When Did I Start Consulting for Dr. Google?

I have witnessed firsthand the evolution of patient satisfaction (2017;27[1]:13-14). When I became an NP in 1986, I worked in rural areas as the primary provider. My patients trusted that I cared for them and in the best way possible. A lot changed with the internet—Google became the primary care provider, and I became the consultant. Expressions of gratitude and respect from patients have been replaced by entitlement to services mandated by them. I have had patients bring in requests for diagnostic studies and further work-up for which there is no clinical evidence of need. They have their minds made up; if I am noncompliant, there is something wrong with me.

I have been reported to administration for being rude, insensitive, and incompetent. Now, I am not perfect, but most of these complaints were a result of me saying “no.” I was initially shocked by these demands and complaints, but they have become the new normal. Precious care time has been replaced by explanations and discussions about why I can’t do what patients want me to do.

Many providers give in to patients’ desires just to keep them happy and coming back. Unnecessary antibiotics, misuse of controlled pain medication, and pointless diagnostic studies have drained insurance and kept providers from just doing what is right. Big corporations run many medical practices, and unfortunately their main goal is to keep the doors open—even if that means compromising evidence-based medicine.

We have a generation of entitled people who become offended when you disagree with them. Many administrators transfer patient complaints to providers so that they will toe the line but fail to include pertinent information, such as what the complaint was and who filed it. This is a control technique; the provider is now automatically guilty, without a trial or defense.

I am blessed to work for a company that agrees that if concern is expressed, I have the right, as the provider, to know the details. If I am perceived as rude or abrupt, then knowing who feels that way can help me improve. Upon that patient’s next visit, I will adopt a gentler attitude and make an extra effort to pick up on cues that I may have missed.

Sometimes, patients express dissatisfaction because I will not dispense a controlled substance for pain upon request. My administration allows me to respond to situations like this in writing, and they can then verify that the complaint is unwarranted, and it will not be held against me or used as a control tactic. This approach has been so helpful. The company I work for also informs providers when patients express gratitude and thankfulness, which creates a great balance.

Surveys can be useful, but only if they are used as a tool to help the provider excel at his/her job—not create compliance for maintaining the patient head count. Providers should not have to worry about pleasing administration; they need to give quality care without fear.

Sue Beebe, APRN
Wichita, KA