I had to take my dog to the vet today - she had something wrong with her ear that made her shake her head frequently. Here's a factual account (though not blow-by-blow) of our visit today. I detail this because it's a great lesson in healthcare delivery.
Arrived at vet and checked in for 10am appointment.
Brought into an exam room. My dog, Callie, is not at all happy to be here. She gets agitated, though she's generally a happy-go-lucky dog in the rest of her life.
Assistant (Edgar) brought me into exam room, vet (Dr. K) arrived seconds later.
The computer system was already logged into my dog's electronic health record, the vet began scanning record. Since this was a last minute appointment, I was not seeing my regular vet. So, the vet was scanning the record and asking me a few questions about my dog.
Vet examined dog, took ear swab and said "I'm going to look at this under the microscope to determine what's going on. I'll be back in a few minutes."
Meanwhile, two things happened. First, the medical record timed out and a login screen appeared. I laughed to myself that this place had better HIPAA privacy practices than some human healthcare providers. The second thing that happened was a screensaver kicked in that showed pictures people had submitted of their pets (mostly dogs, some cats) along with the pet's name. It entertained me as I waited.
As a side note, I'm reading an interesting book, Creative Confidence [Tom & David Kelley], and the issue of waiting came up. In some cases, they said, the objective is to reduce waiting. Other times, you simply want to reduce the perception of waiting. Clearly, this vet's office has that figured out, because before I knew it, the vet came back in with a diagnosis of ear infection.
Dr. K proceeded to tell me about what the diagnosis was, how we were going to treat it and what I needed to do at home. I listened carefully. She then said "Do you have any questions?" I repeated back to her what I heard regarding the instructions. She said "Yes, and Edgar will come out with the medication and go over this with you as well." She asked if there was anything else I needed. She stood calmly, looking at me, waiting for my answer. I honestly felt like I could have stood there several minute pondering my answer and she would have patiently waited. "Nope, we're set. Thank you," I replied and she left.
Mere moments later, Edgar appeared with two medications and a print out. He held up the paper and read to me the relevant parts while he showed me the medication as it was referenced. Then, he took out each medication, showed me how much to use, how to apply it and when to apply it. He gave me a few tips about what works best to make it as easy on the dog (and me) as possible. He asked if I had any questions. "Nope, we're set. Thank you," I replied again.
We went out to the lobby where the medical record had been updated and the invoice was ready but not yet printed. "Is there anything else you need while you're here?" the receptionist asked (they sell vitamins, pet food, toys, etc.). "Nope, we're set. Thank you," I replied for the third time. She printed the invoice, presented it for my review while she processed my credit card. I left with my dog, the detailed invoice, clear and detailed printed instructions and both medications.
Leave vet's office feeling extremely satisfied with an on-time, fast, efficient, competent, complete, caring, compassionate office visit, diagnosis and treatment. OK, so my credit card was now toting a $150 charge, yet I was a very satisfied customer. Why? And what can we learn about human healthcare in all of this?
It's clear this place has veterinary care down to well-established processes. Everything was well-paced and efficient yet none of it was abrupt.
From the receptionist to the vet tech to the vet and back again, each person was warm, friendly and engaged. They were kind and gentle and took their time.
I felt like I was their only customer. I didn't feel like the vet was time-slicing me with 10 other patients. I didn't feel like she was trying to rush through the visit even though the problem was clearly very routine. I didn't feel like she was doing anything more or less than needed because she was fully paying attention.
Though some people do have pet health insurance, many (like me) do not. I was fully responsible for the cost of the visit. While I was not thrilled to have to pay a $150 bill for an office visit, ear infection and medication, I was not displeased. I understood that I'd received VALUE for that $150 and felt it was worth every penny.
I'll be the first to admit there is a huge difference in the nature of veterinary work vs. human healthcare. Still, every time I have a superlative experience at my vet's office (and I do without exception and have for the last 10 years I've been going there), I have to ask why we can't do a bit more of this in human healthcare? I'm sure there are primary care physician offices out there that provide exactly this type of superlative experience - proving that it is possible, but it's not the norm. Pressures to see x number of patients per hour or per day due to payment structures and office costs, pressures to use staff and exam rooms as efficiently as possible, pressures to document thoroughly in an EHR that isn't always workflow friendly, pressures to cut costs and still provide unhurried, compassionate care make this a tough proposition for most healthcare providers today.
It's no wonder we're hearing so many stories about medical errors and physician burn out. And that's a shame, because at the end of the day, these providers all went into their professions to help people, not to hurry through the day at maximum speed and volume.
In healthcare today, we have work ahead of us, but I believe the current environment of working toward improving health and outcomes is pointing us in the right direction. Maybe we should start inviting some of our best vets into the conversation as well.