Hospitals Are Paying More Attention to Patients’ Complaints

Consider the scene: Wrapped in a drafty hospital gown, you wiggle your toes against scratchy hospital sheets. Facing you is a meal of warm juice, cold coffee and rubbery eggs. Do you suffer in silence or complain?

By all means, complain! That’s the message from most modern hospitals.

Today, odds are your hospital will have at least one person--and maybe even a whole committee--to field complaints, requests and other patient input doctors and nurses don’t have time to handle.

Since 1975, the number of hospitals employing “patient representatives” has more than tripled, according to the American Hospital Assn. Fifteen years ago, 15% of hospitals employed them. Now, more than 51% do. At some hospitals, these patient helpers are called ombudsmen; at others, consumer affairs representatives.


And at some Southern California hospitals, the trend, spokesmen say, is to specialize--to let the employee who knows most about the area handle the complaint.

“Some hospitals found that a single patient representative could not handle all complaints or requests,” said Georgia Sobiech, one of about six employees who handle patient requests at St. Joseph Medical Center in Burbank. Each has a specific area of expertise, such as billing, long-term care or patient care services.

At other hospitals, all employees who have contact with patients have been briefed on how to act as patient representatives, helping to direct special requests or complaints to the right person.

Some hospitals train volunteers to help. At Childrens Hospital Los Angeles, half a dozen volunteers devote their time to handling patient requests, said Judy Baker, a registered nurse who manages consumer relations.

For patients, the trick seems to be tracking down who is in charge. Check patient admission packets first; many list a telephone number to call with questions, complaints and requests.

What kinds of complaints get attention? Local patient representatives cited these examples:

* A patient complained about nighttime noise. The patient representative discovered floors were being polished every night, and rescheduled that work to a daytime shift.

* Parents asked to see their children as soon as possible after surgery. The hospital developed a program to permit it.

* Another patient complained he could not decipher a hospital bill. The hospital reformatted the statements.

* Parents of long-term patients balked at high parking rates. The hospital started a reduced-rate system for long-term parkers.

Effective resolution of complaints is good for more than the patient’s psyche, noted Baker. “Studies suggest that patients who are allowed to air their complaints and to feel they have been addressed are more compliant in following their treatment plans.”

POINT COUNTERPOINT Can a Clear Plastic Device Replace Braces?

Every year, more than a million mouths begin orthodontic treatment, according to the American Assn. of Orthodontists. With more than 70% of them under the age of 18, a growing number of parents are wondering whether their children truly need braces. In recent years, an alternative to braces has appeared on the scene. It is called the Occlus-o-Guide and, like a football mouth guard, is a clear plastic device that fits over the teeth. Developed by Earl O. Bergersen, a Winnetka, Ill., orthodontist and dental lecturer at Tufts University, the Occlus-o-Guide is worn for two to four hours a day for four to eight months. It is designed to guide children’s erupting teeth into position.

Here are two views on its effectiveness.

Earl O. Bergersen, Winnetka, Ill.; orthodontist, dental lecturer, Tufts University.

“It doesn’t hurt to try it. Most problems can be corrected in one-third the time conventional orthodontics would require. And it is one-fourth to one-half the cost. It’s especially helpful for children with a deep overbite, with overjet (buck teeth) and with moderately crowded teeth. Starting treatment at age 9 or 10 is ideal because it works best on growing teeth. When a child bites into this, it forces the teeth into a normal bite. It limits the growth of the upper jaw and improves the bite, thus improving the teeth’s appearance. It works on half of the kids who need orthodontics.”

Ralph Allman, Torrance orthodontist; co-chair, orthodontics, USC School of Dentistry.

“Guiding children’s teeth as they erupt is nothing new. But this appliance is limited in what it can do. It can guide erupting teeth. But guiding the teeth alone won’t always improve the bite. Often the position of the jaws must be altered in order to improve the child’s appearance. This appliance can’t do that. This appliance has limited applications. Probably less than 10% of children who need braces will be helped by this appliance. In patients improperly selected, this appliance could make things worse.”

SHOPTALK New Programmable Hearing Aid

Those who wear hearing aids know the problem: The quality of hearing changes with differing environments and background noises. People with normal hearing aren’t aware of the changes because their ears adjust automatically. But aid-users do notice, and so have some manufacturers; they recently have introduced programmable hearing aids to address the problem.

One of the newest, the MemoryMate, lets the wearer choose between eight separate memories for use in different listening situations, said a company spokesman. The memories may be programmed, for instance, to maximize speech clarity for casual listening, music or especially noisy environments. The programmable aids range in price from $1,200 to $2,000, or about twice the cost of conventional hearing aids.

And what does a hearing aid expert say? “These hearing aids do give wearers more flexibility,” said Sigfrid Soli, director of hearing aid research at the House Ear Institute in Los Angeles. He calls the ability to select a different setting for different environments an important feature. “But the downside is these devices are new and there’s not a lot of experience in the field.”