Why should practicing medicine be compared to any other occupation?

A while ago, Atul Gawande, the noted surgeon-author, wrote a long piece in the New Yorker on why health care should look to a restaurant called the Cheesecake Factory for some guidance on how to standardize things.

This was met with some derision by a number of physicians who pointed out, among other things, that the food at the Cheesecake Factory is not great and is loaded with calories. But I guess it’s at least it’s “standardized” mediocre and unhealthy food.

Then a doctor named Peter Ubel wrote in Forbes that doctors should take a cue from Starbucks about how to deal with people. He went so far as to say that baristas have more emotional intelligence than physicians.

He says the Starbucks staff are trained to placate angry customers using the mnemonic “LATTE,” which stands for “Listen to the customer, Acknowledge their complaint, Take action by solving the problem, Thank them, and then Explain why the problem occurred.”

I have never worked at Starbucks, but when I was a surgical chairman, I unknowingly used most of their principles in dealing with patient complaints about my attending and resident staffs. I could add another. I used to ask the dissatisfied patients and families “What can I do to make you happy?”

I was surprised that in many cases, the complainants could not think of a single thing that would make them happy. The question often completely diffused the confrontational nature of the encounter. You might want to try it sometime.

Another way of looking at this issue was suggested by a Twitter colleague, Dr. Edward J. Schloss, who tweeted that we work for the government, and we should be compared to the Bureau of Motor Vehicles or the post office, not Starbucks.

Since doctors are already notorious for making people wait, comparisons to the BMV would seem appropriate. And some docs also take forever to return phone calls, similar to the post office’s habit of delaying the mail.

Surely physicians look better when compared to another government agency, the Internal Revenue Service, especially now that the IRS has been accused of selectively harassing certain political groups and spend lavish amounts of money on conferences.

At least no one has suggested comparing us to pilots lately.

Why should practicing medicine be compared to any other occupation?

Doctors are unique. None of us is perfect, but despite the occasional bad apple, most of us are doing the best we can for our patients under difficult circumstances.

“Skeptical Scalpel” is a surgeon blogs at his self-titled site, Skeptical Scalpel.

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