Great Expectations

today in the ED, was a bad day. or disaster. or madness. however way you want to call it, our shopfloor was full and overflowing. don't ask me why, but all sorts of patients came streaming in - from knee pain to workplace lacerations to high fevers. they came in fast and furious, and were hence admitted just as furiously.

it doesn't take a genius to figure out then, that when the emergency department is full, the wards will be full. so the back log became progressively worse and patients piled up outside the main area and they were made to wait for many hours before their beds were ready.

and it didn't help that just last week an article was published in the papers about a new fangled bed management system that has helped cut down waiting time for beds. we all know what the reality is, but the public of course believes in the magic two hours mentioned almost four times in the short article.

so what happened? relatives and patients began to yell at the poor nurses, who are the ones tasked with speaking to them about their beds and ward allocations. "why does it take one hour just to clean the bed?" one son yelled, completely unaware that his father was one of the lucky ones who got a bed within two hours of admission.

what does yours truly think is the problem?

expectations.

i recall a patient who fumed,"i am also in the service industry!" just because she was not getting the "service" she was expecting - an admission. we have become a society where we are spoilt for choice. if a particular retailer is unable to provide us with what we want, there's always another next door. hence the customer is always right, and whatever he asks, must be done.

medicine is not and should not be a service industry. it is already prevalent in the states, and even amongst the doctors in the private sector, but this should not be the case - and the public should awaken to this fact. you cannot walk into a hospital and decide how you should be treated. we are not a hotel in which you can order a room and room service to come with it.

but of course, with all the medical tourism and competition going around, "service" has now become very important and many times takes priority. we have now become afraid of complaints, much more than those big multinationals who have billions of dollars to lose. i remember a time when mcdonalds barely batted an eyelid when people got hurt trying to rush for some "limited edition" hello kitty dolls, or mattel getting bashed by psychologists for glorying the wrong body type in barbie. these companies know that people will always be hooked on big macs, and that little girls will always love brushing barbie's hair. -we- know that people will always fall sick and need our attention, but every complaint letter is dealt with the utmost respect and fear, even though that we could have had the patient's best intentions in mind.

we are now mindful of everything we do, everything we say. thou shalt not greet the patient with an unsmiling face (even though it's now 4pm and you haven't eaten/peed/pooped in the last 8 hours). thou shalt not make the patient wait for more than two hours for bloods/beds/specialist reviews (even though all these are way beyond your control, especially as a lowly MO).

the hospital is now a hotel, that's what it is.