This is why patients cannot be customers

The customer is always right, or so the saying goes.

If you have ever worked in retail, you may have been frustrated by buyers who ransack neatly folded tables of sweaters and leave them strewn about like tornado wreckage. If you are in the food industry, you may be annoyed by a diner who complains his soup is too cold even as you see steam rising off the bowl.

It can sometimes be hard to bite your tongue, but you do what you can to make the sale, to get the tip. The customer is always right, not because he is technically correct, but because to call him otherwise would cause you to lose business.

What about health care? Are patients customers too? defines customer as, “A person who purchases goods or services from another; buyer; patron.” Customers are people you serve but more than that they are consumers. Patients consume health care. Literally, they ingest medication, but they also utilize services from lab tests, imaging, consultations to procedures. In the eyes of hospitals, administrators, and even the government, this qualifies them as customers.

This is why patient satisfaction surveys have taken over the health care industry. Patient satisfaction has become a metric for a clinician’s performance and can even affect how a doctor is compensated by his employer and even insurance companies. Like Amazon reviews for books and other goods, a doctor’s visit can be rated good or bad based on how long someone sat in the waiting room or what he thought of the doctor’s bedside manner. The sad truth is this does not necessarily reflect on quality of care.

A study in the British Journal of General Practice showed how patient satisfaction surveys can be skewed. More than 980,000 patients were surveyed across 7,800 practices. Doctors who prescribed more antibiotics were perceived more favorably than family doctors who doled out fewer antibiotics. When you consider U.K.’s National Institute for Health and Care Excellence estimates more than 10 million antibiotic prescriptions are inappropriately prescribed every year (antibiotics do not treat colds and other viral infections), there is a serious disconnect.

That does not mean there is not value to patient satisfaction surveys. Of course, there is. Feedback is important if it is constructive and there may be times when a negative review is exactly what the doctor ordered.

The trouble is many people have a tendency to report only on extremes of experience. When they don’t get what they want or when they have a bad experience, they are more apt to complain. It takes an even higher proportion of positive vibes to encourage someone to take time to fill a survey. Most clinic encounters fall somewhere in between. Without all data points, surveys do not give the full picture. How does this help patients get better care?

What doctors know is that patients are not merely customers. They are people. They are individuals. They make mistakes, like all people do. If the customer is always right, patients cannot be customers when it comes to matters of health. Patients may desire certain things, but it does not mean those wants are necessarily evidence-based or are in line with what constitutes the best care.

Health is our most valuable asset, not comparable to a sweater or a bowl of soup. A patient deserves to be treated not as a customer or as a commodity but as a whole person. Opening up a dialogue between the doctor and the patient, rather than a survey, is what makes the real difference.

Tanya Feke is founder, Diagnosis Life.

Image credit:

View 61 Comments >

Most Popular

Join 150,000+ subscribers

Get the best of KevinMD in your inbox

Sign me up! It's free. 
✓ Join 150,000+ subscribers 
✓ Get KevinMD's 5 most popular stories
Subscribe. It's free.