Waiting time, staff misconduct and misdiagnosis were among the most common concerns students had with University Health Services between September 2008 and 2009, according to 46 complaints and suggestions obtained by The Badger Herald.
The documents provide a glimpse into UHS’s procedures for responding to feedback and have led to several major policy changes for the campus health care provider.
The complaints
While the 46 documents “filed with UHS concerning a patient’s dissatisfaction with service, inadequate treatment or misdiagnoses” vary widely in their content, they generally focus on problems with waiting time, staff misconduct, misdiagnosis, general facilities and resources and privacy.
As many list multiple concerns, some complaints and suggestions have been included in the totals for more than one category.
Waiting time was the most common concern among UHS visitors, with 21 complaints listing issues that arose while setting up an appointment, waiting to meet with a health care provider and being informed of a diagnosis.
Some detail included waiting for a nurse or doctor for upwards of half an hour after being admitted, or spending weeks attempting to get in contact with a specific care provider. Others described waiting multiple days for a diagnosis that staff members said would be ready in a matter of hours.
Perceptions of staff misconduct were the second most common concern, with 13 documents listing instances of disrespect or other actions that created discomfort.
One complaint details a visit to a nutritionist by an overweight female student. During the visit, the complaint says the nutritionist took the student by the shoulders and said she had “a very large frame” and “quite the shoulders.”
The student describes the visit as demoralizing and reinforcing the idea there is no hope of reaching “a socially and personally comfortable weight.”
“I came into my appointment with [redacted] feeling positive and like I was taking the right steps toward changing harmful eating patterns,” the patient wrote. “I left feeling as if I had been repeatedly kicked in the stomach.”
Another complaint describes a doctor reacting with surprise when a patient asked what was causing their symptoms instead of what they could do to make them go away.
After the doctor repeatedly asked the patient what they thought was causing the symptoms, the doctor was quoted as responding, “You can always go on WebMD and look up causes for your [redacted].”
Eight documents list cases of misdiagnosis, two of which resulted in $400 charges for seeking ultimately unnecessary additional care.
Another two detail cases where a student was incorrectly assured by phone of a diagnosis. One student spent several hundred dollars traveling home and seeking alternate care after being diagnosed with H1N1 and denied care at UHS, only to find they had the common cold.
In the second case, a student was assured her lack of menstruation was due to stopping birth control and there would be no need to take a pregnancy test. Several weeks later, the student discovered she was in fact pregnant.
Five complaints and suggestions outlined specific issues concerning privacy. In several instances, patients felt receptionists violated the Health Insurance Portability and Accountability Act, which protects the privacy of medical information, by announcing the reason for their visit.
Another complaint critiques the setup of the counseling floor, where the reception desk is visible from the elevator bank. As appointments are set up at this desk, the student said this could create an uncomfortable situation for patients that may deter some from seeking help.
Lastly, five documents detailed concerns with general UHS facilities and resources such as the size of waiting rooms and variety of free pamphlets and condoms.
The follow-up process
While many of the documents convey serious dissatisfaction with UHS’s services, Director Sarah Van Orman confirmed they represent a very small percentage of all visits. In 2009 alone, she said UHS saw over 80,000 students.
While she said these numbers should be used to put complaints into context, she emphasized UHS takes each complaint very seriously and ensures follow up is completed on all concerns.
“Certainly we want every patient to be 100 percent happy when they leave here, but we recognize that that sometimes doesn’t happen,” Van Orman said. “We try to have a process so we can resolve it.”
Currently, patients can file responses to UHS services via forms provided at UHS or their website. Students can also speak with care providers or call Van Orman directly.
Van Orman said when feedback is received, a copy goes to herself and Rob Sepich, the student relations manager. Sepich reviews each response and forwards them to the most appropriate department director or manager.
That director or manager then meets with any employee involved to address issues or conduct retraining. Changes to overall policy are also considered.
Sepich said cases where the student provides his or her name are especially useful, as a full investigation can then be completed.
Addressing trends
According to Sepich, UHS recently revised its policies to make appointments easier to schedule and accessible within 24 hours.
After noticing a pattern of complaints, Sepich said the facility moved toward “open access,” meaning if people want to be seen by a health care provider, they will be. Previously, prescreening and other barriers to access made it significantly harder to secure an appointment.
UHS also switched to an automated phone system following complaints of frequently encountering a busy signal. While Sepich said being answered by a machine is a downside, more students can be put in contact with a receptionist.
After students check in, Van Orman said an electronic system tracks the amount of time it takes for a student to be admitted and seen by a staff member.
Currently, she said patients spend an average of seven minutes in the waiting room. If the electronic system or complaints indicate a specific staff person takes longer than average to begin appointments, UHS will follow up with them.
“We do know we always have certain providers who tend to fall behind schedule and we’ve worked extensively with those providers,” Van Orman said
Sepich said there has been a trend toward more students complaining of waiting times upon being admitted.
“My take on it is as we’ve gotten faster and faster at getting people in for appointments… once they’re in an exam room, it can feel like a long delay,” Sepich said. “Sometimes 15 minutes can go fast for a medical expert, but can feel very long for a student.”
As far as privacy goes, Van Orman said UHS is currently overhauling scheduling procedures on their counseling floor.
The new setup will allow greater privacy for students.
“The way the new counseling waiting room was configured, it really is creating some problems and we’ve noticed that with those complaints,” Van Orman said. “We’re going to be changing how we schedule intakes so they are now scheduled in a separate room versus having them come up to the desk to schedule those.”
Both Van Orman and Sepich strongly encourage students with concerns to contact UHS.
“We love feedback,” Sepich said. “If [patients are] comfortable giving their information that’s fantastic… but even if they would rather be anonymous, that’s fantastic as well.
We always want to get compliments but the complaints seem especially valuable because we use those to make changes in our policies.”
