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What if we asked patients what they want?

Jean Paul Brutus, MD
Physician
December 20, 2022
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Historically, the Canadian health care system has decided what should be done for the care of the population.

Who gets care, when and where, what is a priority, what delays are tolerable, and what degree of saturation is acceptable in a Quebec emergency room? This paternalistic approach is obsolete.

A modern service company must be interested in the needs and desires of its clientele.

Other than in the health sector, no other company dares to claim that it knows better than its clients what is good for them.

In over twenty years of medical practice, why have I never seen a survey given to patients about the experience or quality of care they received in a facility?

Why not ask nurses, orderlies, and physicians what they see on the floors and if they have what they need to care for their patients properly?

It is impossible for me to go to a restaurant, hotel, spa, or veterinarian today without being asked if I am satisfied with my experience, to share my suggestions, and to recommend the place to my friends.

The private medical industry is flourishing in Quebec because the public system is failing but also because of its authoritarian, autocratic, and obsolete approach.

The private enterprise is interested in the needs and desires of its clients and employees, without whom it cannot carry out its mission, and seeks to satisfy them. Why does it do this? Because its survival depends on it.

Patients are not very demanding customers, and if our public health care system asked them, here is what they would learn.

The patient experience is more than just receiving medically necessary care. The warmth, empathy, and compassion with which it is delivered also count.

The ease of making an appointment (virtual or in person), communicating, refilling a prescription, or getting care matters more than ever.

Patients want professionals and support staff who have the time to listen to them and show compassion. With a seven-minute consultation, this is unlikely to happen.

Generations come and go, but they are not the same. Boomers have increasing needs because they are getting older and want to stay active. Gen Xers consume health services for themselves, their children, and their aging parents. Millennials (Y) are interested in optimizing their own health and preventing disease. Post millennials (Z) have little need but demand ease of access online.

Patients want a system that adapts to them rather than the other way around and crave flexibility and convenience. Virtual consultations, popular since the pandemic, are appreciated. Flexible hours for non-emergency care are also popular because patients have to work, right?

Patients want to be able to choose their caregivers based on their virtual reputation and the experiences of other patients, available online; services that have been made available by companies like RateMDs, Google, or Facebook rather than by public institutions or hospitals. Today’s credibility is virtual too.

Patients want to be considered partners in the management of their health. The traditional approach of the doctor who knows “best,” doesn’t listen, or even doesn’t care about the patient’s opinion (thank you, Dr. Google) is over. They want to be treated holistically (whole person) and not as a “medical condition” to be fixed. This fragmented approach is a thing of the past.

Patients want access to their records, just as they access their online bank account, and their information be shared confidentially and securely with their other caregivers.

Patients want transparency and professionals who communicate in an understandable way, before, during, and after their consultation or treatment.

Patients want to spend the time they need with their physician and feel that during the interaction, they are important. They want presence.

If the public health care system proves unable or too rigid to adapt to the needs and desires of today’s more discerning consumers, the private sector will continue to do so and expand in Quebec.

Why? Simply because it asks the questions: How can we help you? What has your experience been like with us?

Isn’t it time for the public health care system to do the same?

Jean Paul Brutus is a hand surgeon.

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