Review: Patients Come Second: Leading Change by Changing the Way You Lead

Patients Come Second: Leading Change by Changing the Way You Lead
Patients Come Second: Leading Change by Changing the Way You Lead by Paul Spiegelman

My rating: 3 of 5 stars

I wanted to like this book more. The provocative title says a lot. However, the point could have been made with fewer words. Moreover, I looked forward to real-life examples to illustrate this idea, and was disappointed.

In brief, the authors claim that over-focusing on the customer (or in healthcare, the patient), although wonderful on the surface, can be twisted into ununtentional results. Shall we, as physicians, chase after the increasingly important “patient satisfaction” metric at the cost of, say, antibiotic overprescribing? “Oh, so you’ve had a cough for a day, and you’d like some antibiotics?” It is indeed easy, and quick, to say “Sure, here you go” and get back on track with an over-scheduled clinic day, and be assured of a higher patient satisfaction rating. Who would rather spend the 5-10 minutes to discuss the patient’s root concerns, explain the risks of overprescribing, and grit the teeth anticipating the inevitable “I drove all the way over, paid my co-pay, and THE NERVE of that doctor to withhold my necessary antibiotics” and resulting low patient satisfaction score.

Burnout.

Yes, this is not news to any practicing physicians. Yes, we know we’re being pinched from all sides. Yes, there is too much ‘fat’ in the US healthcare system and something has to be done. Yes, Obamacare did some great things and also did not do enough. Yes, we need to listen to our patients and ensure we do the best for every one of them. Yes, we need to treat our physicians better, so that they can step back from the brink of burnout, of retirement, of leaving medicine in disgust, of suicide. Yes, this book is a call-to-arms.

No, its not as helpful as it could have been. There’s less substance than the pages would indicate.

CMIO’s take? This book is more valuable for the shocking title and its use in conversation and leadership meetings, than it is for its actual content.

View all my reviews

Author: CT Lin

CMIO, University of Colorado Health; Professor, University of Colorado School of Medicine

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