A Professional Patient
Hi, there. My name is Amanda and it’s a joy to join you today for this week’s Thinking Thursday TIPs. As the mother of four wonderful children (one of which has “special needs”), I’m no stranger to healthcare facilities of all varieties and specialties. My youngest son suffered an anoxic episode at the age of three-months, resulting in a brain injury, and leading to a diagnosis of Epilepsy, Cerebral Palsy, and overall severe developmental delay, just to name the top three. He’s six years old now and we still heavily rely on his healthcare team (a.k.a., fan club) on a consistent basis. We’ve been known to frequent the local Emergency Room while on vacation, all of my contacts listed under “favorites” on my phone are healthcare professionals, and my gratitude towards those in the healthcare field runs deep. My husband and I are indebted to so many who have selflessly cared for our children over the years.
Growing up with asthma and a whole slew of allergies, I can’t contribute my entire healthcare experience to my children’s ailments alone, but they definitely promoted me to the top of my career as a professional patient. Managing my children’s healthcare (particularly my youngest’s) is literally my job. My hope through this series is to provide some insight from the patient perspective in a way that helps, encourages, and maybe even educates your healthcare team.
After my son’s accident, the neurologist explained to us that, although he will most likely be developmentally delayed, the sky is the limit for his progress as long as we work intentionally and consistently to stimulate his brain and “train” his muscles. Physical, occupational, speech, and feeding therapy became our life. As you can imagine, we developed meaningful relationships with his therapists and depended on their services greatly for his daily function. Fast forward to January of this year when our primary insurance changed. The private clinic where my son received therapies was not in-network with our new primary insurance. I’ll spare you the nitty-gritty details, but suffice it to say the clinic’s solution was to bill us out of pocket while we tried to retrieve the proper paperwork required to go through his secondary insurance (Medicaid). My husband and I expressed to the clinic we could not afford the hundreds of dollars it would cost us on a weekly basis to pay for all of his therapies out of pocket. The clinic suggested we strip down his therapies and prioritize only his physical therapy appointments since he was currently rehabbing from a previous surgery in November 2020. So we did, and my son went nearly four weeks without a single speech, feeding, or occupational therapy session.
My husband and I began doing our research, desperate to find a way for him to resume his other therapies. What we quickly learned is that the clinic was in the wrong for billing us out of pocket due to my son’s status as a Medicaid recipient. However, when we brought this to their attention, they insisted they were not in the wrong and stated, “If you cannot pay at the time of service, do not come.” Fast forward a few days, my husband and I were assigned a Medicaid caseworker who advocated for my son’s optimal care, and not only did the clinic agree to resume all therapies, they reimbursed us for our out-of-pocket expenses. However, we never received an apology or admission for the mistake from the clinic. My husband and I couldn’t overlook what their actions were telling us: my son’s wellbeing wasn’t their top priority. As you can imagine, the decision to leave the clinic and those therapists we had a five-year relationship with was extremely difficult and devastating, but we felt it was in our son’s best interest.
An Apology Makes All the Difference
Following the whole insurance debacle, my husband and I both had several one-on-one conversations with the vice president and head of billing at the clinic, hoping to receive an apology for wrongly billing us, as well as any semblance of awareness to the unfortunate fact that our son’s care suffered as a result. Much to our dismay, neither took place. DocFormats provides excellent, practical advice on how to construct a professional and meaningful apology to patients in their article, “Apology Letter to Patient – 5+ Sample Letters.” I’ll highlight the section titled, “Tips for Writing a Perfect Apology Letter:” (1)
- Be straight to the point.
“Just be straightforward and say, ‘I am sorry’ instead of ‘I am sorry but…’
- Own the mistake.
“Do not put the blame on other people. Take full responsibility for the mistake.”
- Explain what happened.
“Take the recipient through the cause of the incident. This will help them know what really happened. However, do not put so much focus on the blame because it may end up making the explanation too long, remain focused on your role.”
- State your plan to amend the mistake.
“Let the recipient know the measures you have put in place to rectify the mistake or to make sure that the mistake will never happen again.”
Ask for forgiveness.
“The main purpose of the letter is to ask for forgiveness. After all the explanation, make sure you ask for forgiveness. You can use a statement like ‘please forgive me.’”
I can honestly say if my husband and I had received a letter that contained the above points, it would have made all the difference. Recognition of the mistake would have assured us it wouldn’t happen again (to us, or other families) and would have communicated that our son’s care truly was their primary concern.
Responding to Feedback
Furthermore, if the clinic had been open to our initial feedback regarding being wrongly billed, things could have gone much differently. According to Patient Pop’s article highlighting their 2020 patient perspective survey, “Responding to patients is one of the most important aspects of managing patient communication, with a direct line to satisfying patients – when practices respond to feedback from unhappy patients, the rate of satisfaction improves… When practices don’t respond, the rate of patient dissatisfaction goes up to 276 percent.” I would like to add from the patient’s perspective, responding to patient feedback in a dismissive and/or defensive manner is equally (if not more) dissatisfying to the patient.
My husband and I expressed both our gratitude for the care provided for our son over the last five years, yet also the points of dissatisfaction that lead to our relocating in a face-to-face conversation with the clinic’s vice president. We were sent off with a written letter containing several bullet points, once again, taking zero ownership of the mistake and explaining how they were not in the wrong. Unlike our choice to keep our feedback private, most patients are choosing to share both positive and negative feedback more publicly, via an online platform. According to Patient Pop’s survey, of the patients surveyed, 45.5% said they post reviews of healthcare providers on Google, 28% on Yelp, 26.5% on the practice’s website, 15.6% on Facebook, 15.6% on WebMD, and 13.5% on Healthgrades. Furthermore, Patient Pop reports, “…7 of 10 patients rely most often on other patient’s experiences by way of online reviews.” (2) It’s important to know what your patients are saying about your facility, where they’re saying it, and respond appropriately, in humility.
Despite the rich relationships we had with our son’s therapists and the quality care we received from them over the years, my husband and I could not look past what the actions of the clinic’s management communicated. Their actions indicated our son’s care was not the top priority. As his parents, and his main healthcare advocates, my husband and I had to make a difficult choice in our son’s best interest. Conflict can be tricky (especially when dealing with financial issues), however healthy resolution – resulting in patient retention, is much more likely with an apology and an open ear to feedback.
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Jerry L. Stone