Dr. Whitecoat refused to remove something that was hurting my ear. He was rude, insensitive, and refused to help me with my medical problem. I would never come back to your hospital if I knew he was working.
That little diatribe was in addition to all of the “1” scores that the patient used to rate my care. Of course, none of them were true, but satisfaction scores are a presumption of guilt, not a presumption of innocence.
What did I do to deserve this scathing review? I actually remember the case.
The patient’s complaint was “foreign body in the ear.” Easy enough. He was in his 70s, so it was probably just a piece of cotton from a Q-Tip.
When I got into the room, it wasn’t quite so easy. The patient had a tympanostomy tube placed about a year ago. He wasn’t sure why it was placed. But the day before he came to the emergency department, he had gone to get fitted for a hearing aid and the person who did the exam noted that the tube was still in his ear. Then he showed up on a Saturday night.
“There’s a tube in my ear. I want it out,” he said, matter-of-factly.
After examining him, the tube was still in place. “It’s still in your eardrum,” I explained, “I can’t take it out.”
“Well … it hurts. You need to do something about it. They won’t put in a hearing aid until the tube is out.”
“I don’t do ear surgery. I don’t have the experience or the equipment to take the tube out. Besides, even if we were able to take the tube out tonight, they wouldn’t put in a hearing aid immediately. You’ll need to follow up with the ENT physician who put the tube in.”
“Are YOU going to get me an appointment?”
“I won’t be able to do anything on a Saturday night. You’ll have to call his office on Monday.”
Then the patient’s wife jumped in.
“The tube is giving him ringing in his ear, also. What are you going to do about THAT?”
“There usually isn’t much we can do with tinnitus. When did it start?”
The patient and his wife looked at each other.
“A few hours ago. And it’s really bad, too.”
“You didn’t have the ringing before a few hours ago?”
So I went to the medical records. The patient’s last visit with the ENT physician was six months prior to his emergency department visit. The note mentioned that the tympanostomy tube was in proper position. It also mentioned that “Mr. Smith also complained about his chronic tinnitus. We had a long discussion about this and I informed him that there wasn’t much we could do to treat it other than possibly having him fitted with a hearing aid.”
I printed out a copy of the note and read it to the patient and his wife.
“I’m not sure what else I can do to help you tonight.”
“C’mon. We’re leaving,” the patient said to his wife, “It’s obvious that this doctor isn’t going to help me.”
So, based on four whole responses rating my care from the last set of Press Ganey questionnaires, guess whose care fell far below the rest of the physicians in the department.
But don’t worry. The results are statistically significant enough to compare me to the other doctors in our department and to all of the other physicians nationwide. Press Ganey says so … and their multi-million dollar business model depends on people believing it.
Want to see the truth behind Press Ganey scores? Check out the Patient Satisfaction articles on this site.
This and all posts about patients may be fictional, may be my experiences, may be submitted by readers for publication here, or may be any combination of the above. Factual statements may or may not be accurate. If you would like to have a patient story published on Dr.WhiteCoat.com, please e-mail me.