What’s Wrong with Health Care?

A Burger King hamburger sesame seed bun, as se...

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Customer service.

We’ve turned taking care of the sick and injured into fucking Burger King. Everyone wants it “their” way. Sorry folks, life isn’t like that especially in my house. When we turn patients into consumers, they begin to expect to treated like customers and hence have no skin in the game. This leads to unrealistic expectations and our administrative “leaders” play up that we are in the business of providing customer service instead of healing. That then becomes our problems on the floors and our “customers” think that “their” way is the only way.

Yes, I will be disturbing you at midnight to check your vitals and then doing it again at 4am.

Yes, you will have blood drawn, probably several times through the day and night.

No, you can’t have your hydrmorphodemerolepam every hour, even if that’s how you take it at home – which is probably what got you here in the first place.

No, burger and fries are not part of your heart healthy diet to help treat your congestive heart failure.

Yes, lasix makes you pee. And, yes, I will be giving you a dose tonight, as the doctor ordered, every 8 hours so that you can breath and not have a hugely swollen scrotum.

Yes, it would be nice for your family to come in to learn wound care techniques so they can care for you at home.

No, not all of them can stay the night with you in a double room.

No, you can’t go out to smoke, even just for a minute. And I’m definitely not giving you an oxygen tank and wheelchair to do it.

Yes, you are more than welcome to leave AMA because we’re all racist assholes who won’t give you IV narcotics every hour, please just sign this form.

No, you don’t get a cab voucher, discharge prescriptions or fresh clothes if you do leave AMA. Sorry.

Yes, Dr. First-Year Intern, they just left AMA after threatening the entire staff, but you might catch them by the ED if you hurry. I’d bring Security with you though.

I will be polite and respectful, but I will not fawn over ingrates, feed into those with unreasonable expectations or take the crap from the dis-respectful. I refuse to be turned into a cashier clerk at the local fast food joint or a Pez dispenser of Oxycontin. There is difference between customer service and letting the public run wild in our house.

It’s time to take it back.

To set expectations.

To educate our patients.

To let the world know that we are not there to be exploited, abused and disrespected.

It’s a long journey, but it starts with a single step, for nurses and other health-care providers to stand up and say, “NO MORE!” and start to expect our patients to be active and involved, to care about their health, to put some skin in the game and start behaving like responsible adults.

But that will never happen. Sad.


  1. I said this countless times as a nurse. Literally word for word. “This isn’t Burger King, you don’t get to have it your way. Your way was wrong, hence, you being in the ICU, shut up and listen to the docs and nurses.” It never gets you anywhere.


  2. Seriously? THIS load of hooey is what’s wrong with healthcare? Here are a few of my own:

    No, well-known Augusta cardiologist, this isn’t the patient you’ve discussed surgery with; apparently you have way too much on your plate to keep up with which patient is which.

    No, ER snotty lady doctor, I’m not a physician myself, but I do have concerns that my 83 year-old mother who’s been smoking since she was 15 might not be able to rebound from the surgery you’re recommending (she wasn’t). Maybe you were right when you asserted that without surgery she would be dead in six months, but we’ll never know because she did have the surgery and she was dead in less than a month.

    No, Neurologist, I don’t mind at all waiting for over three hours for my five minute (not exagerating) visit with you. What is my time compared with yours?

    No, ER doctor, I will not accept on faith that my mother who could walk yesterday and can’t today is “just old,” and “these things happen.” What’s that? Elevated white-cell count? I didn’t quite catch what you were saying because you were speaking so softly. I can only assume that because YOU were wrong seven ways to Sunday, the shock of your mistake robbed you of your voice.

    No, unending list of neurologists, my mother’s trigeminal neuralgia was not astutely diagnosed by ANY of you. Yes, it was my sister, the medical record coder who figured it out. I understand how you might want to take credit for figuring it out but you didn’t. My mother posthumously thanks you for the cocaine, though. For the two years of suffering owing at least in part to your slow-wittedness – not so much.

    I think you’re entirely mistaken, all of you. You ARE working at Burger King, the (correct) assertion that we can’t have it our way nothwithstanding. The service I see smacks of fast-food mentality from here to daybreak. How very clever you are and how very cute this blog is. And you wonder at the contempt in which the public holds you – apparently you don’t have to be all that sharp to graduate medical school, after all.


    1. This is what I’m talking about: fix this. And then blame when it isn’t fixed. When that is the level of discourse it wears you out, the post is about that.

      Health care is a relationship, a 2 way street, but too many treat it as a 1 way and expect a wave of the wand fixes everything. Sorry, it isn’t like that. Diagnoses are missed, doctors are super busy, bad choices recommended, but of all that highlights the need to have personal advocates, clear statements about what care IS wanted and the responsibility to get second, even third opinions.

      I’ve been through the belly of the beast as a family member and as a nurse so I have seen the dysfunction from both sides.


  3. Sorry head-scratcher- you seem to have had a bad experience with healthcare (ahem, doctors it seems!). I think Wanderer is speaking more from the perspective of a nurse, i.e. the slaves of healthcare. He’s getting at the fact that so much of our patient ratio spend their lives making bad choices about their health and think that an admission to the hospital is a vacation at the Hilton resort. Nurses do their best to accept (multiple) patients (at a time) and treat them with dignity, but there needs to be a level of mutual respect.


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