Episode 155

I loved this. I have felt this way for years. early in my career as an Attending in a non academic hospital I received a very low Press gainey from a morbidly obese woman who frequented our ED w c/o BL knee pain which was from OA. I had after about the third visit from this woman, in the most careful and compassionate way I could, suggested she consider a weight loss program, perhaps w guidance of her PCP, as being over 300 pounds was worsening her OA sx and she would greatly benefit from being a healthier weight. While my ED director sympathized w my opinion, the bottom line was I was encouraged to not let it happen again. Had I simply offered her a cheeseburger from our Caf with her NSAIDS I would have probably received a high Press Gainey score. I know Greg Henry has used Disney World as an example of how good customer service can be applied to a business. Unfortunately ED's should not be compared w Disney World. In my particular case Disney world would sell this obese woman more crap fast food and offer her a cart to take the excess weight off her joints so she can whisk around their park, maybe even reward her poor dietary choices with a shorter line for "handicapped/disabled....as docs we should not be so accommodating, even if it upsets her, we really should tell her she needs to lose weight. We aren't selling burgers or amusement rides, we are SUPPOSED to be educating our patients sometimes with info it is unpleasant for them to hear.

Stop it!!!!! You make way too much sense. Apparently, we are no longer about healing but about the scores. About 12 years ago, I had one of my biggest victories in medicine when a pt. of mine, who was hospitalized on a monthly basis, and I had a long talk and she underwent bariatric surgery. She lost 200 lbs and was never admitted to the hospital again until I moved in 2010.

I love how in Australia I don't have any Press Gainey score, and when complaints are made it gets reviewed by other Emergency Physicians so a complaint about being told to lose weight would get appropriately filed and no negative implications.

pt sat scores are well-intentioned, but unfortunately have been bureaucratically metamorphisized into another failed policy designed to promote selfish academic nonsense, and decline reimbursement. this is not unlike mandating EHR without good EHR hardware options. sad.