Our Blog

Navigating In-Flight Turbulence

By John Bielinski, MS, PA-C

The Difference Between Patient and Customer

As 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 customer.

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. Lots of opiates. Bet you can’t guess what he was allergic to.)

Managing Extremes

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 receive Dilaudid – needless to say not so happy. Pain was a 10 and remained a 10.

This is my job as a PA.

See John Bielinski live at any Skin, Bones, Hearts & Private Parts CME Conference.