Doing To, Doing For, Doing With

I had the opportunity to hear a speech from Jason Wolf, the head of the Beryl Institute, about where healthcare is going, specifically where Patient Experience efforts are headed. It was a wonderful talk and one of his slides in particular really resonated with me.

We in healthcare went from DO TO to DO FOR and now we’re moving to DO WITH.

I really like that.

For a long time, medicine was all about fixing people who were sick. You went to see a doctor because something was wrong. Doctors were there to do things TO people.

Things started to change relatively recently, when we began to see medicine as more of a service. We started asking if patients were comfortable. We redesigned waiting areas and made all the inpatient rooms private. We utilized chaplains to address spiritual needs and social workers to assist with planning and care post-discharge. We even brought in animals to help patients heal more quickly. Healthcare became something we can do FOR people.

Now we’re in an age of patient engagement. We want patients to be in tune with their bodies and speak up if they feel something isn’t right. Medicine is becoming more of a partnership. Instead of heading straight to the doctor’s office, people are now looking up their symptoms online. They’re asking more questions. They’re seeking more second opinions. They’re making more informed choices. Healthcare is something we’re doing WITH people.

Yep, I really like that.

I know this can be difficult for physicians, especially if a patient’s wishes fly in the face of his or her advice, or a patient convinced himself of something erroneous because he read about it on the internet. It’s hard to watch patients make decisions that aren’t based in science. That’s why it’s more important than ever to take the time to build trust, listen to what patients tell you is important to them, acknowledge how they feel, and give them accurate information to help them make good choices.

Instead of blindly following doctors’ orders, patients are looking for support, advice, recommendations, and help and, ultimately, the choice is theirs. When physicians and nurses start to see healthcare as something they do WITH people, instead of TO them or even FOR them, we will have achieved genuine patient engagement.

The Platinum Rule

I, like many of you, was brought up with the Golden Rule: Do unto others as you would have them do unto you or treat others as you would like to be treated.

There’s certainly a lot of good in that rule but I now try to do even better. I try to live by The Platinum Rule: Do unto others as they would like to have done unto them.

I’m not sure who coined the expression, but I first heard it when I was working in Physician Relations at a very large suburban Chicago hospital. None of us in the department was a physician, but we all worked very closely with them and had to continuously find ways to keep them happy, engaged, and admitting their patients to our hospital instead of our competitor down the street.

We all approached the task from our own perspective; what would I want, what would make me happy. A few times we got it right, but if we were going to truly be effective, we had to start seeing things from the physicians’ point of view. What would they want?

I didn’t realize it at the time, but it became a very valuable life lesson for me. I started approaching a lot of things with the Platinum Rule and it’s one of my key points when I’m delivering Patient Experience training.

One of my favorite examples is what to call people. My name, as it appears on my medical chart, is Katherine. But I’ve found that most people, for some reason, love to use nicknames when they see a long name like Katherine. They call me Kathy. It drives me crazy.

Don’t get me wrong, Kathy is a perfectly fine name, it’s just not my name and I hate when people assume it’s okay to call me that.

Funny thing is, there are Jennifers out there who don’t mind being called Jen or Jenny, and Margarets who take it in stride if someone calls them Maggie. These people can’t understand why I get so bent out of shape when someone calls me Kathy.

They don’t have to understand why. They just have to understand that it does.

So how are you supposed to know? Simple. Ask.

The key to connecting with patients isn’t in giving them everything that would make you happy and comfortable if you were in their shoes.  We need to ask them what they want.

How many of us actually have a question like that on our admission forms? Or our white boards in patient rooms? We have a perfect opportunity to find out exactly what we can do to make patients’ stays with us a little better (and improve our H-CAHPS scores, by the way) and we consistently miss it.

Individualized, personalized care matters. We can’t keep going with what we think is important. We have to ask our patients what matters to them and then do it.

It’s better than gold; it’s platinum.


A few weeks ago, I got a phone call from an administrative assistant in one of our imaging offices. She asked about the courtesy van that the hospital provides to those who are in need of transportation but are unable to afford cab or bus fare.  A patient who had been in the day before said she had no way to get home but had used that service previously and found it very helpful. This administrative assistant didn’t have the voucher she needed and starting hunting one down.

The hospital had recently changed its policy about which departments were authorized to give these vouchers out to patients. Apparently, people were taking advantage of them. Funny, I thought the whole idea of the program was for people to take advantage of it…

She called another department – one that was authorized – and asked if she could have a voucher for patient who was here and needed to get home. The director responded with, “I don’t know, will I get in trouble if I give this to you?”

She had been in a meeting where the senior leadership team was ranting about how much money it costs us every time someone uses this service. She got the message loud and clear that anyone caught giving the service to someone who didn’t really need it would be in a whole lot of trouble. It was clear that managing the budget was more important than meeting a patient’s needs.

I had to ask myself, what kind of a hospital is this? What do we truly value? The buck kept being passed until someone decided that helping this patient get home was more important than potentially getting yelled at by an executive.

Thankfully, this all happened behind the scenes; the patient had no idea there was such a scramble to find a simple voucher, but as I was listening to this story it became crystal clear to me that we have sent our employees the wrong message. All this talk about patient experience and putting the patient first… it’s just talk.

Until employees – all employees – are empowered to take action that helps patients, you do not have a patient-centered organization.

Your patient experience efforts will go nowhere. And your patients will go elsewhere.