What Makes Consumers Satisfied?

Dear Dr. Jeff: Our facility administrator has asked all the “providers” to participate in a chain-wide program to boost “consumer satisfaction.” Our medical team would be happy to participate in quality improvement projects. But most of us object to the paradigm where our patients become consumers of medical care and we become short order cooks in a medical fast food chain, selling drugs on demand while wearing smile buttons. Good care often requires saying “no” to antipsychotics used as sleeping pills, excessive opioids, siderails, antibiotics for foul-smelling urine, Valium prescriptions for 90-year-olds, and a long list of other substandard practices which are, unfortunately, common in the community.