About the same time the country was debating the merits of passing the Affordable Care Act, the movers and shakers in healthcare introduced a new delivery model they hoped would satisfy Washington and make life easier on providers. That model centered on patients, their satisfaction, and their ultimate outcomes. That was over a decade ago. In that time, doctors have been left wondering what the physician’s job is in patient-centered medicine.
A patient-centered approach requires taking a bit more of a business approach to medicine. Patients become paying customers while doctors, advanced practice nurses, etc. become service providers. The patient-centered model is not necessarily good or bad in and of itself. But it does lead to confusion in an industry that has practiced the fee-for-service model for as long as most of us can remember.
Striving to Satisfy Customers
In any other industry, striving to satisfy customers is expected. If you run a restaurant, you want your customers to be happy from the moment they walk in, to the moment they head out. You want them to be happy with everything from the level of service they receive to the quality of the food. You bend over backwards to make sure that this is the case.
Proponents of patient-centered medicine want to see the same thing in healthcare. Granted, they make a compelling case when they discuss the industry’s long history of clinicians dictating to patients as though patients should have no input in their own care. But on the other hand, healthcare deals with lives. What makes patients happy is not always best for their health.
Physicians take an oath when they begin to practice. We know it as the Hippocratic oath. The oath includes a promise to do no harm to any patient, for any reason. How does that oath play into patient-centered medicine? What if a physician’s job rides on making patients happy even though what their employer wants them to do violates the oath to not harm?
When Patients Abuse Clinicians
Physician jobs are hard enough under the best of circumstances. But in the desire to make patients happy, it is possible to make one’s job even worse by encouraging abuse. For the record, no healthcare professional deserves to be abused. There is simply no place for that in civilized society.
Medscape contributor Dr. Jennifer L. Lycette, MD wrote a piece in June 2022 questioning whether it is her job to make patients happy. Much of her piece dealt with an oncology patient and family member who, by her account, spent their entire visit abusing her. It must have been an ugly visit to say the least.
Lycette’s experience raises an interesting question: are there some patients who can never be made happy regardless of what the physician does? Absolutely. It is impossible to make everyone you encounter happy all the time. And that’s not exclusive to healthcare. It is a problem in every industry. It’s a problem in our day-to-day lives. Still, where does that leave physicians?