I was recently talking with a friend, “Melissa” who was told she needed a hysterectomy due to two large tumors. She was frightened, but her doctor assured her that they were more than likely benign. She would have a day surgery and be home by evening. The doctor spent time answering all of Melissa’s questions and helping her to understand what to expect. Melissa was still a bit nervous but trusted her doctor’s advice. The doctor then sent her to the lab for her preoperative tests. This is a fairly routine description of a pre-op consult. Why then, just one week later, was Melissa ready to cancel the surgery? Simply put – the system broke down, betrayed her trust, and she no longer felt confident that she was in good hands.
Trust Breaks Down
The failure started when Melissa, following doctor’s orders went to the lab for her blood work. She checked in at the kiosk and awaited registration. After 15 minutes she was called to registration where she was told that that didn’t have any doctor’s orders for her lab work. They would call the doctor’s office but chances are no one was there as it was now after hours. After another 15 minute wait, she was told to come back tomorrow. This was a major inconvenience because she works full time and her son is in sports after school. A return trip to the lab the next day meant that she would either have to leave work early or miss half of her son’s game.
Melissa returned the next day and had her lab work drawn. She was told that her results would be sent to her doctor. As a savvy consumer, Melissa was in the habit of checking the portal for results. After two days, no results appeared in the portal. She called the doctor’s office and was told someone would call her back. After a day and a half no one called. She called again and was told that no lab results had been sent and that she may have to have a second set drawn. By this time Melissa was getting really irritated and her surgery was just five days away. She had a second blood draw and the results appeared in the portal – along with the original set of results. So now she had been to the lab twice.
When No One Calls
Melissa had also been told that someone from the surgical department would call to review information and let her know what time to report to the hospital. When she hadn’t heard from anyone 24 hours before the scheduled date, she called the doctor’s office. The doctor’s office took a message and said someone would call her back. When no one called, she tried again to find the office was closed. She called the hospital to find out about the time for her surgery and was transferred three times. By 7 PM the evening before her surgery she still had no confirmed time for surgery or information about when to arrive.
Trust and the Patient Experience
Is it really any wonder that Melissa wanted to cancel her surgery? From her vantage point, “they” couldn’t be trusted. Nothing had gone smoothly and she was forced to jump through hoops for even the simplest steps. If people couldn’t get the right information to her or follow through on promises, how could she trust that they would carry out a safe surgery? Everything about her experience had blown her trust. In this case there were competent and caring clinicians ready to care for her, but how would she know that? Nothing about her experience instilled trust.
We cannot be lulled into thinking that healthcare is a business for solely delivering medical services. It’s really a business of trust. If we don’t instill trust, nothing else matters.