As our hospital administrator emphasizes the importance of high patient satisfaction scores and “pleasing every patient every time,” I’m really becoming disenchanted with emergency medicine. He’s getting his directives from the hospital board and being pressured by statistics on some web site that only administrators look at, so it’s tough to blame him, but this medical system is really heading the wrong way fast.
A 18 year old female is brought in by her mother complaining of lower abdominal pain. She’s doubled over while she’s walking. After the nurse gets the history, she hands the patient a gown and tells her that she needs to get undressed for the exam.
“I’m not getting undressed for you. You’re all stupid here.”
“We’ll if you want the doctor to try to help you, you need to get undressed and put the gown on.”
Then the patient’s mother says “Honey, why don’t we start by putting the gown on?”
The patient replies “Why don’t we start by you shutting your f***ing face?”
Then she whips open the door and leaves.
A 22 year old female also complaining of lower abdominal pain. She is accompanied by her sideways-hat-wearing pants-on-the-floor boyfriend. Urinalysis was normal, so I explained to her that we needed to perform a pelvic exam to look for other causes of the pain.
Boyfriend immediately chimes in “Yo! Ain’t nobody looking at my woman’s s*** but ME!”
I looked at the patient. “Do you want me to do the exam?”
She shrugged her shoulders and said “I guess so.”
Then I told boyfriend that he needed to wait outside. He pulled his pants up, puffed out his chest, and left.
The patient was ultimately discharged with diagnosis of an ovarian cyst.
Following day, the nurse manager finds me and says that boyfriend came back to her office and wanted to know my name because he was going to sue me for raping his girlfriend.
Drunk guy brought in by police after beating up his girlfriend. He was fighting with police, so he was cuffed and escorted by a couple of officers. When he got to the ED, he was still fighting and threatening the staff, so he was put in 4 point restraints. Then he started in on one of the officers.
“You won’t be able to keep me in these things forever, you know. I’ll get out. When I get out, I’m going to find you, throw you up against your police car and [sodomize you].” The term that he used was too vulgar to post.
He could see that he was getting on the officer’s nerves, so he kept it up.
“Yeah, maybe I’ll even let your chief watch. I’ll enjoy every minute of it hearing you scream like a b***h, too.”
All the while the officer just stood there until he was secured in restraints. I don’t know that I could have stood there with this guy talking like that to me and not done anything.
There were other similar encounters. They all took place within two days. All of these patients will receive patient satisfaction surveys. I doubt any of them will be “pleased” as our administration desires.
Treat a judge like this and you get thrown in jail for contempt of court.
Treat an employee this way and you get sued for harassment or sexual discrimination.
Treat an average person on the street like this and you get a fist in your mouth.
When people can come to your place of employment and treat you like a piece of toilet paper – yet your continued employment depends on pleasing “each one of them every time,” it’s time to think about whether to continue practicing medicine.