Customer Service 2

Customer Service 2

Last week, I posted about a man who complained to Customer Service after being refused intravenous morphine. Today I will share with you another noteworthy complaint.

A middle-aged woman came to the emergency department with many complaints. From the time she arrived, the staff found her to be difficult to deal with. She was seen walking around the department in no obvious distress. Yet, she was so uncooperative that every attempt to care for her was met with disregard for the staff’s effort to address her needs.

When she decided she was going to leave, she asked that she be provided by a taxi voucher to pay for her ride home. When she was told that would not be possible, she threw herself onto the floor in the waiting room, screaming and making a huge scene. She later wrote a letter of complaint about her care.

I was Chairman of our department at that time and it fell on me to respond to her complaint. I never saw this patient but I had to review her complaint and respond to Customer Service. I wish I had her original letter but I do have the memo I wrote to Customer Service in response to her letter. I will share it with you. This is another example that shows how hard it is to make the patient a customer with a motto: “The customer is always right.”

To:            Customer Service

From:                        Dr. Tad, M.D.

Subject:            Patient Complaint

I have reviewed the letter of complaint and medical record of this patient. Her long letter outlines many complaints against the emergency department staff. Here is a partial list:

1. She saw many seriously injured people getting no attention.
2. She saw staff eating donuts.
3. She saw staff laughing and giving each other “high-fives.”
4. It took thirty minutes and four nurses to get her initial care.
5. It took ninety more minutes to get the next episode of care.
6. She was in the hospital three hours before she was diagnosed.
7. She was told to get pain medication from Long’s Drugs.
8. She was forced to sign the Leaving Against Medical Advise form.
9. She was treated “without any concerns or sympathy.”
10. She “fell unconscious at the foot of my bed” and “saw my face hitting the cold floor.”
11. She was not allowed to make a phone call for help.
12. She was stuck outside in the cold, unable to get up because the wheel chair was locked.
13. She was treated with “disregard and carelessness.”
14. She was not given a cab voucher.
15. She was not treated for asthma.
16. She was not “emotionally comforted.”
17. The nurses and receptionists were having a picnic of chips and soda.
18. Her “intelligence has been insulted and (her) private rights have been violated.”

Interestingly, she also admits in the last paragraph of her complaint that she behaved “impudently” and apologizes for her “peculiar impoliteness that evening.” Impudent is defined as “marked by contemptuous or cocky boldness or disregard for others.” I have talked to several of the people who had opportunity to care for this patient that night. From all accounts, it sounds like she has used the appropriate word in describing her behavior. The staff saw her walking around the department in no obvious distress. Yet, she was so uncooperative that every attempt to care for her was met with contemptuous boldness and disregard for the staff’s effort to address her needs.

The episode where she describes going to the ground was seen by the staff to occur when she threw herself on the floor when she was told that there was no taxi voucher for her.

The staff attempted to provide her with an appropriate exam and treatment. They tried to help her get a ride home. They were insulted and rebuffed at every attempt to help her. She signed out against medical advice rather than accept any appropriate evaluation and care in the emergency department.

It is clear this lady was not happy with our care but it is also probably true that her expectations were unrealistic. It is very clear from talking with the staff that her impudent behavior was responsible for a good part of her unpleasant experience here.

Thank you very much.