Sunday, August 19, 2012

The Customer Is Always Right

You may have met him. I like to call him Dr.Patient Pleaser.  In fact, who knows, he may even be your doctor.  He is quite an agreeable chap.  Most requests are answered with an affirmative without giving it much thought.

If Dr. Pleaser knows the most current guidelines, he certainly doesn't show it.  His guidelines are based on patient preference. They line up day and night to fill every spot in his schedule.  They walk in with reams of papers copied from the Internet, or their brother in laws advice to start an antibiotic right away.

He thinks of his patients as customers. 

The customer is always right!

His clients love him.  They greedily gobble down scripts for antibiotics.  They rush to the hospital to get the stat cat scan.  They chase down every incidentaloma.  Ravenously pursuing each new test and biopsy until they are emotionally exhausted and their insurance company bankrupt. And when the workup finally comes back negative, they rejoice and sing the praises of their brave and insightful doctor.

Don't forget the drug seekers.  They all have his office speed dialed into their phones.  Maybe they have his private mobile number.  The hypochondriacs too.

It's not clear why Dr. Pleaser does it.  Certainly he has no problem paying the bills.  But it's deeper than that.  He doesn't want to be disagreeable.  He avoids confrontation because it's difficult.  For instance, he never tells a patient that they are dying. Better, he thinks, to create hope-even if it's false. 

He's just as destructive as our PR Problem or the Administrator.

But unlike those other villains,

he has the full support of the American Public.

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