Every day, millions of Americans walk out of Starbucks with beverages that meet all of their individual preferences. If the coffee empire were to stop fulfilling its promise to give customers exactly what they ask for, it would flop. In contrast, hospitals — which are supposed to attend to peoples' individual needs — consistently fail to fulfill patients' medical care preferences.
"A company that delivers a product that does not honor and respect the individual preferences of its customers is a recipe for disaster," Angelo E. Volandes, MD, writes in a recent Forbes article.
For end-of-life care in healthcare, unfortunately, hospitals often fail to honor and respect patients' individual preferences. Unlike Starbucks, hospitals benefit financially from disregarding patients' end of life preferences, because admitting patients who are dying means more reimbursement, Dr. Volandes argues.
Dr. Volandes, faculty at Harvard Medical School and Massachusetts General Hospital in Boston and author of "The Conversation: A Revolutionary Plan for End-of-Life Care," argues there is a large discrepancy between the kind of care patients want at the end of their lives and what actually happens because many physicians fail to have this discussion with them.
Although CMS has introduced reimbursement penalties to change physicians' tendency to admit end-of-life patients to hospital care, American healthcare is rewarded for keeping hospitals at status quo, according to the article.
The vast majority of Americans — 86 percent — want to spend their last few months at home with family and friends, not in hospitals and nursing homes, according to Dr. Volandes. However, 63 percent of Americans older than age 65 die in hospitals and nursing homes, often attached to machines and in pain, while only 24 percent die at home.
"Despite the billions of dollars that are invested in new medical technologies, the most important intervention in medicine today happens to be its least expensive and technological: timely and comprehensive discussions with patients as they near death," Dr. Volandes says. Not having these conversations usually leads to oversight of patients' personal preferences and trauma for both patients' and their families.
Dr. Volandes argues this needs to change. While he admits solving America's end-of-life care problems is not as simple as preparing a cup of coffee, it is healthcare's inability to simply listen and adhere to the desires of its "customers" — as Starbucks does — that inhibits its success.