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Excellence- the New Mediocre?

By Amy Holmes posted 01-24-2014 22:49


If you’ve had work on your car or been waited on in anyway over the last year or two, you have probably been asked to complete a satisfaction survey.  Chances are you heard something like this: “If you were happy with your service today, please be sure to rate it as excellent.”  I have had at least one request include the plea, “It doesn’t count unless I’m rated excellent.”  Similarly, when some organizations look at patient satisfaction scores, they report as percentage of excellence.  It appears that “good” and “very good” are inadequate.  Many times I have thought to myself that evaluations like these have little merit.


Wikipedia defines excellence as “a talent or quality which is unusually good and so surpasses ordinary standards.”  Another online source defines it as “superiority.”  Taking that into consideration, doesn’t it seem that a rating of excellent should be reserved for the best of the best?


First, consider whether anyone can ever be excellent in all things all the time?  Not if they’re human they can’t!  I strive to be the best that I can be, but after years of practice and experience I can’t say that every presentation that I give or every task that I complete is excellent.  So why do I feel bad about rating a resident’s work as less than excellent?  Still I do find myself compelled to score them 4 (“very good”) or 5 (“excellent/exceptional”) as if 3 (“acceptable/good”) is not good enough!   Less than excellent does not equate to inadequate.  If the baseline is excellence, then doesn’t excellence become average?


Second, consider that evaluations are meant not only to praise.  Evaluations are meant to give meaningful feedback which should include positive comments about specific things that were done well along with areas for improvement.  Constructive feedback is the only way to grow a professional.  For those businesses looking for “excellent” scores, I must assume that they are not really interested in what I think of the service or work that I had done.  If John Doe is going to hand me a survey and ask me to rate him as excellent, then what is really the point of the survey?


Obviously I am really frustrated by the futility of this “only excellence counts” approach, but my opinion of this broken system doesn’t count for much.  What I can concentrate on is my own little microcosm- my residency program and my professional practice.  We will try to take the good with the bad- allowing “good” to be good enough so that when we really get it right, the word excellent has true meaning.  And we can feel satisfied (and proud) in the accomplishment. 

#Quality #PatientSafety #Residency
1 comment



01-28-2014 07:27

Well said! I hope that other preceptors share this with their colleagues and residents. It's a good discussion topic for organizations with residency programs as personal and professional growth is the ultimate goal of the residency experience.
Thanks for sharing your perspectives.