At one time, patients decided whether their problem was worth a visit to the doctor.
Patients were welcomed. Minor concerns gave providers a chance to relax in an otherwise stressful day.
But, attitudes change.
Instead of welcoming all patients & all complaints, nurses and doctors get taught to judge whether patient complaints are deserving.
They learn that caring for patients with problems unsuited to their highly specialized skills should be done by someone else.
Anyone else.
Over time, providers develop strong opinions about who really needs their care.
Only the truly sick patients ‘deserve’ to be in the ED….except the very sickest of all….dying patients. They shouldn’t have come to the ED in the first place.
Here are some of the flags nurses and doctors use to identify undeserving patients.
Undeserving patients –
1. Seek help for minor complaints that should have been handled at home.
2. Take poor care of themselves.
3. Attend the ED/clinic out of convenience.
4. Demand repeat investigations.
5. Should be seen by their family doc, or public health nurse, or not at all.
Otherwise really nice nurses and doctors adopt these attitudes. They reason it’s all part of being a good steward of public funds and common sense. They confuse a reasonable expectation to educate patients about options to access care – best done at discharge – with turning patients away.
“Let’s face it: most patients don’t need to be seen.”
‘Undeserving’ patients don’t get great care. EVER.
We need a new attitude.
We need –
to always let patients define whether their concern is legitimate.
to welcome all patients no matter how ‘minor’ their complaint.
to treat all patients as privileged – like family.
Nothing less than a new attitude, ideal and service standard will do.
If we want to change the way patients access care, we need to provide attractive options for patients. We cannot provide few, inconvenient options for access and then train providers to hold a ‘send them away’ attitude. This never promotes great service or care.
Changing minds will require changing incentives in our present system. We need redesign at the highest level. In the meantime, how are you going to change attitudes in your ED or clinic?