Survey says: more patient harassment is on the way

This survey madness in the healthcare setting is dangerous for many reasons.
Written by Denise Amrich, Contributor

Surveys. They're everywhere. These days, you can't escape them.

From the insurance and cable companies that follow up every telephone call you make to them by calling you back with a robo-survey, to the websites that interrupt your surfing with constant requests for feedback (No, Thanks!), to the form with little boxes you're handed when you're trying to leave a place you've just paid for their services, these attempts to wrestle a back-pat out of you at every turn are getting really obnoxious.

As the economy grinds on depressingly, and cutbacks are evident everywhere, surveys seem to be increasing.

Don't get me wrong. Companies should absolutely be concerned with providing excellent customer service. But more often than not, these surveys leave the feeling that our service providers are more interested in the perception of good customer service than in the actuality.

It feels that way because the types of questions asked and the canned responses available betray a disconnection with the actual customer experience, which increases a sense of alienation. They don't measure what's really important because that stuff probably isn't measurable.

There's usually no place for genuine feedback about how they could improve. Just check off the highest boxes, please. Never mind that this devalues the truly superlative experience, which probably should be rare outside of five star restaurants (which, incidentally, don't usually give survey forms).

My husband got one recently that asked, "How delighted are you," with whatever it was that they were surveying about. Among the options were "extremely delighted, very delighted, only moderately delighted." Seriously? Only moderately delighted? Are they trying to con us into believing that we love them? Do they think we're that easily hypnotized? If they can get us to say it, will it become true? Not only am I not delighted, now I'm pissed.

All too often these infuriating surveys add insult to injury by wasting more precious time and energy trying to get you to effuse about things that just don't warrant feelings of extreme satisfaction. Believe me, if the experience hasn't involved a romantic dinner with a dozen roses, followed by some quality nookie, I'm just not going to be checking off the extremely satisfied box.

Actually, I am likely to want to give lower marks, because my sense of satisfaction significantly decreases when I am importuned. Where's the check-off box for, "Well, I was pretty happy with my experience until you slapped me with a survey?"

Also, bullying me into saying your service doesn't suck isn't the same as making darn sure your service doesn't suck. Put your energy where it belongs, into actually making your service better.

On principle, I've tried to institute a strict "No Survey" policy, and politely refuse to play. But I can't really enforce it, because sometimes the surveybots call multiple times, and continue to ring the phone until they can get a complete survey. And worst of all, I know that if I exercise my annoyance and give in to the temptation not to check off the highest boxes, the employee who most likely did a reasonably decent job with the resources they had (that's all I ask, really) will probably be penalized in some way.

What does this have to do with health?

Other than the fact that I probably need to acknowledge that some stress management is on order, the reason I'm cranking about one of my pet peeves today is that I just read a Kaiser Health News article about how Medicare reimbursement for hospitals may be riding on the customer satisfaction survey. The topic was also covered in the Wall Street Journal.

This survey madness in the healthcare setting is dangerous for many reasons.

What's best for a patient isn't always going to engender feelings of warm fuzzies. Many patients are, in fact, depressed. Who's going to have feelings of extreme satisfaction when they're sick in the hospital? Our healthcare system here in America seems so troubled that people are generally disgruntled to begin with.

Healthcare providers who are already stretched to the limits trying to improve actual patient outcomes are going to be unduly concerned with what patients are going to say about them when survey time rolls around. That can constitute a conflict of interest when you think about it.

It's extremely important to be respectful and kind to people. That's a given. But it should come from true a place of authenticity, not some cheesy customer service interaction formula, and not because of concern about grades.

It's not the Hilton, it's a hospital. As a nurse, I'm here to tell you that you can't always give people what they want when you're charged with giving them what they need. It boils down to likeability, which is very hard to quantify or replicate. A good time may not always be had by all, but a life may be saved. Where's that check-off box on the survey?

Actual quality care should not be confused, or replaced, with perceived quality care. I'm going to just come out and say it. Strong-arming people into spouting positivity about their hospital stay is unethical.

Them that's got shall get

It'll be just like high school. Hospitals will be engaging in popularity contests for these quality bonuses, and the beautiful rich ones will win just like they always do. And the hospitals that serve less wealthy communities will get lower marks because of shared rooms and non-gourmet food. They'll get the shaft and lose out on desperately needed funding. The communities that need to go there for care will be less well-served. And maybe, eventually, if funding isn't there, they'll be out of a hospital altogether. No free, Medicare-provided patient-experience consultant is going to change that.

News flash: the places who need funding the most are probably the places with less satisfaction. Maybe withholding money shouldn't be a punishment for not having enough money to do a better job to begin with.

I'm not arguing that the need to improve hospital quality isn't real, or that patient satisfaction isn't important. I'm just saying that this method of measurement and reward isn't going to help, and may worsen things. It'll definitely increase the need to harass patients with surveys, though, which just can't be good.

Ironically enough, it's time for your survey. How do you feel about this trend toward surveying in hospitals, especially where funding is involved? I actually do really want to know. At least you folks aren't shy about giving real feedback, (whether negative or positive). Share in the TalkBacks below.

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