BMJ blog: The language used to describe patient feedback has a detrimental influence on safety culture

[Daisy]

Worth a read. Considers how patient feedback is viewed by health professionals and managers and cultural problems that PWME will likely recognise.

When a health professional flags up something that has gone wrong, it is called an incident report. But when a patient does the same, it is called a complaint. The word “complaint” is synonymous with words like “objection”, “grievance,” and “criticism”. Culturally, it creates a tone of negativity.

It is perhaps unsurprising, therefore, that research finds health professionals perceiving complaints as “a breach in fundamental relationships involving patients’ trust or patients’ recognition of their work efforts“. [2] Consequently, “it was rare for [professionals] to describe complaints raised by patients as grounds for improving the quality of care“. [2]

and

A similar language problem affects wider patient feedback—from the Friends and Family Test, patient surveys, focus groups, social media posts, etc. This is frequently described as “anecdotal evidence.” The term indicates a cultural tendency to see patient feedback as subjective, irrational, and potentially unreliable. The term “soft evidence” is also used to distinguish patient feedback from the “hard evidence” of statistics—seen as objective, rational, and reliable.

https://blogs.bmj.com/bmj/2019/02/0...as-a-detrimental-influence-on-safety-culture/

 

[rvallee]

Whether medical professionals like it or not, medicine is a customer service profession and it should act accordingly. It's very difficult to give feedback within health care systems that are not an official complaint, they are unlikely to ever be handled appropriately.

I saw a thread on Reddit today about the most insulting thing said by a doctor. Many of those basically compare to someone working in a typical customer service and telling the client to go F themselves. But in medicine, that's basically fine and tolerated as long as the work is technically correct. Even in the software industry, something few people understand requires lots of communication and service, programmers are expected to present a minimum level of basic decency and manners.

This approach of rejecting most patient input at the exclusion of official complaints is a huge part of the problem. Most of the feedback is ignored since most problems do not amount to the level of official complaints.

Ironically, this precisely leads to the kind of situation where Clare Gerada was arguing that patient complaints should be eliminated because of the anxiety it causes, because by the time something amounts to an official complaint at least a dozen things have gone wrong that could have been handled quicker and with less dramatic overtones.

The most basic question of all is never even asked: were you helped? Of course it's hard to ask this question in a way that gives an accurate portrait of what it even means to be helped, but at least it would avoid weird situations like the illusion that a significant % of medical consults are a waste of time because apparently the patient did not have any medical problem, when it's likely that in most cases they do and it was simply missed.

It always seems to come down to the great ideas about patient engagement. It sounds great, when does it begin officially? Any day would be fine.

 

[Daisy]

There are also double standards regarding patient feedback. With our local ME community service positive comments are taken as read, but for years no action was taken about negative comments as the provider maintained that to take action they had to have a dialogue with the patient. This was even though the same issues were raised year after year. Formal complaints made to the CCGs last year have not been actioned other than acknowledgement. It's dire.

 

[Andy]

 

[NelliePledge]

Maybe it’s not even seen as a complaint maybe it’s put down to health anxiety or catastrophising through spending too much time researching on the internet and talking to others on patient forums

 

[TiredSam]

programmers are expected to present a minimum level of basic decency and manners

Things must have changed significantly since I last worked with programmers.

 

[TiredSam]

I saw a thread on Reddit today about the most insulting thing said by a doctor. Many of those basically compare to someone working in a typical customer service and telling the client to go F themselves.

If that happens in everyday life, the customer can take their custom elsewhere. I hear that in the UK doctor shopping is difficult, and having a monopoly or being in such a powerful position does bring out the worst in some people and they start taking liberties (sad pun intended). Fortunately in Germany, if one doctor insists on being a patronising idiot, you can go and find another one (which I did). The situation is far from ideal though, and there is little redress for dissatisfied customers.

 

[rvallee]

Things must have changed significantly since I last worked with programmers.

Programmers with poor manners can be kept out of meetings and promotions and still be capable of doing their job, but exceptions have to be made to accommodate them and they require extra management.

Bad medical professionals don't have that option, other than doing lab work, I guess. Medicine is about people first.

 

[NelliePledge]

If that happens in everyday life, the customer can take their custom elsewhere. I hear that in the UK doctor shopping is difficult, and having a monopoly or being in such a powerful position does bring out the worst in some people and they start taking liberties (sad pun intended). Fortunately in Germany, if one doctor insists on being a patronising idiot, you can go and find another one (which I did). The situation is far from ideal though, and there is little redress for dissatisfied customers.

Nope it may not be that common but I found it very easy to change to another GP Practice. And within practices there are often several Drs available. I only changed because the practice was relying on locums and I had very poor experience with them. My current GP practice is well run and while the Drs aren’t exactly what you’d call ‘ME friendly’ they have been ok.

 

[Andy]

Nope it may not be that common but I found it very easy to change to another GP Practice.

Where I live which GP practice you are allocated to is dictated by location, I investigated changing practice and was told that I couldn't.

 

[NelliePledge]

Where I live which GP practice you are allocated to is dictated by location, I investigated changing practice and was told that I couldn't.

There used to be 3 practices covering my area 2 now as my old one has since closed down.

 

[ladycatlover]

other than doing lab work, I guess.

Working in a medical lab is very different to being a doctor, involving completely different training. Believe me, I know, I used to be a Med Lab Tech way back when (60s! ), then for 4 years before I got ill I was a Cytogenetics Tech.

It really irks me when they show stuff about NHS on the news and it's always about doctors and nurses and physios and radiographers, and us lab techs never get a look in.