Abdus Salam Khan, MD FACP – November, 2016
Patients coming to see their doctor and similarly when they go to the emergency department want best treatment for themselves. They want cure for their ills and comfort for their distress. For them the quality lies in their satisfaction and alleviation of their sickness. The physicians caring for them have a greater burden by addressing the illness in a methodical way as well as communicate well with their patients to make them satisfied about the treatment.
Plenty has been written regarding quality, ethics and patient satisfaction. Are they synonymous or is there a meaningful difference between these terms. Let us examine these concepts and make some sense for the doctors, nurses and paramedical and other staff who serve the patients on daily basis.
By quality care it means, right care to the right patient at the right time – every time. There are three components to the quality: structure, process and the outcome. By structure we means the people who provide the care and areas where the care is provided. So it is the medical personnel and the medical facilities like clinics, hospitals and other areas like nursing homes. Once the structure is right then quality care requires right process. Was right things done at the right time. For example when blood sugar was needed to be done, was it actually done. The third component of the quality care is the outcome. The quality care should result in improvement of the condition that was addressed and acted upon. The outcome study thus represent the quality of the care provided to patients. Consistently produced bad outcome can not be seen as quality care, and so needs the structure or the process be changed to influence the outcome.
Patient satisfaction is the most sought out quality indicator. Patient satisfaction is the measure of the extent that a patient is satisfied or content with the healthcare that they received by their healthcare provider. Patient satisfaction translates into better clinical outcomes, improved patient retention, and decreased medical malpractice claims. A satisfied patient perceives the care as meeting the expectations, so of perceived good quality. The perception of patient may not be accurate but can be a good indirect measure of the quality, as it correlates directly to the outcome that is very important aspect of the quality care.
Ethical medicine is treating the patient with moral values, or incorporating ethical concepts into the day to day medical practice. It deals with the issues of right and wrong. In other words the medical decisions can be judged as done right or wrong on the basis of defined principles. These principles are called ethical principles and serve the purpose of elevating the quality of care from ethical standpoint. It sometimes can be construed as having religious basis but as a global perspective it has taken a more secular role in defining medical morality. These principles govern aspects of medicine that enrich the patients experience with his or her care giver and thus may indirectly affect the perception of quality. Ethical principles may seem contradicting from certain religious dogma, but looking closely they have enough flexibility to incorporate patients personal preferences and even religious impliabilities.
Taking a deeper and wholesome look at these concepts it is important to note that the medical care has to incorporate all three concepts to be seen as superior care. A good medical personnel is expected to be ethical person who provides quality care that leads to good patients satisfaction. So when we teach our youth the lessons about clinical medicine and diagnostic skills, we need to spend equal time on teaching them ethical principles and the incorporation of these principles into medical practice. The youth need to see us, the senior lot practicing what we preach and they need to learn the practical point by observing us rather than listening to what we say only. It’s the right thing to do as we know the big component of the quality is keeping up with the ethical standards.
I can be reached at askhan65@yahoo.com.