My family and I recently had the opportunity to accompany our disabled son to Germany. The purpose of the trip was to obtain an experimental adult autologous stem cell therapy in the hope that my son with cerebral palsy would somehow benefit from this developing technology. The clinic providing the service is privately owned and operated. It is the first of its kind in all of Europe.
Part of the procedure involved anesthesia which requires the patient to be fasting for several hours prior. Upon arrival at the clinic, the receptionist offered us drinks – apple juice, water, coffee. Our other children and I accepted the offer but did not wish to break the fast my son was still engaged in. When my wife read the paperwork she was filling out, we noted it said that fasting was not required. So, we gave a small amount of apple juice to our son. This was a mistake.
When it came time for the anesthesia to be administered, the physician asked if my son was still fasting. We informed him of the small amount of apple juice he just consumed. With this, the doctor became distressed and a bit agitated as the risk of aspiration while under anesthesia is significant. And so we waited an additional hour to begin the procedure.
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This is where things get interesting.
After the procedure, which went fine, we sat down with the doctor to review the entire episode. The purpose was to identify the reasons why we gave the juice to our fasting boy. It was in this context that the doctor shared something interesting with us:
"This is a private facility. I came here because I like to work; I like to get paid for my work. Each hour I see a new patient. Each new patient means I get paid. When I worked in the public system, it did not matter if I sat at my desk and twiddled my thumbs and only saw two patients a day. I still got paid the same amount. Here, when I have to wait another hour to see a patient, it affects my entire day."
He then showed us his schedule – full each hour for days on end.
The doctor became one of our favorite people we met on this trip. We were able to overcome culture and language barriers together. He listened to our concerns and was genuinely interested in improving the services his facility delivered. He took notes. He followed up. And when we returned for the final portion of the treatment, he was prepared for our arrival and had informed his staff on the suggested improvements. It took less than two days to implement the changes we suggested.
In economic terms, this is what is called the profit motive. The doctor was motivated how? He said it himself: money – he likes to get paid. But it wasn't only that. His actions indicated he had an additional motivator: customer satisfaction. He understood that we referred other clients to him and would likely refer more. He understood that there was a whole community supporting our son in this treatment that would likely be given the details of our experience. He understood the power of maintaining a good reputation. So, he listened, took notes, reacted quickly, and was happy to make positive changes to his practice.
What a remarkable, efficient display of health care delivery! Must I point out that the government was not involved in this outcome in any way? And even if it was, does anyone really think the outcome would have changed for the better?
So how is my son? Wonderful! The therapy seems to be working. The experience was a success.
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