My LinkedIn update this week referenced a term I recently became acquainted with when it was used by an administrator in my system. It seemed vaguely offensive at the time but I couldn’t quite get my head around it to understand why. It’s called leakage. When this article, “How to reduce patient referral leakage” popped into my inbox, it hit me–is this going to be one more set of numbers administrators can threaten me with? I understand this is a term used in other industries to refer to the consumers they are losing to competitors and I’m fine with that. However, what does leakage mean to a doctor? It’s what aging bladders do. It’s what comes out of an infected wound sometimes, or an imperforate anus. When doctors use the term leakage it is not a pleasant visual. Maybe a tube is blocked. An organ is swollen. The idea that my patients are being referred to in this way is offensive. I’d like to do a study with my patients. “Tell me, how do you like being referred to as leakage if you go to another healthcare system or an independent imaging facility for your healthcare needs?” Somehow, I suspect I already know the answer to that question.
The way we use words is important. Leakage is simply not an appropriate term to use in healthcare. If I didn’t have faith that my system employs some of the best doctors around and takes extraordinary care of patients both inpatient and outpatient, I wouldn’t be working for it. Unless my patients request otherwise, and they seldom do because they trust me and they trust my system, they are referred within. But how much trust would they continue to have in me if they knew I was being pressured to refer in-system? Let’s stop talking about leakage and instead attract the best doctors to take care of our patients because they deserve it. Let’s make our system one where the best doctors want to come and know their patients will be well cared for. Let’s put our patients first and they will continue to come back to us. Let’s be careful with our terminology. Just because other industries use a term that does not mean it is appropriate to use it in healthcare.
When the chair of the board brings his daughter to me and she needs to see a cardiologist do you think he’s going to want me to choose the physician she sees based on who employs her? I suspect not. And next time he or anyone else uses that term around me, be prepared for an earful. My patients are not leakage. You will not refer to them as such in my presence.by