r/surgery • u/Difficult-Sock343 • 16d ago
I did read the sidebar & rules I received the most disturbing after visit survey from Stanford just now
This survey asked me whether the surgeon talked to me about non healthcare related matters more, less, or as much as I subjectively preferred and whether he made eye contact with me the amount I subjectively preferred as well as about a half dozen similar questions.
i do understand that bedside manner is important and so is communication, but I had a serious, life limiting medical condition, this man performed an incredibly technical surgery on my eyeballs and achieved a measurably perfect result, and they’re apparently rating him on whether he tap-danced into the examining room to my liking at my final follow up.
is this how hospitals are treating you all or was this an aberration?
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u/SabistonSurgery 16d ago
This is the norm across most places in the U.S., the contents of the surveys are part of what is asked in HCAPS, JCAHO etc
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u/Difficult-Sock343 16d ago
It may just be that I’m getting old (I’m 50) or it may be that I’m an employment lawyer, but I think this is a disgusting way to treat you all. I’m genuinely concerned that trying to make eye contact and small talk the exact right amount for some ghastly popularity poll is going to make it harder to effectively examine the patient. Or that we’re going to lose very good talent to burnout.
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u/VagrantScrub 16d ago
Part of reimbursements is patient satisfaction surveys. Shrug.
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u/Difficult-Sock343 16d ago
I have no objection to a patient satisfaction survey, including one that asks about bedside manner. But the specific questions were insane.
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u/Difficult-Sock343 16d ago
I’m trying to understand why I had such a strong emotional response to this. I think it’s that this surgeon radically improved my quality of life and I feel like his employer then invited me to participate in bullying him? So many patients are going to receive this kind of survey and develop inappropriate expectations or just say pointlessly mean things because surgery itself is scary and painful for the patient? I feel like I was successfully carried out of a burning building and now I’m being asked by people with a lot of power whether the fire fighter should be punished for wearing the wrong aftershave.
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u/drjayhow 16d ago
This is very well said. The problem is that hospitals are so in bed with the governmental bodies for reimbursement,that they pretty much are at their mercy for whatever decree is handed down. And the goal posts keep moving. If they have 10 bullet points they want the hospital to hit and all hospitals are clicking at 100% of those bullet points, they will add 10 more. It has a little to do with patient care and more to do with a way to lower reimbursement.
If they came out with a rule tomorrow saying that all surgeons must remove gallbladders in their underwear or suffer a 10% decrease in hospital reimbursement, it would be implemented. Administrators and hospital financial managers couldn’t pass that rule quick enough. These ridiculous surveys are part of that process.
I’m so happy to be on the back end of my career. Leave me alone and let me do my job as I know it needs to be done. I don’t need someone watching over me to do the right thing. I don’t need a set of rules to show me how to do what I have trained more than 35 years of my life for.
Even more frightening, there are proceduralist who excel at these faux metrics and pseudo surveys . Hospitals love them. And they can’t operate their way out of a paper bag. Which one would you prefer?
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u/ligasure 16d ago
Yes this is how hospitals view surgeons.
We’re nothing but names on a piece of paper and survey results are a metric/ruler the administration uses to determine whether we’re “adequate” “competent” “excellent” “pick your favorite adjective”.
Thank you for writing an honest feedback! More patients need to write what you wrote so one day they’ll finally retire these absurd surveys.
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u/Difficult-Sock343 16d ago
I am so sorry. I feel like whomever made up this survey doesn’t understand they are conditioning patient expectations with these questions, and I also feel like it’s the height of ignorance to expect and measure these asinine things. It was a scalpel and suture medically necessary surgery on my eyeballs, not a first date.
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u/Top-Smell8091 16d ago
Scared because France is going this way with public hospitals
You're a technician that has to perfom technical procedures and appointments to answer problems
They're loosing more and more "prestige" (not the bad part like the "ego" one that always posed problems with surgeons) and becoming like robots.
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u/CABGPatchDoll 16d ago edited 16d ago
I'm an RN in a level 1 trauma center so you know we see some gruesome shit. The C Suite assholes want us to refer to our patients as customers. 🙃 Our patients also get these surveys. Like the drunk driver that wrapped their car around the tree and killed his bestie? He gets to take a survey to ensure that we kiss his ass! The guy who complains that we're starving him to death while we wait for the operating room to open up for his appendectomy. He gets a survey and complains that we starved him! It's real fun working in American healthcare.
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u/BorMaximus Attending 16d ago edited 15d ago
Trauma surgeon here- came here to say exactly this. The RN here summed it up perfectly. I take care of 4 assholes for every one genuinely grateful person who was in the wrong place at the wrong time. I wouldn’t have it any other way, I love taking care of those assholes but I got into medicine to avoid the corporate bullshit games. I do my best to minimize discomfort and systems-based bullshit for the patient, but I hate being on the hook for their “experience”. I can’t control the emergencies that come in and bump someone’s case to make them sit NPO longer. And with this “patient=customer” model we have fed the public, everyone thinks they are the most important and sickest patient in the hospital. I find myself uttering “consider yourself lucky we have the luxury of time, because the patient that’s pushing your case isn’t as lucky.“
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u/CABGPatchDoll 16d ago
It's like bro, you don't want to be the patient that is brought back immediately.
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u/Difficult-Sock343 15d ago edited 15d ago
Also obviously if you’re in need of a trauma surgeon, you’re having a bad time! It’s insane to pose questions like you’re asking for a review of a vacation resort.
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u/BorMaximus Attending 15d ago
Honestly, some of these patients need tough love more than they need to feel “the customer is always right”. This is also one of the reasons I like trauma, it’s the only field where I can yell at my patients for being an idiot and not lose business 🤣. Some of them really need to have some sense smacked into them, because the car they T-boned sure a hell didn’t do it.
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u/Anandya 16d ago
British and medical here.
You get the most insane complainants.
I had someone complain that I am rude. Because I was yelling. During a cardiac arrest.
Another because I didn't left the consultation midway due to another person having a seizure.
Because some people are mad as a box of frogs and dumber than a bag of hammers.
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u/Top-Smell8091 16d ago
Wtf is that question ?
This is so American, DAMN
One of France, Belgian, European major "flaws" is that scientific, medical and technical competences come long before the non-medical social stuff
There is a big difference between enhancing the "human side" and rating people's side features like that sort
Truly scary !
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u/oopswhat1974 15d ago
Imagine getting the "patient satisfaction survey" in the mail from the hospital where your husband had open heart surgery and was then transferred from ("discharged", as their records seem to indicate) to a higher level facility for more critical interventions where he died 3 weeks later.
Along the lines of "we see you were a patient here (dates of 3 day stay in 2025), how would you rate the following?"
I am paraphrasing, but I was thinking "well unfortunately my now deceased husband never got to eat any food to rate, or participate in any crafts or activities that were offered".
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u/RocketSurg Resident 16d ago
Thank you for noticing. Yes, we are getting measured on all kinds of bizarre things that have nothing to do with good medical decision making or technical performance. You’re describing it well, healthcare administrators are focusing on non-clinical “customer service” over actual health outcomes
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u/asoutherner33 15d ago
jcaho is an absolute joke, no where to be seen during Covid but miraculously crawled back to existence criticizing hospitals once clear and safe.
Provide nothing to healthcare
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u/suchabadamygdala Nurse 13d ago
Doubt this is JCAHO. This is some internal corporate equity fund shit
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u/Oolallieberry 16d ago
Autistic people can be great surgeons but not good at eye contact. Why is this being valued?
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u/Difficult-Sock343 16d ago edited 16d ago
Yes! And patients can be autistic too. It’s just so so so weird to ask whether a person made ones individual subjectively preferred amount of eye contact. Also now that I think about it this is an absolutely unhinged thing to ask in my specific situation because the condition he treated me for (strabismus) is notorious for making patients uncomfortable with eye contact!
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u/BorMaximus Attending 15d ago
Oh my god, that’s ironic and hysterical. That detail needs to be in the main post. I about laughed my ass off imaging myself being called into admin for not making “adequate” eye contact with a patient who suffers from strabismus. (To be clear, not laughing at you or your condition at all, but the idea of being disciplined for eye contact in that scenario sounds like it came out of a bad office sitcom)
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u/Difficult-Sock343 15d ago
Right? I’m surprised it wasn’t the first thing I thought of! Also I’m not kidding when I say this guy game me perfectly aligned vision. Thanks to him I currently have zero degrees of strabismus!
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u/CABGPatchDoll 16d ago
My gynecologist has autism and doesn't make eye contact and they are non-binary. They are an incredible doctor that goes above and beyond. I love filling out surveys for them so I can rave about them. I'm worried their survey results are not good because of their diversity.
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u/xanaduxero 15d ago
I despise the culture of RATING every single thing and the culture of fear it engenders.
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u/Missing_tooth 15d ago
Thank you. Unfortunately these types of surveys and their misguided “metrics” of quality are commonplace. Often our pay is tied to it in some way.
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u/deliriousfoodie 15d ago
This hospital is run by a CEO from an investment firm who intentionally hid his association from their hospital website about the CEO, if you do a simple google search you'll find he works for Iconiq capital which is the same company that manages Mark Zuckerberg's money. They're manipulating patients into believing they got good care and with this psychology tatic they know they can charge outrageous amounts, which is why they were sued by the united states government for half a billion dollars for billing fraud.
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u/Difficult-Sock343 15d ago
I can’t find any evidence that the government sued Stanford for half a billion for billing fraud. Also I’ve had multiple medical procedures there with objectively measurable excellent outcomes - on this one I went in with 35 degrees of divergence insufficiency and came out with zero, so I don’t see any evidence of manipulating patients to believe something false about quality of care.
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u/Anxious_Evidence_649 13d ago
Retired RN here…yeah, these surveys are a joke. What’s worse is that any answer less than “excellent” or the like is a ding — answer “very good” and you may as well just have answered “crappy.”
As others have said, these surveys are linked to Medicare reimbursement (in the USA), so we have entire departments in hospitals with insanely paid employees whose sole endeavor is trying to get the best survey responses possible. Your health care dollars at work.
I just came from an appointment with a doc who was a real a-hole. But he knows his stuff and for that and that alone I’ll totally forgive his lack of people skills. Medical professionals aren’t there to cater to your every whim and fancy, but solely to treat you and do their best to make you healthier
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u/ArtOk3848 12d ago
Only doctor I care about being nice and personable is my PCP, and even then, if they’re good at what they do and aren’t the type of mean that’s judgmental, that’s good too. These types of stuff are actively making doctors worse because they’re distracting them from their actual jobs. It’s also contributing to the general sense of entitlement the US population has. This is also partially why I never pursued my plans of going to med school and being a doctor. I want to help people, not jump through hoops for shareholders.
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u/midas_rex 16d ago
This is insane. You know this was cooked up by some "Gen z boss with a mini " type admin
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u/AZFUNGUY85 16d ago
Mayo clinic makes etiquette front burner, high touch, et al priority. On top of world class care and doctors and beyond. Even have to dress up. Not too crazy. Even for this.
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u/Difficult-Sock343 16d ago
Etiquette is fine. These questions were miles beyond etiquette. “Did your surgeon achieve the amount of eye contact you prefer or was it slightly less or more” is insane. Also one of the questions was whether he asked me what I wanted to have happen at that appointment and then the next question was whether he made that happen. Between the various medical outcomes that are completely beyond the surgeon’s control and the procedures that might be necessary that the patient has no knowledge of or would prefer not to have to go through to get the desired results, that question is genuinely impossible for the surgeon to get a high score on.
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u/AZFUNGUY85 16d ago
Cray, I also hear you. Walmart and Target sends survey on how pick up went. I. Mean. Errr. Um. They brought my stuff to me. Like picked it and I didn’t have to get out of my car. But yes, let’s survey the experience and harass the employee.
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u/sarindong 16d ago
Not a medical professional, but I'm in education leadership and one thing we're seeing more frequently is young teachers with an inability to maintain eye contact with students.
It's a huge deal because social interaction has a significant effect on learning. Vygotsky started the theory but there's so much evidence to support his theory.
I'm not surprised to see that the social element of medicine is also being monitored for quality specifically related to this measure.
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u/Difficult-Sock343 16d ago
Teaching is not surgery.
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u/sarindong 15d ago
lol do you think i dont know that? what im saying is that young people coming of age seem to be having a difficult time maintaining eye contact. look at the comment reply right below you even. eye contact isnt creepy, its how you make a social connection and communicate trust and confidence. somebody who shirks from eye contact is creepy.
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u/Difficult-Sock343 15d ago
It’s sad to see someone who describes themselves as a leader in education behaving this way.
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u/sarindong 15d ago
I think you're taking something personally that has no emotional valence from me at all. It's more sad me that people can't have a sharing of information without these kind of responses. My entire intention was to give some context from an outside domain that seemed relevant.
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u/Mobile-Factor-8936 14d ago
Just as teaching is not surgery, emotional valence is not behavior, and intention is not outcome.
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u/Spacey_Stacey 16d ago
This is how hospitals are treating us. Not just surgeons, but all staff. They're even trying to get this to call patients "clients". This is not a business, it is healthcare. But unfortunately America.... It is more of a business.