if all radiology reports and services could be McDonaldized. Hard to imagine, though, with various vested interests in different geographic locations. I worked in a suburban area where, when a hospital’s radiology group got a new MRI scanner, suddenly all the CT reports started saying “suggest MRI correlation”. Hmm, coincidence? Or were they trying to get the new MRI scanner paid for?

  • Healthcare Observer

    Oh dear – the idea that any complex medical service should be McDonaldized does not inspire confidence. Fast food is a model of fragmentation that has contributed massively to unhealthy eating. Radiology properly belongs in an integrated medical service with multidisciplinary learning, and not driving overdiagnosis in diseases such as cancer.

  • KP Internist

    I do agree that the needs to be more invested in systems development. Much of what makes doctor’s time so limited is that we are asked to do much of the work that doesn’t contribute to patient outcomes. In many places, it is up to the ordering physician to make sure that a patient gets a procedure booked. So, you have to call the schedulers constantly to ensure that you can get them in. You can imagine that there are many pcps calling every day and the backlog grows each day. First, issue is do you have the right number of slots if you have that many request? The second issue is, is the requests appropiate. You should be able to measure and institute the appropiate remedy. If you need a new machine, then you are justified in requesting it. If you need a new radiologist then that is the remedy. If the issue is that your ordering doctors are ordering inappropiately, then you can offer educational opportunities or reports that shows the ordering habits or other similar providers. This level of reporting does allow a corporation like McDonald’s to manage it’s resources. Why is medicine the only industry that doesn’t have this built in?

  • http://www.MDWhistleblower.blogspot.com Michael Kirsch, M.D.

    “Would you like to supersize that CAT scan?

  • zzz05

    Hmm.. either some folks are missing your point, or else it’s first priority to grab the chance to bash MacDonalds (an emotion I can well understand).

    But yeah, it would be nice if there were some basic minimum standards of quality, speed, and efficiency that could be counted on; on the other hand, I would think it would be nice to foster the development of a department where you could also rely on therer being a skilled chef or even just an experienced cook to put together a specific dish to exacting standards, even if conditions were difficult and some ingredients were unavailable (to stretch the metaphor to the breaking point).

  • http://dinosaurmusings.blogspot.com/ #1 Dinosaur

    Oops. I thought you wanted to offer fries with each chest x-ray.

  • http://drpauldorio.com Paul Dorio

    Beautiful comments so far and thanks kevin for putting my post on your site.

    To be clear to all: I ONLY wanted to suggest to radiologists (and maybe pathologists and anyone else in a similar situation professionally) that we should attempt to deliver “SERVICE WITH A SMILE.” There was NO other comparison to McDonald’s that I was trying to make. Perhaps I should have thought a bit more about the particular example I chose!

    But thanks all – your words ring true on all sides!

    • http://www.SynergyWW4Health.com Linda R

      You’re point was pretty clear to me, so I’m puzzled by all the negative comments!!!??? Customer service (including a smile) and quality control (including rapid turn-around) goals would help all concerned!

      • http://drpauldorio.com Paul Dorio

        Thanks, Linda!

  • oopah

    radiologists should occasionally come out of the reading room and speak to the patients, i am aware why you guys wouldn’t( i see 40 pts a day) want to that but it would probably help, especially since radiologists are among the smartest of all physicians, its good for the radiologist to provide some more face time.

    • http://drpauldorio.com Paul Dorio

      Well, not “you guys” of course. But perhaps “those guys.” As a guy who treats ailments, and doesn’t just “view” them, I enjoy my frequent, daily, patient contacts! And the rest of my diagnostic partners are quite good at the “service with a smile” mentality, especially since we push it all day long. But you’re right about face time being important – fits right in here.

      Thanks for the comment!

  • Larry

    The clinic I work at orders as many xrays as possible, particularly on pedis. After 30+yrs in imaging, it is my experience that the more xrays a doc orders, the less capable they are as a clinician.

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