Dear health care industry:
I think we have a serious problem, and I think we both deserve some of the blame. Over the last couple of decades, I the patient have been demanding many things of you: reduced wait times, increased access to medications and procedures, more luxurious and colorful accommodations, and numerous scheduling conveniences among other things.
Meanwhile, I have watched as an industry long-based on the revered call of service slowly turning into a capitalistic venture that seems more about capturing patient volumes and generating revenue than truly meeting patient needs.
I continue to hear the news about increased physician shortages and burnout due to excessive demands and misguided focus. Yet, I the patient continue to be more unhealthy and often demand that you make up for my poor lifestyle and unstable circumstances in ways that require minimal effort on my part. I am slowly realizing that in giving into my wants, my needs are not being met the way they should be.
So, I propose the following treatise:
What I want are health care providers at my beck and call; what I need are physicians I know and trust who live what they preach. OK, so I admit it. I want to you to be available as much as possible. Whether it is having later hours or working on the weekends, or taking call at all times, I want to have access to you at any time that I have a concern. And if you won’t make yourselves available, I admit that I will threaten to take my business elsewhere to a place that is more convenient for me.
But now I am concerned that my demands are interfering with my progress. The more people I see, the less I trust them or their credentials, and you and I both know that if I the patient don’t trust and respect you, the chances of me following through on your recommendations is compromised. It’s one big reason why 1 in 3 us don’t fill first-time prescriptions. Just as bad, I am now worrying that my demands are putting a strain on your work-life balance that we all know is critical to health and happiness. Even though I want you available at all times, I need you to live a healthy life and take care of your family so that when you are with me, I can believe that your advice reflects how you live and that your mind is truly in the right place.
What I want are quick fix solutions that make me happy; what I need are courageous providers who do what is best for me in the long-term. So, here is the problem. I feel really stressed. If it isn’t my kid causing problems at school or my mother complaining of constant pain, it is those daily crises that cause me to feel depressed. I just want a medication that can help my kid focus better and help me feel a little happier. And I want it now. If I don’t get it, I am either going to start crying in your office or find me another physician.
Deep down, though, I have a sense that maybe this isn’t the best way. I know that my unhealthy lifestyle is a problem. I know that I could work less if I was willing to do without a few of my extras. And I know that changes such as these could help me be happier. So, there is a part of me that wishes that you would ask the hard questions and follow up with discussions that I know are most important so that I would consider making changes that could improve things for the long-term. There may be times that my desire for the quick fix is warranted. But I must admit. What I really need is a physician who builds his or her practice around the call to do what it is right for me, the patient, even if the volumes and the financials must remain modest.
What I want are plush maternity wards, technologically-wired waiting rooms, and a trendy café; what I need is a clean, pleasant atmosphere and money spent where it most matters. Have you ever been in a hospital room that looks like a hotel? Satellite television, space galore, unlimited menu, plush mattress, and a Pottery Barn décor. It is pretty sweet. If I am going to be in the hospital, or go in for an outpatient appointment, I want to be indulged. I mean, as the patient, don’t I deserve this at least? Right?
But then I wonder. Where does this money come from to create and maintain this lavish atmosphere? I worry that just like those professionals who are losing out to technology and administrative costs, it seems the highly-qualified providers are pressed to do more with less so that the hospital budget can stay in the black. The money has to come from somewhere, and maybe that somewhere also ends up being my bill. Although all these perks are nice, what I need the most is a clean, affordable, pleasant, cheery place where expenses are focused most on the care that I need and less on the extras that I want.
What I want are promises and presentations that make me feel good; what I need most are highly-qualified providers who treat me as an individual in need of holistic care. So, I must admit something. I am easily swayed by sappy commercials and trendy billboards. Titles impress me, and well-known hospital names convince me that whatever I get there will be good.
But I have discovered a dark secret. Many hospitals and clinics have figured out that they can fill positions with less-qualified personnel who don’t meet my needs as they should. Some of these people lack even a simple bedside manner or basic skills, but many of them seem to be taking on responsibilities that are truly outside their scope of practice or expertise. Meanwhile, the hospitals keep advertising that they are ranked number one in the area in this, and number four in the area in this. It seems that everyone is more focused on bragging about the accolades they are given instead of recruiting and keeping the professionals that I truly need. What I want are for hospitals to keep advertising reassurance; what I need are hospitals to allocate much of their advertising to providing for my holistic care.
Ultimately, what I want is you to meet all my demands; what I need is for us to work together, so my true needs are met. OK, so I am about done. I guess in some ways, it comes down to this. I want you to meet my demands in the way I want you to meet them. I have been on the Internet. I have talked to people. I know what I want, so if you would comply, it would help us both.
On second thought, though, maybe what I want is not what I need. In my distress, in my discomfort, I might be short-sighted, and I might be unwilling or unable to consider what lies further in the future. If that is true, then what I really need is for us to work together closely. I need you to expect that I make changes of my own before giving into my wants, if that is what is best for me. And I need you to not be afraid that I will go elsewhere or give you bad ratings, even though I know that others are tracking this closely. In the end, I guess what I need most is an expert provider with integrity, courage, empathy, and a deep call to service, who is first and foremost guided by doing what is right for me, the patient, even if the outcomes and income is not always stellar. Despite my wants, I do believe that if my needs are met in this way, I the patient, and you the physician, will learn to thrive again together even during these uncertain times.
Thank you for your consideration.
Jim Schroeder is a pediatric psychologist.
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