The customer is always right!
What do they teach you in the service sector?
The customer is always right! I totally agree to be frank.
This letter to the ST forum illustrates this very well.
And this reply from KKH reinforces my view.
I'll summarize the case in question. Customer goes to see the doctor and expects to have an ultrasound scan for her problem. The doctor says she doesn't need one. The customer insists she wants one. So the doctor reluctantly performs the scan and tells her beforehand that it would be normal anyway. But it turns out it is NOT normal. the customer is admitted to hospital and has an emergency operation that very night! Sounds scary eh?
Put it this way, an ultrasound scan is totally harmless. It has no side effects whatsoever. The customer wanted it. So why not serve the customer?
Ok so some doctors out there would say, most likely the scan would be normal. Well 9 times out of 10 you would be right, but then you can't be 100% correct all the time either. So why not just accede to the request, please the customer and make sure everything is alright? Or in this case, pick up something much less common but still nonetheless a dangerous pitfall?
The communication could have been indeed better. The customer SHOULD GET what they request for. But of course you are welcome as a professional to give an opinion of what the test is likely to show or not show. But nonetheless, why deny the patient?
I can only think of ONE reason. MONEY.
People don't realise that at the government hospital A&E's you pay a flat rate for all consults, test and medications given at that visit. Hence you don't earn more for ordering that scan or an extra test of any kind.
In the private sector, the customer is king. Whatever you want, we'll do it especially so if the procedure is totally harmless with no side effects! I am sure the guys at Mt E or Mt A or Gleneagles must be laughing when they read this letter!
In today's day and age....the customer is KING and IS always right. I pity the doctors working in the government sector though. They are schizophrenic.
One moment they are told that they have to keep costs low for the customers. Save on health care costs for the country. But at the same time, keep service standards world class. That's like saying you make sure customers don't buy those Bang & Oloufsen TVs but instead go for the Akira, Nachus or Prima brands? What kind of business is that? I can't imagine a professional TV expert telling his customer "You don't need a Bang & Oloufsen!"
Of course in this case it is a bit different. But then we are all taught in medical school the ICE of consults. The customer's Ideas, their Concerns, and their Expectations.
This can be applied to any service transaction don't you think?
When a customer wants something just give it to them.
On the other hand, customers should also be aware that SOMEONE has to PAY for what you want at the end of the day. It is better if it's you but if not then someone has to do it for you.
posted by Dr Oz bloke @ 6:50 PM
4 Comments:
Hi DrOz,
In private practice, if the patient insists ( or even suggests firmly) on an investigation, we usually accede to the request (if the test is not harmful).
After all, the patient pays for it.
However in the case of a subsidized clinical setting, I fully understand why the doctor has to prioritise according to who really need the test.
Just imagine, everyone walking to Singapore Gen. Hospital (govt hospital) and demanding a PET Scan ( which costs upwards of US$2000).
The line has to be drawn and decisions has to be made.
Unfortunately sometimes the patient's hunches are right and doctors do miss diagnoses.
That's life.
Dr.Huang
If one miss in diagnosis is non-lethal and not life threatening, well it may be OK. What if that miss pull the patient's life in danger? What will be the cost that will represent the life of this patient?
Do we play Russian's roulette with another person's life? It is up to the doctors to decide: to cut cost or save life.
A death affects the patient's immediate family the most. Will this death affects the doctor who did not diagnose the patient properly?
concerned person
Hi Dr Huang and concerned person.
Both of you are correct.
The question is what is the job of a doctor? In the eyes of people, it is to save lives and relieve suffering. It's certainly not about cost control.
But the reality is that in the public sector, cost control is part of the job.
And who are the bosses of doctors in the public sector? The bosses should be the ones to explain to the people.
What happens is that the bosses hide behind the doctors and leave the doctors to look like the bad guys. Stupid enough the doctors play along and agree to be the scapegoats.
Of course a doctor's patient's death affects the doctor too. I certainly don't believe that the majority of doctors don't care about human lives.
Most of us do. We are emphatic people and we do care for our fellow man. On the other hand as doctors we also understand that we have a role to play to help in controlling cost. Like Dr Huang says, if we were to practise defensive medicine, the cost to the nation would be very high. But do people appreciate this effort?
The answer is AN OBVIOUS NO!
So the question then is why should we continue to do this when the decision was not really ours and the bosses would not be honest enough to come out and educate people.
I just had a gathering with my clinical groupmates. They are all in institutional practice. They all lament that the hospital admin and MOH still tries its best to avoid acknowledging that if you are in C class you will have to accept a difference in the quality of medical care.
Of course the medicines may be the same. But medical care is not just about drugs and medical equipment and doctors. The state of the ward where you recover in is also part of it.
MOH should be more consistent and bold and tell people that you get what you pay for.
My friend like to ask patients who complain this : "What is the basic mode of public transport in Singapore?"
"Bus?"
"Correct! And subsidized clinic/ward is like bus! We are not taxi. Can you understand that?"
Found that rather funny.
Happy New Year to all!
Hi there,
I just discovered your blog from a link from Mr Wang-Says-So. Interesting.
A few years ago, i was working in a restructured hospital. I was scarred for life. It was stiffling.
Prior to that, i was with the private sector.
I came to the conclusion that either you are made for the private sector or you're not. They are a world of a difference.
FrauP.
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