The wife and I took our son to see his doctor for a checkup this afternoon. His doctor is a family practice physician in a small two doctor office. He was the only doctor working today and covering the entire patient load, so we had to wait more than fifty-five minutes to even get into the exam room. Unfortunately, the office staff was rude, unhelpful and didn’t make our wait any more pleasant.
I commented to my wife that we wouldn’t accept this kind of service even from the trashiest fast food restaurant, so why do we suffer through it for something as important as health care. I realized the answer on the way home: We don’t pay for it directly.
When I go to a taco truck to grab a quick bite for lunch I reward tastier food, lower prices and faster service with my lunch money. If my lunch sucked today, tomorrow I can go somewhere else.
Because my family’s health care costs are paid for by an HMO that is funded partially by my employer and partially by funds deducted directly from my paycheck, I don’t have the same level of control for the service we receive. No matter how atrocious the service at the medical office, I can’t easily take my money and go elsewhere. Besides, other than my perceived quality of the service, what else do I have to rate the medical care on. I can’t rate it on its price, since my insurance is hiding most of the direct costs from me. No matter where I go, its always $25.
Last week, I read and article in Fortune Small Business that I meant to post then, but now is much more apropos: Its about a Florida-based medical chain is persuading thousands of patients to pay extra for doctors who do house calls and answer their own cell phones 24 hours a day.
Chuck on July 8th, 2004 at 11:33 am
Having once been married to a physician with a bad case of M-Diety
(god complex… )I can say that some specialities do not lend themselves to service orientation.
Some specialities like family practitioners, pediatricians, etc. might.
Economics drove the doctors to the office (along with HIPAA - privacy protection laws - now).
It might work for a husband wife team.
I’ll bet you’re more likely to see it with nurse practitioners first. Less likely to have MDiety problems.
Anonymous on July 11th, 2004 at 7:14 pm
I don’t see how absence of price competition makes the service problem worse. When airlines didn’t compete on price, they offered much better service, since it was the only thing they had to compete on.
I suspect that the M-Diety thing is a big part of the problem. The reverence in which doctors are held developed in days when educated people were few; now, educated people are a dime a dozen.
The other factor in the reverence, of course, is the life-and-death character of a doctor’s work. But the average air traffic controller deals with life-and-death decisions for more people in the course of an afternoon than does a doctor in the course of a year.
The Outsourcing Weblog on July 12th, 2004 at 12:11 am
Carnival of the capitalists on the Outsourcing Weblog
Please enjoy the following hand selected, outstanding entries in this week’s carnival. Lachlan Gemmell at “Software Startup” confesses - he is a lazy programmer. You might try outsourcing instead? Peter Caputa at “pc4media” is reflecting on Michael Moo…
Christina on July 13th, 2004 at 6:23 am
I’ve noticed the greatest drop in service among the medical and administrative support staff in doctors’ offices. I think that they, like service jobs in general, have suffered from the movement of smart women into better jobs.
Clay on July 13th, 2004 at 8:15 am
“I don’t see how absence of price competition makes the service problem worse”
The problem would be helpded by COMPETITION, not merely *price* competition.
Actually, we already have PRICE competition: every doctor competes for HMO contracts by offering the ONE thing that HMO’s care about: PRICE.
It’s not that competition MAKES the doctors behave. It’s that competition has is NATURAL SELECTION: the doctors who meet the needs of patients (in terms of price/benefit) survive. The others go out of business.
Right NOW, the best doctors, who WILL spend more than 10 minutes with a patient are LEAVING THE MEDICAL FIELD. My wife is a speech therapist and she’s seen it happen to several EXCELLENT doctors. They can’t afford to be the kind of doctor they WANT to be.
If there was competition, we could pay a little more for that better service IF WE WANTED to. Likewise, someone who wanted a cheap surgery could go to the new surgeon down the street: he’s new, inexperienced, but cheap.