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Introduction

In December 2010, I received a letter from the husband of a deceased patient who said the Clinic had failed his wife. Enclosed was a photograph of the couple at their daughter’s wedding. My heart sank. Looking at the beautiful picture, I immediately feared that we had missed something, that there had been a terrible medical error causing a treatment failure that led to her death. His wife had been diagnosed with breast cancer; she was successfully treated and cured. Several years later she had a recurrence, which was treated and controlled. She subsequently developed a final recurrence, and despite aggressive treatment, the disease won the war. She began palliative treatment and was sent home on hospice. She was readmitted to the hospital for dehydration and died after four days.

Her last wish had been to die peacefully at home, with her family at her side. We had failed at helping her realize this last wish. She did not need to be in the hospital the last three days of her life. The patient and her husband told everyone who would listen that they needed to get home. No one could help them. They talked to doctors, nurses, case managers, social workers. No one could make the appropriate arrangements to have her discharged. Furthermore, no one was coordinating her care. She had no hope from further medical treatment; she wanted to be with her family at home. We did not fail in her medical treatment; we failed in her treatment as a person. Our organization was unable to integrate the emotional and spiritual elements of this patient’s care with her medical care. We failed her because no one was listening to the patient or the family. Everyone was focused on his or her “job,” and collectively they ignored the primary purpose of why we are here, which is to put the patient first.

Today that letter and photograph sit on my desk as a constant reminder that treating patients is about more than just treating disease, and that to be successful, we need an organization where the patient is at the center of everything we do. It is a reminder of why we are here and the purpose of what we do every day for patients.

I have heard it said that up to 90 percent of service businesses say they know exactly what their customers want, but only 10 percent actually take the time and invest the resources to be sure they are right. This is an interesting but shocking statistic. Most people leading service businesses would say they understand their markets and customers. I’m sure many can point to robust market share and sales growth. Imagine how much more successful these companies could be with research to intimately target customer needs.

Healthcare providers—doctors, nurses, and administrators—are guilty of this phenomenon as well. We think we know exactly what’s ...

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