Skip to main content

Rated Lower On Satisfaction, Hospitals Blame ‘Cranky’ New Yorkers

Say the headlines. Of course the official explanation is “Well, Manhattan residents are crankier, tougher to satisfy and have higher expectations than those ‘nice’ Midwesterners.”

Really? Let’s parse cause and effect here. (Fair warning: I’m not the least bit sympathetic to the official explanation.)

The NY Times’ article offers an anecdote of a NYC patient waiting 8 hours for an imaging exam and not getting a magazine when she asked for one. And she refused to give the hospital a top score because…she’s CRANKY?

Excuse me?

And there’s this: NYU Medical Center is building new elevators to reduce waiting times, though they won’t be ready until a new building opens in 2017. How long has NYU known about their slow elevators? Decades, probably, yet we’re still 5 years and several hundred million dollars away from a solution. And we’re supposed to believe the problem is…CRANKY PATIENTS?

Excuse me?

I’ve worked in markets ranked #183 (Hinsdale, IL), #27 (Omaha, NE) and now #1 (Mason City, IA.) Admittedly 3 markets – two urban, one fairly rural - is not a huge sample size, but the difference in patient satisfaction scores between them is NOT the patients.

Leadership, culture, training, processes, strategy, focus, investments, priorities, - yes.

Patients – no.

The "our patients are crankier..." explanation is just the latest example of the "our patients are sicker..." nonsense used for 40 years by doctors and hospitals to avoid any and all quality comparisons. I don't buy the excuse-making. You, dear healthcare strategist, shouldn’t either.

The problem, IMHO: Too many leaders walking past problems - er, opportunities – without taking direct, remedial action. The symptoms:

• Talking becomes doing.
• Hiring a consultant becomes action.
• Scripting substitutes for conversation.
• “It’s on my list…” passes for progress.
• “I’ve called a meeting…” becomes accomplishment.
• Taking it to committee is a milestone achieved.
• Forming A NEW committee is considered innovation!
• Bulging PowerPoint decks become communication.
• It’s one priority among many…unless budget realities intervene, then it’s not even that.

And of course, whatever we do, we musn’t upset the docs!

Suddenly Medicare changed the grading curve. “Good enough” no longer is. And some leaders, up against the hard realities of lost revenues, must make twenty years of progress in two. Can you spot the problem here? I can and, once again, IT’S NOT THE PATIENTS!

It's time to say to the excuse-makers "Sometimes when the data say you have room to improve...YOU DO! Deal with it!"

Might New Yorkers have good reason to be cranky?

Comments

Popular posts from this blog

Michael Porter On Health Care Reform

Michael Porter, writing in the New England Journal of Medicine, proposes "A Strategy For Health Care Reform - Toward A Value-Based System." His proposals are fundamental, lucid and right-on, meaning they're sure to be opposed by some parties to the debate, the so-called "Yes, but..." crowd. Most important, in my opinion, is this: "... electronic medical records will enable value improvement, but only if they support integrated care and outcome measurement. Simply automating current delivery practices will be a hugely expensive exercise in futility. Among our highest near-term priorities is to finalize and then continuously update health information technology (HIT) standards that include precise data definitions (for diagnoses and treatments, for example), an architecture for aggregating data for each patient over time and across providers, and protocols for seamless communication among systems. "Finally, consumers must become much mor

Being Disrupted Ain't Fun. Deal With It.

Articles about disrupting healthcare, particularly those analogizing, say, Tesla's example with healthcare's current state, are frequently met with a chorus of (paraphrasing here) "Irrelevant! Cars are easy, healthcare is hard." You know, patients and doctors as examples of "information asymmetry" and all that. Well, let me ask you this: assuming you drive a car with a traditional internal combustion engine, how much do you know about the metallurgy in your car's engine block? I'll bet the answer is: virtually nothing. In fact it's probably less than you know about your own body's GI tract. Yet somehow, every day, us (allegedly) ignorant people buy and drive cars without help from a cadre of experts. Most of us do so and live happily ever after (at least until the warranty expires. Warranties...another thing healthcare could learn from Tesla.) Now, us free range dummies - impatient with information asymmetry - are storming healthcare

My Take On Anthem-Cigna, Big Dumb Companies and the Executives Who Run Them

After last Friday's Appeals Court decision, Anthem's hostile takeover of, er, merger with Cigna has but a faint pulse. Good. Unplug the respirator. Cigna's figured it out but Anthem is like that late-late horror show where the corpse refuses to die. Meanwhile, 150 McKinsey consultants are on standby for post-merger "integration" support. I guess "no deal, no paycheck..." is powerfully motivating to keep the patient alive a while longer. In court, Anthem argued that assembling a $54 billion behemoth is a necessary precondition to sparking all manner of wondrous innovations and delivering $2.4 billion in efficiencies. The basic argument appears to be "We need to double in size to grow a brain. And just imagine all those savings translating directly into lower premiums for employers and consumers."  Stop. Read that paragraph again. Ignore the dubious "lower premiums" argument and focus on the deal's savings. $2.4 billion saved