Almost Likely to Recommend

Added on Mar 12, 2014

The week leading up to my elbow surgery was stressful.  I felt as though I was at the mercy of an irrational scheduling system that failed to consider my needs as a person and a patient. With details about the time of my surgery unclear until just days before, I recognized that I was pretty lucky to have family, friends and colleagues who could be flexible. What if I lived alone and didn’t have a support system to accommodate last minute ambiguities?


Leading up to my surgery, I spoke to a couple of clinician friends who assured me that my outpatient procedure was fairly straightforward and I shouldn’t worry. They told me this surgeon does this operation routinely. For me, this was an important and challenging decision that took me two years to make and countless visits to rehab before I finally resorted to surgery.


I woke up this past Friday morning filled with anxiety. “Should I back out? Should I do more physical therapy? Will it go well? What if there is a complication? When will I return to full strength?” I was the first patient in the waiting room, but as others arrived, the stress was palpable. One mother in particular fretted over her son’s knee surgery, which could sideline his college soccer career. Her concerns were twofold—the immediate post-operative caretaking and the potential long-term implications. We all sympathized with her as we considered our individual situations.


Once the process started, though, the coordination—and my confidence—shot up. The reception process was quick and easy. Linda, one of my nurses, clearly explained the course of events, answered my questions and provided reassurance. Similarly, in pre-op, the anesthesiologist came in and described what he was going to do and how I would feel. His clear communication combined with a little lighthearted humor put me at ease. My surgeon visited me, went through the checklist for a third time, reinforced what he was going to do and the process; the whole time he was confident and reassuring. Once in the operating room, he again explained the procedure and before I knew it, I was in recovery!


I awoke to an equally positive recovery experience. Carla, another nurse, assured me that the surgery went well and explained the discharge process. She described how I would feel in the coming days and how long the rehabilitation process would take. My physician then came in and confirmed that the surgery was a success and communicated what to expect during the next 10 days. Within the hour, I was groggy, but ready to go home.


The surgery went fine. Great, actually.  And when things go well, most patients tolerate the unnecessary anxiety and stress they may have experienced in the process. I’m certain that if I weren’t a 34-year veteran of the industry, I wouldn’t be reflecting on poor scheduling any more than I do about TSA lines or 4-hour cable appointment scheduling windows.  But I am, so my personal health care experiences serve as market research as well. 


I came away from this relatively straightforward procedure hoping we can do better as an industry. I had fantastic care that was exceptionally coordinated—once I was in the surgical team’s hands. Clearly, antiquated processes, functional silos or perhaps even outdated assumptions are preventing coordination on the front end. We cannot think of the patient experience in fragments. We must consider all aspects of the care experience as potential contributors to suffering and deliver an experience that reassures, builds confidence and helps engage the patient in their care. The challenge for our system is to not accept or explain away structural inefficiencies that create or increase unnecessary, suffering. At the same time, we must recognize that no matter how “minor” a patient’s issue may be, it’s important to them.


I remain optimistic that all of these issues can be solved!