A Model Patient Experience

Added on Jan 24, 2017

By Dr. James Merlino, President and CMO, Strategic Consulting Division

By Dr. James Merlino, President and CMO, Strategic Consulting Division

136_emergencyMy wife and I recently needed to take the newest member of our family to the hospital. At 11 months old, it was his—and our—first brush with a family illness requiring a late-night visit to the emergency room. He clearly had not been feeling well, was a little lethargic, and started vomiting. In non-medical parlance, he looked punky.

We had weathered his sickness most of the day, but now our wait-and-see-approach was coming back to haunt us, not only because it was late at night but because we feared we pushed the self-management too far and he was getting much worse. Being a two-surgeon household, we thought we could handle it but when the little guy started retching and was unable to keep things down, we knew the problem was above our license level and we needed the help of a professional. 

We arrived at the busy emergency department and were met with a friendly receptionist who carefully listened to our story, recorded all of our information, and provided compassionate and empathetic conversation. She told us the triage person would be out in about 10 minutes to see us, but before we were even able to sit down, we were directed into to a triage room. The nurse listened to the history, empathized with us and took great pains to connect with the patient in a friendly manner. 

My wife and I were more than a little worried, but we found great comfort in the attention and care that we were receiving. After a short wait, the doctor knocked on the door and came in. She introduced herself, addressed our little guy—in a warm and friendly manner—and then turned her attention to us. First she apologized for the wait (I was thinking, What wait?), and then she said that while she had all of the information from her triage partner, she just “wanted to get the whole story herself so that she completely understands what is going on.” Another star point as far as we were concerned. How many times do patients complain about being asked the same questions over and over again with no real explanation of why?

The doctor did her exam, ordered some lab work and took some x-rays. Finally, differential diagnosis time. The verdict was severe enteritis or the possibility of a foreign body obstruction. Jumping the story ahead, the final diagnosis turned out to be enteritis, not obstruction, and with an overnight admission, intravenous fluids and a little caring, our little guy was eating again and resting comfortably at home.

We didn’t really know what to expect when our new puppy, Einstein, became ill. But fortunately this team of animal caregivers gave two helicopter pet parents an experience that made us come away recognizing that they were likely delivering more compassionate, connected care than many of our colleagues in medicine, and we wondered why. Was it their training? Are the incentives more tightly aligned in veterinary medicine? Is this a function of real competition in veterinarian medicine, or does veterinarian care attract a different kind of caregiver that is more attuned to the needs of his or her patients and their families? 

As a surgeon and an executive, I am envious of this experience and I have learned that we can and should extract value from other industries. There were four important elements that stood out and should serve as a standard for any care environment:

  1. Compassion and Empathy From the moment we walked in, everyone was concerned, did things to engage the patient and us, and consistently demonstrated that they understood exactly what we were going through. Many relayed stories of their own pets to help put us at ease.

  2. Shared decision making We encountered three veterinarians through this process. The first one did not know my wife and I were both physicians until we were well into the discussion of diagnosis and treatment. Each practitioner talked about options, the pros and cons of each, and we decided on how to proceed together. At one point, both my wife and I were concerned that our human view of medicine would dangerously bias their decision making. The vet reassured us that she would not allow that to happen.

  3. Excellent communication skills Each person directly involved in our dog’s care communicated to us clearly and with good eye contact. We walked away with a sense they were interested and that they truly cared.

  4. Coordinated care The emergency animal hospital informed our private vet that Einstein was admitted, and our private veterinarian’s office called us to check on him, not once, not twice, but three times: Once at admission, once during the treatment and once after he was discharged. The records were shared, and our vet was aware of everything that had been done.

Notably, these attributes from our veterinary experience created a sense of humanity that, ironically, is sometimes missing from human medicine.

Read more from Press Ganey's Dr. Jim Merlino.