Most hospitals claim that their core mission is to treat patients with respect and compassion the essence of the “patients first” philosophy. Patients expect to be heard, given clear explanations, and involved in decisions.
This is what “patients first” is supposed to mean. Patients expect to be heard, given clear explanations, and involved in decisions.
However, many patients say that their real experience in hospitals feels rushed or confusing. Studies show that effective patient-provider communication directly influences patient satisfaction, treatment adherence, and clinical outcomes, with poor communication being a significant contributor to patient safety incidents. Patient experience is shaped by how well doctors and patients communicate and work together, not just by medical treatment alone. [1,2,4]
Modern hospitals operate within administrative systems that track performance, efficiency, and cost. These structures are meant to improve consistency and accountability. However, they can also shift the focus of care. When time schedules, billing models, and performance indicators dominate decision-making, patient interaction time can decrease. As a result, the clinical environment may begin to feel more like a structured service industry than a healing setting.
Private hospitals need money to keep running. They earn through tests, procedures, room charges, and specialist consultations. But when earning targets influence decisions, patients may be asked to undergo more investigations or longer hospital stays than necessary.[3]
While hospitals must remain financially sustainable, the concern arises when revenue considerations begin to direct clinical choices more than medical necessity. The issue is not profit itself, but how profit is prioritized in day-to-day clinical practice.
I’ve seen systems where success meant the spreadsheet looked good even if families left frustrated. Where “efficiency” meant shaving minutes from conversations, not adding clarity. Where “improvement” meant the numbers went up while trust went down.
Dr. David B. Granet, Endowed Professor, Vice Chair (Strategic Initiatives & Pediatric Ophthalmology), Surgeon & Television Host, at UC San Diego
In a recent LinkedIn post, Dr. David B. Granet, Endowed Professor, Vice Chair, Surgeon, and Television Host at UC San Diego, shared his reflections on this growing concern, highlighting how hospital systems often find themselves caught between the ideals of patient-centered care and the realities of financial sustainability. His post sparked thoughtful discussion among other professionals in the field, underscoring the urgency of addressing this imbalance.
Doctors, nurses, and hospital staff are under constant pressure. They deal with long hours, emotional stress, and heavy paperwork. This can lead to burnout.
Burnout affects how staff speak, listen, and respond to patients. Multiple studies demonstrate that burnout is associated with decreased quality of care, increased medical errors, and compromised patient safety through communication breakdowns and operational inefficiencies. [4] When healthcare workers are exhausted:
Conversations become shorter
Patients get fewer explanations
Mistakes may be more likely
So when a patient feels a doctor is rushed, it may be because the doctor has too many patients, not because they do not care.
When the system becomes the patient, things like HR, risk management are beholden to a system that’s too big to fail, and priorities may become “shifted”
Dr. Thomas Steinemann, Professor of Ophthalmology, MetroHealth System, Ohio, USA
Clinical treatment focuses on diagnosis and medicines. Patient experience focuses on how the patient feels during care. Research shows these two are linked. Better patient experience often leads to better recovery and health outcomes.[2]
So listening to patients is not just compassion. It is part of good medical care.
Healthcare has become expensive. Families often struggle to pay hospital bills. For many, the worry of cost affects decisions about when to seek care and how long to continue treatment.
When healthcare becomes difficult to afford, the idea of “patients first” does not feel true in practice.
Healthcare turned upside down. The patient has become a tool for the institutions to generate revenue.
Dr. Dan Bohl, Urologist, Edenton, North Carolina, United States
Patients need clear explanations. They need to know:
What the illness is
Why a test is needed
What to expect next
Research demonstrates that poor communication between patients and practitioners contributes significantly to patient safety incidents, while effective communication reduces uncertainty, enhances patient engagement in decision-making, and improves treatment adherence. Hospitals can improve outcomes simply by allowing more time for conversation and questions. [4]
Patients often blame the doctor when they feel ignored. But many doctors work inside strict systems that control how much time they can spend with each patient. The problem is mostly with the system, not individual doctors.
To improve patient care, the system needs change, not just the people working in it.
Absolutely! Our entire system is built around provider centric data where data is often about the system itself, not the people it’s meant to serve. Provider-centric metrics dominate dashboards, while patient experience, dignity, and understanding get reduced to optional surveys. We need to reimagine what “patients first” truly means. Not use it as a slogan or PR but as a design principle. That means:- Metrics that reflect meaning and care of the person as a whole - Time for listening, not just pushing patients through for one issue per visit - Care that’s relational, not just transactional
Sangeeta C, Management Consultant, Strategy and Operations, Jennings Consulting Ltd - Bermuda
Hospitals can move closer to “patients first” by:
Including patient feedback in planning
Reducing workload stress on staff
Being transparent about costs
Giving time for patients to ask questions
Supporting shared decision-making
Small changes in how hospitals talk to and support patients can make a meaningful difference.
Medicine can’t heal patients if it spends all its time treating the system.
Dr. David B. Granet, Endowed Professor, Vice Chair, Surgeon & Television Host, at UC San Diego.
“Patients first” should not only be a slogan. It should be reflected in how hospitals communicate, how staff are supported, and how decisions are made. When hospitals focus on listening, explaining, and involving patients in decisions, trust grows. This is how healthcare becomes not only effective, but humane.
Putting patients first is not expensive or complicated. It is about respect, clarity, and empathy in every interaction.
1. Lateef F. Patient expectations and the paradigm shift of care in emergency medicine. J Emerg Trauma Shock. 2011 Apr;4(2):163-7. doi: 10.4103/0974-2700.82199. PMID: 21769199; PMCID: PMC3132352.
2. Shale S (2013), "Patient experience as an indicator of clinical quality in emergency care". Clinical Governance: An International Journal, Vol. 18 No. 4 pp. 285–292
3. Needham BR. The truth about patient experience: what we can learn from other industries, and how three ps can improve health outcomes, strengthen brands, and delight customers. J Healthc Manag. 2012 Jul-Aug;57(4):255-63. PMID: 22905604.
4. Panagioti, Maria, et al. "Association between physician burnout and patient safety, professionalism, and patient satisfaction: a systematic review and meta-analysis." JAMA Internal Medicine 178, no. 10 (2018): 1317-1331.
Edited by M Subha Maheswari
