Patient Surveys to Fund Hospitals

Like education, medical care in the U.S. has been enduring cuts after cuts in the budget, and consequently hospitals are struggling to survive in this time of hardship. Nevertheless, hospitals are still able to provide the one thing they are designed for: efficient and quality medical care to the patients of the community. But with a new rule proposed by the Affordable Care Act that will allow patients' reviews to influence the way hospitals are funded by Medicare, hospitals across the nation have to start worrying about providing quality and decent care to their patients.

However, physicians, nurses and other medical staff may be laid off due to the lack in funding. In addition, basic diagnostic and efficient treatment services as well as supplies may be cut or lowered in quality. Since hospitals cannot be accredited with these types of problems, they may have no option than to close, a common trend in the past few years.

The Affordable Care Act's new rule will allow Medicare patients to take a survey after a hospital visit and rate the type of treatment they received in the hospital, which will later influence the amount of reimbursement funds hospitals get from Medicare. Doesn't sound too bad, right? But according to the New York Times, the types of surveys provided are mediocre at best, focusing more on luxuries and amenities rather than health-related questions such as "Did the doctors and nurses communicate well? Was pain well controlled? Was the room clean and the hospital quiet at night?" These questions are more focused on the subjective feelings of the patient rather than their actual effectiveness of their treatment. Another flaw is that these surveys are given after the hospital visit is over so the patient may not be feeling good after a hospital visit (who does?), thus proving these surveys are ineffective in the long-term effect of the patient's experience.

These patient surveys are troublesome to those, like me, who are planning to work in a health sciences-related career. Our jobs and work environments for the future may be in jeopardy. Hospitals are struggling to stay alive and with this new rule there is a fear that hospitals will focus more on making the patient's visit much more enjoyable as if it were a vacation rather than having effective medical procedures and treatments. It might sound a little silly, but with the current budget situation, it is not a far-fetched fear.

As a volunteer for two years in local hospitals in Orange County as well as UC Irvine's own research hospitals, I would be the first to say that hospitals here provide appropriate and high quality care. They also feature some of the best-looking architectural amenities and interior luxuries in their waiting rooms, layouts and design. Compared to the hospitals I worked at in Mexico, hospitals here are like mansions. However, one very important aspect I learned from volunteering in Mexico is that no matter how it looks, the most important thing that a hospital should be able to provide is its service to the community.  Everything else is secondary, and this new survey-based review rule makes hospitals look like restaurant reviews on Yelp.

The hospital I volunteered at in Ensenada, Mexico did not provide any of the nice-looking luxuries that we have here in California. It was a simple hospital in a well-constructed building and contained all the facilities, equipment, staff and funds to run as a type-3 hospital. The indoors didn't feature much decoration or feel of luxury. It was what it was: a hospital. And that is very well fine, because even though it didn't look or feel like home, it provided efficient care from the staff I had the privilege to be mentored by.

And so the question lies in what the patients wish to get from a hospital: a hospital that provides you efficient care or a hospital that also makes you feel like you're at home? Granted hospital funding is not all based on Medicare, but the bonuses they receive are great help. Cutting down these bonuses will present a new challenge to medical care since the new rule will only give these bonuses to hospitals that get a 9-out-of-10 or 10-out-of-10 rating.

As a future nurse, I see this as an inefficient and unfair way to put hospitals in a situation where they might focus training and protocol for staff more on making the patient's visit much more enjoyable.

From the little but important experiences I've had with patient care, politeness should be more than satisfactory when it comes to treating a patient. The most important thing will always remain providing proper care and improving the patient's health; that's why we're here, not to become friends or stewardess.

It's important to remember that even in times of crisis we shouldn't compromise the focus of the health care system. Even with the cuts, the health care system still provides efficient and quality care. The solution? Simple: Do not use this new survey system to add new things for hospital management to worry about. The medical field has enough to deal with at the moment, and even with that they are doing an efficient job. It isn't like we live in a third-world country. Patients should be happy with the quality of care they get here in the U.S. It might not be free but at least it exists and has quality.

Also, we as patients should be more patient with our care and not expect the highest standards from our medical providers. Yes, they are expensive but it isn't the fault of the nurses or doctors. This is how the system works now (until further notice) and it isn't the job for a nurse or doctor to make you feel like you're in a timeshare.

But we need to understand that patience is strength. So the next time you see your physician, think carefully on how you would answer a survey. Think of the treatment you received to cure whatever problem you had, instead of the extra glamorous things that in the end don't really matter. Otherwise our hospitals may start focusing on looking like hotels and having nurses act like waitresses instead of what they should be doing, which is saving lives and improving our health.

Marko O'campo is a third-year nursing sciences major and can be reached at genaroo@uci.edu.