Doctor-Patient Interactions, not Transactions

Borrowing from business parlance to describe the diverse elements involved in optimum healthcare provision is fraught with peril. We need our own lexicon.

I’ve spent much of March traveling, accounting for my sporadic writing as my hypothalamus shut down after an excess of traversing oceans and continents.

A month sleeping at home and grinding my own coffee beans in the morning has appeal, but there’ll be particular satisfaction in avoiding the misery of airline travel which some time ago passed beyond the ‘benign decay’ part of the deterioration curve and now officially qualifies as truly abysmal.

Returning from California two days ago, we were offered the opportunity of paying a supplemental $136 for 5 extra inches of legroom on a flight from LAX to Detroit. I passed, not even caring to know whether it was $136 each (probably), rather laughing at the absurdity of my 61-inch tall missus needing the extra space anyway. Are we going to be strap-hanging in midair next?

Besides, it was obscure to me how 5 more inches of legroom was going to compensate for the foul air, the hardness of the seat, and lavatories that are surely too small for 30% of the American populace.

I see a certain irony in the frequency with which the airline industry is trotted out as a paragon that those involved in providing healthcare services should model.

The fundamental purpose of the service is hardly comparable, so we need to constrain our tendencies to compare error rates, on-time rates and other facets of services between travel and healthcare. Taken to an end-point the absurdity of the comparison really shows itself:

“For an extra $35 our physicians will warm the diaphragm of their stethoscope before placing it on your chest or abdomen.”
“Doctors wearing ties are available at a $15 surcharge.”
“We’ve been forced to add a $5 supplemental charge per visit to account for increments in our utilities and antiseptic soap bills, as we’re now requiring all our physicians to wash their hands prior to examining you.”

It would be naiveté of the first order to pretend that fiscal and business discipline is not required when the behemoth of American healthcare has an annual operating budget of approximately $1.8 trillion.

Within healthcare, though, we need room for both business transactions and human interactions. Our engagement with patients is a human interaction – our relatively recent tendency to view it in transactional terms has caused us to slide well down a slippery slope to an ugly morass at the bottom, an end that is equally miserable for the patient and the doctor.

Borrowing from business parlance to describe the elements involved in optimum healthcare provision is fraught with peril. We have our own lexicon and need to insist on its usage.

Needing to call our patients “customers” to reinforce our responsibility to treat them considerately is a crock foisted on us by shallow unimaginative thinkers. It’s time to give these dimwits the boot and retake the hill.