Sunday, April 10, 2011

What is the Number? (MDOD Physician Poll)

One of the easily anticipated consequences of EMTALA + customer satisfaction surveys in the Emergency Department is to create an environment where the patient is always right.

Yes, I meant to say that... for surely they are not customers like a pizza parlor or car dealership has customers.... for those customers can easily go to the next pizza parlor or car lot and have some idea of what a fair price would be and what good service would be.

Now, given that pizzas and cars are too important to be left to the free market, I don't know why pizza parlor operators and car lot owners have not had an EMTALA-like law crammed down their throats, but they haven't... and last time I looked the pizza AND car industries were doing quite well (with the notable exception of GM), and, to boot, most reserve the right to refuse service to anyone.

So here's the question docs.... What percentage of patient complaints should an ER physician get. There has to be a number UNDER which you are not practicing good medicine because you are not saying "NO". I have my own ideas what this number is, but what say you?

The patient is not always right, and we do not have customers.


  1. we might be the only industry that sends customer satisfaction surveys to shoplifters.

  2. in Internship had a patient complain that I was "Smiling" during her "Bi Manual" Exam..
    (Sidebar, has anyone ever found ANYTHING of note by doing one?)and it was a simple case of cultural misunderstanding, She mistaking my Angry-Chimpanzee-showing-teeth-look-of-horror with the UniversalFacial-Expression-of-Friendship...
    So did the rest of my exams with a "Mr Yuck" frown, and got complaints about that too...


  3. And don't even get me on my "Awareness under Anesthesia" Soapbox...
    First of all, 99% of em are totally bogus, just hoping for a quickie settlement..
    The other 1% are idiots who mistake the Post Op recovery room experience with the operating room, honest mistake, I had the same thing happen when I was a kid,
    OK when I was 29, just back from the War, guy bought me a drink at an airport bar(No Homo, I Was in Uniform) and I woke up the next day in a grimy motel room with...
    NEVER MIND, but moral of the story is I didn't run screaming to a Lawyer.
    Cause I'd have had to tell him what that 70 year old Hooker was


  4. I'm wondering if the location of the hospital and/or the type of clientele and insurance would affect the acceptable or optimal complaint level.

  5. dear CardioNP,
    of course not... that would imply a difference in people based on social scale or social position or ethical position, and, as we all know from our dear leader, every one of us is exactly the same.
    drone #4738889abneu

  6. but surely an increase in the crime rate per capita and children born per under(or really non)-achieving baby factory, combined with a proportional fluctuation of people that get their "health insurance" for "free" would obviously breed the type of person that is an expert in medical care. What right does an EMT, paramedic, nurse, or god forbid a doctor have to disagree with these obvious medical experts? Especially the ones that request EMS for chest pain, are transported across town, get wheeled into the ED, and promptly hop off the stretcher, walk out of the hospital, and into the bar across the street. Isn't it obvious that the ride to the hospital combined with an immediate ETOH oral bolus miraculously clear up all but the most minor cases of chest pain? You know, those ones so minor that get rushed into a cath lab to have the pain located, or have the evil medical people pushing on their chest to make the pain worse, and easier to find.