The below are my own personal unaffiliated unbiased thoughts.

I was sitting at a bar in Rochester, Minnesota one night eating dinner and listening to the conversation of the bartender with another patron besides me. They were discussing openly some of their medical pitfalls and unique situations and at some point, I joined the conversation and asked very openly, “So, I’m curious. You just said you’ve been seen at these hospitals all over the country, those are also some big names… Sacramento? Seattle? Boston? Hmm… What makes the hospital system here so much better to you?” I never divulged what I do, and they never asked; I was just another lost soul at the bar. His answer was different than I expected, very simple, and critically important for hospital administrators and facilities alike to think about among all of the bureaucracy, “Well, The Communication.“

He went on to tell me that in some places he’d been treated in the past, he felt like he wasn’t listened to, he felt that he was lost in an abyss and that his questions weren’t being answered or even addressed in the appropriate manner – at least… He didn’t understand what he was told. However, at the nearby “Destination Medical Center,” as one of my mentors once said, he felt that when he went to his doctor with a question whether in person or via the online portal, “An entire team is working on me. That’s why it’s the [Insert Hospital Name Here] experience.” Or, as some say The Effect.

When you’re on one side of the curtain, it’s hard to see what things look like from behind it. Until a health care provider or one that works in the system is a patient, it can be hard to understand or really see what matters. We all have various opinions and the way that we are perceived can vary 1000% from our intention – i could go on about this forever. I have been lucky to only be a patient a few times but also unlucky to have an unclear condition that took some time to tease out – I’m fine, don’t worry, it’s not that exciting. But, what really mattered to me at that time as a patient? What dictated this neighbor’s feelings of comfort and satisfaction?

The medical system is wrought with administrative waste in the United States and the burnout rate from paperwork and systemic issues being dictated by those not on the ground floor is a very openly discussed issue. Transparency and work productivity metrics are unfortunately the believed ways to theoretically objectively visualize, for the ones at the top, how GOOD a place is. Subjective responses aren’t always what make money and also not what the top wants to hear about as much, until of course the one on top is subjugated the same humanity as all of us in sickness. As a Doctor that has worked at over a dozen various health facilities, I find one thing interesting: I am the same Doctor regardless of where I work. But what changes the experience for the patient?

Structurally, high efficiency optimized systems focused on quality improvement time and time again make the news both formally and anecdotally via social media for being places of interest when people are in need of help. So, If i am the same doctor at two different hospitals – I as the individual am not the answer as to why one place is viewed as superior to the other; but it’s the small things, and not the small things that the top thinks matter, that matter.

It doesn’t matter that the drinks aren’t in the cupboard. It doesn’t matter that the productivity metrics for how charting needs to be done in very anal ways. It doesn’t matter hitting a certain volume of patients. Now, do these elements dictate financial success? Probably, but they don’t dictate a place being the “Destination Medical Center” that a patient wants to go to or send their loved ones to for care.

Now, I am by NO means saying that it is a simple situation nor do I suggest that there actually IS a ‘Best’ medical system or hospital in the world, although i DO feel that administrations with higher proportions of medical providers from the ground floor could help with balance.

Allowing some release of the reigns from metrics can allow for reaching back to the heart of medicine: providing quality care to take care of the sick and to help those in need. The deeper we go into administrative regulation, lack of transparency and focus on nuances that have nothing to do with actually physically seeing and caring for patients, the farther we move from the satisfaction that they seek. I have been privileged to not only wander the atmosphere of some of the highest regarded medical systems in the country or the world, but understand that to become what they become, we have to bring the focus back to the patient and away from the white noise.

There is no best hospital system in the world, but there are those that make patients feel safe, hopeful, and compassion. Individually we can contribute, but structured teams, internal and external communication skills and quality improvement will hopefully eventually bring about the best experience for those we care for. As always, collaboration and teamworks are key, but focus on what is actually important is King.

It was an honor to work for one of the best, or was it that I was set up to be at my best that made it that way?

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