Sunday, May 10, 2009

Heath care satisfaction down

Patients are apparently less satisfied this compared to last year, by 2 percentage points, from 76% to 74%. Typical of the quality of reporting of our newspapers, no one bothered to ask what was the confidence levels of the data generated by the survey, and whether this difference was statistically significant. It apparently didn't matter to them, as long as a number could be reported. *sigh*.....

In truth, even at 74% satisfaction (or poor bottom place CGH at 66%), it is actually not too bad. Not that I am advocating complacency and suggesting that no improvement is required, but simply that patients and relatives are by and large, quite difficult to satisfy.

What is interesting, and also important to note, is that patient satisfaction does not seem to parallel the amount of investment the hospital put into developing technology, or providing services. I had a recent experience of relative who had been diagnosed with cancer, and I must say I was pretty peeved at the service she received. Yes, there was electronic medical records and transmissibility of information across hospitals, and all kinds of technology access etc, but the common touch that showed the doctor(s) actually cared for the patient was glaringly missing.

This I believe is something the hospitals need to pay special attention to. Increased technology, impressive glass and steel only increase health care costs. Overall patient satisfaction probably can only improved through proper staff training and change in mindsets of our healthcare givers. Let me say that by and large many of our healthcare givers are committed caring individuals.....otherwise the patient satisfaction cannot be 'so high'. But there is a distinct population of relatively inexperienced and poorly trained/motivated staff which drag everybody down. This is where the hospitals need to place their emphases on.


Anonymous said...


I worked in one of the biggie hospital in SG. I believe the institutions are trying to improve customer service as employees, medical, allied health & other support staff are routinely sent on customer service improvement courses.

Unfortunately, high staff turnover as well as perenial manpower shortage often means that hospital staff are pressured to complete not only their designated duties but also "duties" that happened to fall on them when someone in the department goes on leave or quits.

Personally, I find it a challenge sometimes to remind myself that I need to see patients as individuals needing attention & care, not just another case to review, or another task to complete.

I am not a dr, but my husband is. He has many colleagues who leave the institution for private practice so that they are able to spend more time with each patient.

The healthcare cost in SG is perhaps much lower than many other developed countries? I am not sure if in the effort to keep a lid on rising healthcare costs, we are losing out on quality (and I mean not only the standard of treatment) care. Of course one may argue that you can still have a heart even if you are busy. However, healthcare professionals are also human. Our intentions may be noble but really, after years of working in public healthcare, compliments and words of thx & appreciation from the public are few & far in between. The morale of the healthcare team has been low for the longest time..

gigamole said...

Thanks for dropping by, Anon.

We see a lot of the things that you mention. It is kinda sad because we seem to be starving in the midst of plenty. I mean there seems a lot of money flying around, but they seem to be going to all the fancy glass and steel edifices or into the creation of some service that looks good on paper that does nothing to really improve the human touch. I think this is really a consequence of how we measure performance.

Profit centres tend to be well supported. Image enhancers tend to be well supported. But many of the real quality issues are relatively intangible. And in a sense the only indicator of this mismatch is when patient satisfaction reveals itself. So despite all the $$ flowing around and expanding services etc etc, patient satisfaction either drops or remains static.

Food for thought isn't it? Perhaps if we invested a bit more on human factors, and in the development of softer issues related to real care and compassion we might be able to see a change in the right direction....?

auntielucia said...

Hi Giga, thought I shld let u know that yr comment on the survey prompted me to praise TTSH aloud in my blog-- since I have more intimate knowledge of the hospital --at the receipt of service end, than the nameless pple who were probably surveyed at random... I also echoed yr sentiment that a 2/3 approval rate ain't bad at all. After all, didn't only 2/3 of S'poreans voted PAP ;)))))

gigamole said...

Hi AuntieL,

Glad you had some good experiences at TTSH. I think healthcare providers are a very heterogeneous lot. There are many who are very compassionate and caring in the way they manage patients, and correspondingly there are a whole bunch of them who seem like they have no clue about what it's all about. Often it's the luck of the draw who we encounter when we are sick, or when we bring a sickie loved one. Sometimes (shamefacedly blushing) even so called caring doctors get bad tempered when busy, stressed or just encountering unreasonable patients at the wrong time of month!

Most feel that AH looks better than others simply because their workload is way less than the other more 'in-demand' hospitals. I know TTSH has probably more than their share of caring (old school) doctors, but they also have one of the highest patient loads, and they are stressed to break points.

So we do need to look at these figures that MOH generates with a pinch of salt. Not withstanding my tolerance of the 74% satisfaction rate, I got no qualms in kicking the hospitals a bit, because it makes them (not the doctors, but the damned managers) sit up and notice, so they do not forget it's not just about revenue generation.

[This was also posted as comment in AuntieL's blog (