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EM Physician Assistant – Patient vs. Customer

John Bielinski, MS PA-C By February 15, 2015March 14th, 20172 Comments
EM Physician Assistant – Patient vs. Customer

Slide1As a “lone wolf EM physician assistant” (PA that works in a critical access hospital ED) I am never surprised at what is asked of me. I understand that about 50% of my job is social work and demands high-end human interaction skills. With that said, there is a huge difference between a patient and costumer.

My ED shift started after a brief sign out from the night PA. Two patients presented at the same time – 48 yo F with chest pain and a 32 yo M with chronic left shoulder pain. One was a patient. A STEMI. She was scared and only wanted to live. She knew her life was in jeopardy. The male wanted a shot of Dialudid. (Pain for 3 weeks… no new injury. Lot’s of opiates. Bet you can’t guess what he was allergic to.)

It’s like flying in an airplane. On the extreme end of the spectrum, I want the plane not to crash. Please. Get me there safe. (That’s the expectations of a patient.) But, we like to judge the airline by on time departure, luggage, pillows, smiles and drinks. These are customers.

So, my shift starts with extremes, a true patient and a customer. The STEMI received lytics and was satisfied when pain dropped from 9 to a zero. Chronic pain didn’t received Dilaudid – needless to say not so happy. Pain was a 10 and remained a 10.

This is my job as a PA.

I love it.


  • Bob says:

    How true. We see people, and some come as customers with the idea that they are always right regardless of how badly they act, what demands they make etc.

    Working for a big corporation as I do, I just sit back and bite my tongue when they give us the “Customer Care” speeches, knowing that patients will come in for care, and some people will leave unhappy. Fact of life.

    AK PA #545

  • Debbie Taylor says:

    I remember seeing the transition of our patients into “customers” when I initially became a PA 20 yrs ago. I didn’t totally understand the impact this was bringing to health care at that time. It was a silent but brutal transition. I took a few years off after about 10 yrs then returned to work (because I missed patient care). It was only then that this change slapped me in the face. I sit through classes regarding customer service/care and cringe the entire time and get frustrated as well. I went through PA school to learn how to care for my patient’s mentally and physically. I have the compassion and knowledge to care for their over all well being and there are times when what they want is truly not best for their health. I realize that there is a place for good service (customer friendly) however it should not be the focus in our daily mission of taking care of our patient’s health. I would prefer that more of our “free time”, monthly staff meetings be individual medical cases and CMEs. This I can take with me and utilize to improve patient care. Customer Care translates into, if a patient can’t find what they want (not necessarily what they need) at this establishment they will go to another. It’s like trying to find the right pair of shoes…

    I still enjoy what I do and will continue in patient care (family medicine) as long as I am able. I don’t see an end to this “trend” in customer service but focus on my individual patient’s health/trust and provider to patient relationship. The customer service portion comes naturally with the compassion and integrity I continue to hold for caring for my patients total well being.

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