Starving Dietitian

No Kitchen Left Behind

You might be pleasantly surprised, next time you’re forced to chow down on hospital food, that it’s not the food you so despised.


Hospital foodservice competition has skyrocketed in the past few years. As my preceptor used to say “People can get care anywhere, they come for the service“.

See in a time when Doctors float between hospitals, there’s really not much differentiating each facility.

Competition isn’t the only reason for this renewed value on fresh food though. Would you be surprised if I told you there’s money involved?

Part of the Patient Protection and Affordable Care Act (Obamacare for those that care) is a change in how Medical and Medicare reimbursements are handled. No longer can hospitals skate by with poor food and unhappy patients, now reimbursements are directly tied to patient satisfaction scores. What could be wrong with that?

One of my favorite quotes goes “The road to hell is paved with good (political) intentions“, I added a word but the message is the same.

I know it sounds good; happier patients, better food, but it’s an incredibly reductionist way to view quality of care.

The survey I’ve seen calls patients at random and asks “Have you Always, Sometimes, Rarely, or Never been satisfied with the foodservice?

Head in Hands

Even in my basic research classes we were taught not to use words like “always” in our surveys. I mean, how many of us can honestly say we are always content with anything?

So the patient hears the word always, and thinks “well, there was that one time my eggs were a little cold”. That person just gave the hospital a score of 0.

Which brings me to my next point, the survey is all or nothing. If they don’t say “always”, they might as well be a “never” because the points are the same.

Just like No Child Left Behind shifted the focus from well-rounded children to test scores, I’m beginning to see the shift from nutrition care to satisfaction scores.

Given the choice between charting on another patient or going room to room doing foodservice PR, the latter is being chosen.

Call me old-fashioned but it’s my humble opinion that cold eggs shouldn’t take precedent over sick patients,


Be good to each other.

– Joshua Iufer

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