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Prompted By Customer Service

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The women’s health movement in the seventies focused a lot on empowerment and respect—giving women the information and resources they needed to make good health decisions, in a supportive environment.  Which is what anyone deserves of course.  It is what inspired me to go into medicine, but I was not alone; the larger community health movement evolved to address many local needs in “underserved” populations due to poverty, gender, color, language, or immigration status.  They still carry this torch, and those who staff these clinics are some of the most dedicated and community-oriented people you can meet.

Are people merely “consumers” seeking to get the best deal from health “providers” based on market factors (and their satisfaction is important so they will keep being customers?) Or are they just people needing to heal? 

Keeping “the mission” of service and empowerment is not easy of course.  Good intentions are not enough—you also need skills, training and support.  Growing into a large organization struggling to survive financially can lead to missteps.  Disrespecting the staff will poison their ability to provide service. There are myriad pitfalls.

I experienced many of the stresses working in both frontline care and as administrator.  Those of us interacting with patients daily were driven to take time to listen, discuss, problem solve, comfort, document and create relationships.  Those minding the books were driven to get more “productivity”, going so far as to accuse those seeing patients of doing “too good a job”.  To be fair, everyone shared a desire to provide health care and keep the doors open, but finding a balance was hard.  And harder since we were trying to create another model within a larger health environment that didn’t share our passions.

The tension between trying to heal people and to run a business may be inevitable in any health system but it is worth asking whether the primary mission is to improve health of people or of pocketbooks. Are people merely “consumers” seeking to get the best deal from health “providers” based on market factors (and their satisfaction is important so they will keep being customers?) Or are they just people needing to heal?

My position is that healing comes from taking care of each other, not taking advantage.  Health does not simply emerge when treated as another business transaction between customer and purveyor–as a critique of the US system can attest.  And as It turns out, having growth and profit as the primary goal is not a healthy paradigm for planetary survival either.  There are many opportunities for change. I believe that if we see our most important mission as one of mutual service, empowerment and respect, then we have the best chance for the future.

Profile photo of Khati Hendry Khati Hendry

Characterizations: right on!, well written


  1. So well put Khati, and luckily there are still caring health care providers like you out there.

    By coincidence both my husband and I landed in the local suburban ER on different days and for different reasons last week, and each of us experienced compassionate and knowledgeable caregivers. But I know in large urban hospitals that’s not always the case.

  2. Marian says:

    Marvelous essay, Khati, and how true. One of my pet peeves about the healthcare system is being surveyed to death, and then never seeing improvements. Maybe because of COVID, the lead times to get appointments are really daunting.

    • Khati Hendry says:

      Good point. In the guise of patient satisfaction, it seems we just give data points for systems to pressure component parts, not to actually respond to any particular concern. A bit more human time and connection would seem to work better.

  3. Betsy Pfau says:

    Well-said, Khati. You thesis is compassionate and correct. Medical care should not be a cost center, driven by a profit motive. Unfortunately, that is what we’ve experienced here in the US and we are living with those consequences.

  4. John Shutkin says:

    What a beautiful, conmpassionate and enlightened story, Khati. You are one of the good ones, that’s for sure.

    And, from the standpoint of this Retro prompt, a fascinating perspective not from the customer standpoint (as most of us have written about), but from the “business” side — though you make clear that you would never operate as the usual “business” in our society would. Brava!

    • Khati Hendry says:

      Thanks John. There is certainly a place for business relations, but they also are best tempered by the human interaction. It is no secret that there are real benefits to knowing the people you do business with—not what you know, but who you know. And then there are places where the business model as the primary reason for interaction just falls down.

  5. Laurie Levy says:

    You state the problem with our current version of healthcare perfectly. What I see is older doctors leaving, especially in the primary care field, because the demands of the business side of things keep them from doing what they love to do — helping their patients.

    • Khati Hendry says:

      Yes, I think there is a lot of fatigue from administrative burdens, and not just in the US, and not just physicians. Money alone won’t fix it, though if used to provide better support it would certainly help. Of course teachers, social workers and other care workers would say the same. When you put your heart and soul into difficult work and burnout it is really tragic. So many examples of societal imbalance out there.

  6. Suzy says:

    I have always been lucky enough to have good healthcare, as a child because my father was my doctor, and as an adult because state employees in California get excellent health benefits. But you certainly make good points about managed healthcare and the problems of treating it like a business. “Mutual service, empowerment and respect” is a great goal that could be applied to most areas of life!

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