Famed Nigerian author, Chinua Achebe, made a jibe of hospital consultations in one of his books. I may not recollect the scene exactly, but it is a patient complaining that before one opens the mouth to say “Aargh”, the doctors have already injected you. Incredibly this was 50 years ago, yet such sentiments still prevail.
Experience narrated by patients shows just how oblivious we doctors and hospitals are to patients’ concerns, particularly around visit satisfaction and what they hope for once they walk into our practices.
As far as choice of health facility goes, patients rely on a three-legged matrix to decide where to go — cost, convenience and quality of care.
Depending on the illness, each aspect has a varying weight in the decision-making algorithm. Past experiences determine whether they will return to the same place or seek care elsewhere.
Based on where you live in Nairobi, it takes close to one hour just to get to your preferred hospital. For those who had travelled from rural areas even longer. Patient registration, waiting time etc, consume an extra hour or so, again depending on clinic queue and speciality sought.
Here is where it gets really interesting. After that entire wait, it culminates to a five-eight minutes consultation. It is crucial that these few minutes leave a positive experience on the patient. Otherwise, the entire visit is summed up with the other negative experiences like traffic and long wait.
For some, having sold chicken, goats or taken a loan to finance a specialist visit, they hope their fears and worries are listened to keenly, get examined thoroughly and investigated to know what ails them.
A recent personal experience affirms these fears. Of the total five hours’ spent to get care, two hours went to traffic, two and a half in the waiting room only to culminate in a six-minute consultation devoid of the experience anticipated.
Traditionally, a patient’s history and a thorough physical examination have formed the bedrock of all clinical consultations. Yet they appear to be slowly disappearing from many of our patients’ concerns. On average, three out of 10 complaints on the quality of visit revolve around the absence or lack of thoroughness in examining patients and history taking.
Specifically, they complain about the contact time with the doctor. Nobody likes to spend Sh5,000 in five minutes and leave feeling dismissed. As part of the ethos we subscribe to, physicians must always put themselves in patients’ shoes.
The good news is that in the future, provider selection is going to be a patient-driven one. Evaluation of search engines requests shows patients are no longer searching for doctors, but “good doctors”.
Aggregators of patient experience will influence where patients will go, who to see and who to avoid.
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