Information

Solving Common Health Industry Complaints


Dr. Phil Zeltzman is a traveling, board-certified surgeon in Allentown, PA. His website is www.DrPhilZeltzman.com. He is the co-author of “Walk a Hound, Lose a Pound” (www.WalkaHound.com).

Kelly Serfas, a Certified Veterinary Technician in Bethlehem, PA, contributed to this article.

In 2013, Consumer Reports magazine surveyed 1,000 people about their doctors. The intention was to identify and rate the most common client complaints. Having recently come across the article, I felt compelled to examine a few of these concerns from a veterinarian’s point of view. If you find yourself nodding in agreement with any of these statements when you visit the veterinarian, it’s important that you bring them up. Remember, a stronger bond with your pet’s doctor will probably mean a healthier pet.

I’m often unclear on an explanation of a problem
How well you understand your veterinarian will likely depend on the individual communication style. Some family veterinarians and specialists are very good at using everyday words and simplifying things so you can understand. Others may need to be asked if they can simplify.

  • What should you do? If you do not understand something, don’t be shy or embarrassed, and please ask questions until you get it. Your pet’s health is at stake here!

Test results are not communicated fast enough
Some veterinarians will call personally with test results, especially positive test results. Sometimes, when results are straight-forward or negative, they may ask a technician to call you. That said, please keep in mind that some tests take time to perform — sometimes up to a week if not two.

  • What should you do? Ask when you should expect your test results and write the date on your calendar. If it is time and you have not heard from your veterinarian, simply call to inquire.

Billing disputes are hard to resolve
This is hopefully less commonly an issue in veterinary medicine, because human medical billing (which is notoriously nebulous) goes not only through your doctor’s office but also your insurance company. That’s not to say pets shouldn’t have insurance too., but it tends to be less complicated. Click here to learn why ensuring your pet is so important.

  • What should you do? You have the right to ask for a detailed estimate (before services are rendered) and a detailed invoice (after treatment has been provided). If you have a concern, have someone go over each item and voice your concerns.

It’s hard to get quick appointments for sick pets
Some veterinary hospitals are clearly busier than others. Some are more able than others to cater to their clients and will fit in a sick patient no matter what.

  • What should you do? Try not to let small issues become large problems or emergencies. If your pet is vomiting, call sooner for an appointment rather than letting a few days go by. For true emergencies, know where your nearest veterinary emergency hospital is.

I’m rushed during office visits
Some clinics dedicate 5-10 minutes for appointments, while others may allow 20-30 minutes. Things are a bit different at an emergency hospital. If you are the only client, you shouldn’t feel rushed. But chances are, there are multiple other patients — some in critical situations — being seen or treated. In such cases, the doctor will logically have less time to dedicate to less critical patients. This is very similar to what happens at a human ER.

  • What should you do? Prepare a list of the three most important questions you have, and make sure you at least get these answers.

My pet is discharged from the hospital too early
We are very fortunate in the veterinary world that insurance companies (or at least the good ones) do not dictate how we practice medicine. Overall, most veterinarians use good judgment before sending a patient home.

  • What should you do? If you have concerns about the duration of your pet’s hospitalization (it’s too long or too short) you should have an open discussion with your veterinarian. Sometimes, the stay is shorter than we’d like due to financial or behavioral concerns. For example, an aggressive pet may not be able to be treated properly without endangering the staff (or himself). Or a pet may refuse to eat at the hospital. In such cases, an agreement should be reached with the guardian before the pet is sent home.

You may notice that most of these complaints have to do with communication issues, and most should be solved by having an open conversation with your veterinarian. Click here for part two of this topic>>

If you have any questions or concerns, you should always visit or call your veterinarian -- they are your best resource to ensure the health and well-being of your pets.


Contents

  • 1 Etymology
  • 2 Clinical practice
  • 3 Institutions
    • 3.1 Delivery
  • 4 Branches
    • 4.1 Basic sciences
    • 4.2 Specialties
      • 4.2.1 Surgical specialty
      • 4.2.2 Internal medicine specialty
      • 4.2.3 Diagnostic specialties
      • 4.2.4 Other major specialties
    • 4.3 Interdisciplinary fields
  • 5 Education and legal controls
  • 6 Medical ethics
  • 7 History
    • 7.1 Ancient world
    • 7.2 Middle Ages
    • 7.3 Modern
  • 8 Quality, efficiency, and access
  • 9 Traditional medicine
  • 10 See also
  • 11 References

Medicine ( UK: / ˈ m ɛ d s ɪ n / ( listen ) , US: / ˈ m ɛ d ɪ s ɪ n / ( listen ) ) is the science and practice of the diagnosis, prognosis, treatment, and prevention of disease. [7] [8] The word "medicine" is derived from Latin medicus, meaning "a physician". [9] [10]

Medical availability and clinical practice varies across the world due to regional differences in culture and technology. Modern scientific medicine is highly developed in the Western world, while in developing countries such as parts of Africa or Asia, the population may rely more heavily on traditional medicine with limited evidence and efficacy and no required formal training for practitioners. [11]

In the developed world, evidence-based medicine is not universally used in clinical practice for example, a 2007 survey of literature reviews found that about 49% of the interventions lacked sufficient evidence to support either benefit or harm. [12]

In modern clinical practice, physicians and physician assistants personally assess patients in order to diagnose, prognose, treat, and prevent disease using clinical judgment. The doctor-patient relationship typically begins an interaction with an examination of the patient's medical history and medical record, followed by a medical interview [13] and a physical examination. Basic diagnostic medical devices (e.g. stethoscope, tongue depressor) are typically used. After examination for signs and interviewing for symptoms, the doctor may order medical tests (e.g. blood tests), take a biopsy, or prescribe pharmaceutical drugs or other therapies. Differential diagnosis methods help to rule out conditions based on the information provided. During the encounter, properly informing the patient of all relevant facts is an important part of the relationship and the development of trust. The medical encounter is then documented in the medical record, which is a legal document in many jurisdictions. [14] Follow-ups may be shorter but follow the same general procedure, and specialists follow a similar process. The diagnosis and treatment may take only a few minutes or a few weeks depending upon the complexity of the issue.

The components of the medical interview [13] and encounter are:

  • Chief complaint (CC): the reason for the current medical visit. These are the 'symptoms.' They are in the patient's own words and are recorded along with the duration of each one. Also called 'chief concern' or 'presenting complaint'.
  • History of present illness (HPI): the chronological order of events of symptoms and further clarification of each symptom. Distinguishable from history of previous illness, often called past medical history (PMH). Medical history comprises HPI and PMH.
  • Current activity: occupation, hobbies, what the patient actually does.
  • Medications (Rx): what drugs the patient takes including prescribed, over-the-counter, and home remedies, as well as alternative and herbal medicines/herbal remedies. Allergies are also recorded.
  • Past medical history (PMH/PMHx): concurrent medical problems, past hospitalizations and operations, injuries, past infectious diseases or vaccinations, history of known allergies.
  • Social history (SH): birthplace, residences, marital history, social and economic status, habits (including diet, medications, tobacco, alcohol).
  • Family history (FH): listing of diseases in the family that may impact the patient. A family tree is sometimes used.
  • Review of systems (ROS) or systems inquiry: a set of additional questions to ask, which may be missed on HPI: a general enquiry (have you noticed any weight loss, change in sleep quality, fevers, lumps and bumps? etc.), followed by questions on the body's main organ systems (heart, lungs, digestive tract, urinary tract, etc.).

The physical examination is the examination of the patient for medical signs of disease, which are objective and observable, in contrast to symptoms that are volunteered by the patient and not necessarily objectively observable. [15] The healthcare provider uses sight, hearing, touch, and sometimes smell (e.g., in infection, uremia, diabetic ketoacidosis). Four actions are the basis of physical examination: inspection, palpation (feel), percussion (tap to determine resonance characteristics), and auscultation (listen), generally in that order although auscultation occurs prior to percussion and palpation for abdominal assessments. [16]

The clinical examination involves the study of: [17]

  • Vital signs including height, weight, body temperature, blood pressure, pulse, respiration rate, and hemoglobin oxygen saturation[18]
  • General appearance of the patient and specific indicators of disease (nutritional status, presence of jaundice, pallor or clubbing)
  • Skin
  • Head, eye, ear, nose, and throat (HEENT) [19]
  • Cardiovascular (heart and blood vessels)
  • Respiratory (large airways and lungs) [20]
  • Abdomen and rectum
  • Genitalia (and pregnancy if the patient is or could be pregnant)
  • Musculoskeletal (including spine and extremities)
  • Neurological (consciousness, awareness, brain, vision, cranial nerves, spinal cord and peripheral nerves)
  • Psychiatric (orientation, mental state, mood, evidence of abnormal perception or thought).

It is to likely focus on areas of interest highlighted in the medical history and may not include everything listed above.

The treatment plan may include ordering additional medical laboratory tests and medical imaging studies, starting therapy, referral to a specialist, or watchful observation. Follow-up may be advised. Depending upon the health insurance plan and the managed care system, various forms of "utilization review", such as prior authorization of tests, may place barriers on accessing expensive services. [21]

The medical decision-making (MDM) process involves analysis and synthesis of all the above data to come up with a list of possible diagnoses (the differential diagnoses), along with an idea of what needs to be done to obtain a definitive diagnosis that would explain the patient's problem.

On subsequent visits, the process may be repeated in an abbreviated manner to obtain any new history, symptoms, physical findings, and lab or imaging results or specialist consultations.

Contemporary medicine is in general conducted within health care systems. Legal, credentialing and financing frameworks are established by individual governments, augmented on occasion by international organizations, such as churches. The characteristics of any given health care system have significant impact on the way medical care is provided.

From ancient times, Christian emphasis on practical charity gave rise to the development of systematic nursing and hospitals and the Catholic Church today remains the largest non-government provider of medical services in the world. [22] Advanced industrial countries (with the exception of the United States) [23] [24] and many developing countries provide medical services through a system of universal health care that aims to guarantee care for all through a single-payer health care system, or compulsory private or co-operative health insurance. This is intended to ensure that the entire population has access to medical care on the basis of need rather than ability to pay. Delivery may be via private medical practices or by state-owned hospitals and clinics, or by charities, most commonly by a combination of all three.

Most tribal societies provide no guarantee of healthcare for the population as a whole. In such societies, healthcare is available to those that can afford to pay for it or have self-insured it (either directly or as part of an employment contract) or who may be covered by care financed by the government or tribe directly.

Transparency of information is another factor defining a delivery system. Access to information on conditions, treatments, quality, and pricing greatly affects the choice by patients/consumers and, therefore, the incentives of medical professionals. While the US healthcare system has come under fire for lack of openness, [25] new legislation may encourage greater openness. There is a perceived tension between the need for transparency on the one hand and such issues as patient confidentiality and the possible exploitation of information for commercial gain on the other.

Delivery Edit

Provision of medical care is classified into primary, secondary, and tertiary care categories. [26]

Primary care medical services are provided by physicians, physician assistants, nurse practitioners, or other health professionals who have first contact with a patient seeking medical treatment or care. [27] These occur in physician offices, clinics, nursing homes, schools, home visits, and other places close to patients. About 90% of medical visits can be treated by the primary care provider. These include treatment of acute and chronic illnesses, preventive care and health education for all ages and both sexes.

Secondary care medical services are provided by medical specialists in their offices or clinics or at local community hospitals for a patient referred by a primary care provider who first diagnosed or treated the patient. [28] Referrals are made for those patients who required the expertise or procedures performed by specialists. These include both ambulatory care and inpatient services, Emergency departments, intensive care medicine, surgery services, physical therapy, labor and delivery, endoscopy units, diagnostic laboratory and medical imaging services, hospice centers, etc. Some primary care providers may also take care of hospitalized patients and deliver babies in a secondary care setting.

Tertiary care medical services are provided by specialist hospitals or regional centers equipped with diagnostic and treatment facilities not generally available at local hospitals. These include trauma centers, burn treatment centers, advanced neonatology unit services, organ transplants, high-risk pregnancy, radiation oncology, etc.

Modern medical care also depends on information – still delivered in many health care settings on paper records, but increasingly nowadays by electronic means.

In low-income countries, modern healthcare is often too expensive for the average person. International healthcare policy researchers have advocated that "user fees" be removed in these areas to ensure access, although even after removal, significant costs and barriers remain. [29]

Separation of prescribing and dispensing is a practice in medicine and pharmacy in which the physician who provides a medical prescription is independent from the pharmacist who provides the prescription drug. In the Western world there are centuries of tradition for separating pharmacists from physicians. In Asian countries, it is traditional for physicians to also provide drugs. [30]

The scope and sciences underpinning human medicine overlap many other fields. Dentistry, while considered by some a separate discipline from medicine, is a medical field.

A patient admitted to the hospital is usually under the care of a specific team based on their main presenting problem, e.g., the cardiology team, who then may interact with other specialties, e.g., surgical, radiology, to help diagnose or treat the main problem or any subsequent complications/developments.

Physicians have many specializations and subspecializations into certain branches of medicine, which are listed below. There are variations from country to country regarding which specialties certain subspecialties are in.

The main branches of medicine are:

  • Basic sciences of medicine this is what every physician is educated in, and some return to in biomedical research
  • Medical specialties
  • Interdisciplinary fields, where different medical specialties are mixed to function in certain occasions.

Basic sciences Edit

  • Anatomy is the study of the physical structure of organisms. In contrast to macroscopic or gross anatomy, cytology and histology are concerned with microscopic structures.
  • Biochemistry is the study of the chemistry taking place in living organisms, especially the structure and function of their chemical components.
  • Biomechanics is the study of the structure and function of biological systems by means of the methods of Mechanics.
  • Biostatistics is the application of statistics to biological fields in the broadest sense. A knowledge of biostatistics is essential in the planning, evaluation, and interpretation of medical research. It is also fundamental to epidemiology and evidence-based medicine.
  • Biophysics is an interdisciplinary science that uses the methods of physics and physical chemistry to study biological systems.
  • Cytology is the microscopic study of individual cells.
  • Embryology is the study of the early development of organisms.
  • Endocrinology is the study of hormones and their effect throughout the body of animals.
  • Epidemiology is the study of the demographics of disease processes, and includes, but is not limited to, the study of epidemics.
  • Genetics is the study of genes, and their role in biological inheritance.
  • Histology is the study of the structures of biological tissues by light microscopy, electron microscopy and immunohistochemistry.
  • Immunology is the study of the immune system, which includes the innate and adaptive immune system in humans, for example.
  • Medical physics is the study of the applications of physics principles in medicine.
  • Microbiology is the study of microorganisms, including protozoa, bacteria, fungi, and viruses.
  • Molecular biology is the study of molecular underpinnings of the process of replication, transcription and translation of the genetic material.
  • Neuroscience includes those disciplines of science that are related to the study of the nervous system. A main focus of neuroscience is the biology and physiology of the human brain and spinal cord. Some related clinical specialties include neurology, neurosurgery and psychiatry.
  • Nutrition science (theoretical focus) and dietetics (practical focus) is the study of the relationship of food and drink to health and disease, especially in determining an optimal diet. Medical nutrition therapy is done by dietitians and is prescribed for diabetes, cardiovascular diseases, weight and eating disorders, allergies, malnutrition, and neoplastic diseases.
  • Pathology as a science is the study of disease—the causes, course, progression and resolution thereof.
  • Pharmacology is the study of drugs and their actions.
  • Gynecology is the study of female reproductive system.
  • Photobiology is the study of the interactions between non-ionizing radiation and living organisms.
  • Physiology is the study of the normal functioning of the body and the underlying regulatory mechanisms.
  • Radiobiology is the study of the interactions between ionizing radiation and living organisms.
  • Toxicology is the study of hazardous effects of drugs and poisons.

Specialties Edit

In the broadest meaning of "medicine", there are many different specialties. In the UK, most specialities have their own body or college, which has its own entrance examination. These are collectively known as the Royal Colleges, although not all currently use the term "Royal". The development of a speciality is often driven by new technology (such as the development of effective anaesthetics) or ways of working (such as emergency departments) the new specialty leads to the formation of a unifying body of doctors and the prestige of administering their own examination.

Within medical circles, specialities usually fit into one of two broad categories: "Medicine" and "Surgery." "Medicine" refers to the practice of non-operative medicine, and most of its subspecialties require preliminary training in Internal Medicine. In the UK, this was traditionally evidenced by passing the examination for the Membership of the Royal College of Physicians (MRCP) or the equivalent college in Scotland or Ireland. "Surgery" refers to the practice of operative medicine, and most subspecialties in this area require preliminary training in General Surgery, which in the UK leads to membership of the Royal College of Surgeons of England (MRCS). At present, some specialties of medicine do not fit easily into either of these categories, such as radiology, pathology, or anesthesia. Most of these have branched from one or other of the two camps above for example anaesthesia developed first as a faculty of the Royal College of Surgeons (for which MRCS/FRCS would have been required) before becoming the Royal College of Anaesthetists and membership of the college is attained by sitting for the examination of the Fellowship of the Royal College of Anesthetists (FRCA).

Surgical specialty Edit

Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate or treat a pathological condition such as disease or injury, to help improve bodily function or appearance or to repair unwanted ruptured areas (for example, a perforated ear drum). Surgeons must also manage pre-operative, post-operative, and potential surgical candidates on the hospital wards. Surgery has many sub-specialties, including general surgery, [31] ophthalmic surgery, [32] cardiovascular surgery, colorectal surgery, [33] neurosurgery, [34] oral and maxillofacial surgery, [35] oncologic surgery, [36] orthopedic surgery, [37] otolaryngology, [38] plastic surgery, [39] podiatric surgery, transplant surgery, trauma surgery, [40] urology, [41] vascular surgery, [42] and pediatric surgery [43] . In some centers, anesthesiology is part of the division of surgery (for historical and logistical reasons), although it is not a surgical discipline. Other medical specialties may employ surgical procedures, such as ophthalmology and dermatology, but are not considered surgical sub-specialties per se.

Surgical training in the U.S. requires a minimum of five years of residency after medical school. Sub-specialties of surgery often require seven or more years. In addition, fellowships can last an additional one to three years. Because post-residency fellowships can be competitive, many trainees devote two additional years to research. Thus in some cases surgical training will not finish until more than a decade after medical school. Furthermore, surgical training can be very difficult and time-consuming.

Internal medicine specialty Edit

Internal medicine is the medical specialty dealing with the prevention, diagnosis, and treatment of adult diseases. [44] According to some sources, an emphasis on internal structures is implied. [45] In North America, specialists in internal medicine are commonly called "internists." Elsewhere, especially in Commonwealth nations, such specialists are often called physicians. [46] These terms, internist or physician (in the narrow sense, common outside North America), generally exclude practitioners of gynecology and obstetrics, pathology, psychiatry, and especially surgery and its subspecialities.

Because their patients are often seriously ill or require complex investigations, internists do much of their work in hospitals. Formerly, many internists were not subspecialized such general physicians would see any complex nonsurgical problem this style of practice has become much less common. In modern urban practice, most internists are subspecialists: that is, they generally limit their medical practice to problems of one organ system or to one particular area of medical knowledge. For example, gastroenterologists and nephrologists specialize respectively in diseases of the gut and the kidneys. [47]

In the Commonwealth of Nations and some other countries, specialist pediatricians and geriatricians are also described as specialist physicians (or internists) who have subspecialized by age of patient rather than by organ system. Elsewhere, especially in North America, general pediatrics is often a form of primary care.

There are many subspecialities (or subdisciplines) of internal medicine:

  • Angiology/Vascular Medicine
  • Bariatrics
  • Cardiology
  • Critical care medicine
  • Endocrinology
  • Gastroenterology
  • Geriatrics
  • Hematology
  • Hepatology
  • Infectious disease
  • Nephrology
  • Neurology
  • Oncology
  • Pediatrics
  • Pulmonology/Pneumology/Respirology/chest medicine
  • Rheumatology
  • Sports Medicine

Training in internal medicine (as opposed to surgical training), varies considerably across the world: see the articles on medical education and physician for more details. In North America, it requires at least three years of residency training after medical school, which can then be followed by a one- to three-year fellowship in the subspecialties listed above. In general, resident work hours in medicine are less than those in surgery, averaging about 60 hours per week in the US. This difference does not apply in the UK where all doctors are now required by law to work less than 48 hours per week on average.

Diagnostic specialties Edit

  • Clinical laboratory sciences are the clinical diagnostic services that apply laboratory techniques to diagnosis and management of patients. In the United States, these services are supervised by a pathologist. The personnel that work in these medical laboratory departments are technically trained staff who do not hold medical degrees, but who usually hold an undergraduate medical technology degree, who actually perform the tests, assays, and procedures needed for providing the specific services. Subspecialties include transfusion medicine, cellular pathology, clinical chemistry, hematology, clinical microbiology and clinical immunology.
  • Pathology as a medical specialty is the branch of medicine that deals with the study of diseases and the morphologic, physiologic changes produced by them. As a diagnostic specialty, pathology can be considered the basis of modern scientific medical knowledge and plays a large role in evidence-based medicine. Many modern molecular tests such as flow cytometry, polymerase chain reaction (PCR), immunohistochemistry, cytogenetics, gene rearrangements studies and fluorescent in situ hybridization (FISH) fall within the territory of pathology.
  • Diagnostic radiology is concerned with imaging of the body, e.g. by x-rays, x-ray computed tomography, ultrasonography, and nuclear magnetic resonancetomography. Interventional radiologists can access areas in the body under imaging for an intervention or diagnostic sampling.
  • Nuclear medicine is concerned with studying human organ systems by administering radiolabelled substances (radiopharmaceuticals) to the body, which can then be imaged outside the body by a gamma camera or a PET scanner. Each radiopharmaceutical consists of two parts: a tracer that is specific for the function under study (e.g., neurotransmitter pathway, metabolic pathway, blood flow, or other), and a radionuclide (usually either a gamma-emitter or a positron emitter). There is a degree of overlap between nuclear medicine and radiology, as evidenced by the emergence of combined devices such as the PET/CT scanner.
  • Clinical neurophysiology is concerned with testing the physiology or function of the central and peripheral aspects of the nervous system. These kinds of tests can be divided into recordings of: (1) spontaneous or continuously running electrical activity, or (2) stimulus evoked responses. Subspecialties include electroencephalography, electromyography, evoked potential, nerve conduction study and polysomnography. Sometimes these tests are performed by techs without a medical degree, but the interpretation of these tests is done by a medical professional.

Other major specialties Edit

The following are some major medical specialties that do not directly fit into any of the above-mentioned groups:

  • Anesthesiology (also known as anaesthetics): concerned with the perioperative management of the surgical patient. The anesthesiologist's role during surgery is to prevent derangement in the vital organs' (i.e. brain, heart, kidneys) functions and postoperative pain. Outside of the operating room, the anesthesiology physician also serves the same function in the labor and delivery ward, and some are specialized in critical medicine.
  • Dermatology is concerned with the skin and its diseases. In the UK, dermatology is a subspecialty of general medicine.
  • Emergency medicine is concerned with the diagnosis and treatment of acute or life-threatening conditions, including trauma, surgical, medical, pediatric, and psychiatric emergencies.
  • Family medicine, family practice, general practice or primary care is, in many countries, the first port-of-call for patients with non-emergency medical problems. Family physicians often provide services across a broad range of settings including office based practices, emergency department coverage, inpatient care, and nursing home care.

  • Obstetrics and gynecology (often abbreviated as OB/GYN (American English) or Obs & Gynae (British English)) are concerned respectively with childbirth and the female reproductive and associated organs. Reproductive medicine and fertility medicine are generally practiced by gynecological specialists.
  • Medical genetics is concerned with the diagnosis and management of hereditary disorders.
  • Neurology is concerned with diseases of the nervous system. In the UK, neurology is a subspecialty of general medicine.
  • Ophthalmology is exclusively concerned with the eye and ocular adnexa, combining conservative and surgical therapy.
  • Pediatrics (AE) or paediatrics (BE) is devoted to the care of infants, children, and adolescents. Like internal medicine, there are many pediatric subspecialties for specific age ranges, organ systems, disease classes, and sites of care delivery.
  • Pharmaceutical medicine is the medical scientific discipline concerned with the discovery, development, evaluation, registration, monitoring and medical aspects of marketing of medicines for the benefit of patients and public health.
  • Physical medicine and rehabilitation (or physiatry) is concerned with functional improvement after injury, illness, or congenital disorders.
  • Podiatric medicine is the study of, diagnosis, and medical & surgical treatment of disorders of the foot, ankle, lower limb, hip and lower back.
  • Psychiatry is the branch of medicine concerned with the bio-psycho-social study of the etiology, diagnosis, treatment and prevention of cognitive, perceptual, emotional and behavioral disorders. Related non-medical fields include psychotherapy and clinical psychology.
  • Preventive medicine is the branch of medicine concerned with preventing disease.
    • Community health or public health is an aspect of health services concerned with threats to the overall health of a community based on population health analysis.

Interdisciplinary fields Edit

Some interdisciplinary sub-specialties of medicine include:

  • Aerospace medicine deals with medical problems related to flying and space travel.
  • Addiction medicine deals with the treatment of addiction.
  • Medical ethics deals with ethical and moral principles that apply values and judgments to the practice of medicine.
  • Biomedical Engineering is a field dealing with the application of engineering principles to medical practice.
  • Clinical pharmacology is concerned with how systems of therapeutics interact with patients.
  • Conservation medicine studies the relationship between human and animal health, and environmental conditions. Also known as ecological medicine, environmental medicine, or medical geology.
  • Disaster medicine deals with medical aspects of emergency preparedness, disaster mitigation and management.
  • Diving medicine (or hyperbaric medicine) is the prevention and treatment of diving-related problems.
  • Evolutionary medicine is a perspective on medicine derived through applying evolutionary theory.
  • Forensic medicine deals with medical questions in legal context, such as determination of the time and cause of death, type of weapon used to inflict trauma, reconstruction of the facial features using remains of deceased (skull) thus aiding identification.
  • Gender-based medicine studies the biological and physiological differences between the human sexes and how that affects differences in disease.
  • Hospice and Palliative Medicine is a relatively modern branch of clinical medicine that deals with pain and symptom relief and emotional support in patients with terminal illnesses including cancer and heart failure.
  • Hospital medicine is the general medical care of hospitalized patients. Physicians whose primary professional focus is hospital medicine are called hospitalists in the United States and Canada. The term Most Responsible Physician (MRP) or attending physician is also used interchangeably to describe this role.
  • Laser medicine involves the use of lasers in the diagnostics or treatment of various conditions.
  • Medical humanities includes the humanities (literature, philosophy, ethics, history and religion), social science (anthropology, cultural studies, psychology, sociology), and the arts (literature, theater, film, and visual arts) and their application to medical education and practice.
  • Health informatics is a relatively recent field that deal with the application of computers and information technology to medicine.
  • Nosology is the classification of diseases for various purposes.
  • Nosokinetics is the science/subject of measuring and modelling the process of care in health and social care systems.
  • Occupational medicine is the provision of health advice to organizations and individuals to ensure that the highest standards of health and safety at work can be achieved and maintained.
  • Pain management (also called pain medicine, or algiatry) is the medical discipline concerned with the relief of pain.
  • Pharmacogenomics is a form of individualized medicine.
  • Podiatric medicine is the study of, diagnosis, and medical treatment of disorders of the foot, ankle, lower limb, hip and lower back.
  • Sexual medicine is concerned with diagnosing, assessing and treating all disorders related to sexuality.
  • Sports medicine deals with the treatment and prevention and rehabilitation of sports/exercise injuries such as muscle spasms, muscle tears, injuries to ligaments (ligament tears or ruptures) and their repair in athletes, amateur and professional.
  • Therapeutics is the field, more commonly referenced in earlier periods of history, of the various remedies that can be used to treat disease and promote health. [48]
  • Travel medicine or emporiatrics deals with health problems of international travelers or travelers across highly different environments.
  • Tropical medicine deals with the prevention and treatment of tropical diseases. It is studied separately in temperate climates where those diseases are quite unfamiliar to medical practitioners and their local clinical needs.
  • Urgent care focuses on delivery of unscheduled, walk-in care outside of the hospital emergency department for injuries and illnesses that are not severe enough to require care in an emergency department. In some jurisdictions this function is combined with the emergency department.
  • Veterinary medicine veterinarians apply similar techniques as physicians to the care of animals.
  • Wilderness medicine entails the practice of medicine in the wild, where conventional medical facilities may not be available.
  • Many other health science fields, e.g. dietetics

Medical education and training varies around the world. It typically involves entry level education at a university medical school, followed by a period of supervised practice or internship, or residency. This can be followed by postgraduate vocational training. A variety of teaching methods have been employed in medical education, still itself a focus of active research. In Canada and the United States of America, a Doctor of Medicine degree, often abbreviated M.D., or a Doctor of Osteopathic Medicine degree, often abbreviated as D.O. and unique to the United States, must be completed in and delivered from a recognized university.

Since knowledge, techniques, and medical technology continue to evolve at a rapid rate, many regulatory authorities require continuing medical education. Medical practitioners upgrade their knowledge in various ways, including medical journals, seminars, conferences, and online programs. A database of objectives covering medical knowledge, as suggested by national societies across the United States, can be searched at http://data.medobjectives.marian.edu/. [49]

In most countries, it is a legal requirement for a medical doctor to be licensed or registered. In general, this entails a medical degree from a university and accreditation by a medical board or an equivalent national organization, which may ask the applicant to pass exams. This restricts the considerable legal authority of the medical profession to physicians that are trained and qualified by national standards. It is also intended as an assurance to patients and as a safeguard against charlatans that practice inadequate medicine for personal gain. While the laws generally require medical doctors to be trained in "evidence based", Western, or Hippocratic Medicine, they are not intended to discourage different paradigms of health.

In the European Union, the profession of doctor of medicine is regulated. A profession is said to be regulated when access and exercise is subject to the possession of a specific professional qualification. The regulated professions database contains a list of regulated professions for doctor of medicine in the EU member states, EEA countries and Switzerland. This list is covered by the Directive 2005/36/EC.

Doctors who are negligent or intentionally harmful in their care of patients can face charges of medical malpractice and be subject to civil, criminal, or professional sanctions.

Medical ethics is a system of moral principles that apply values and judgments to the practice of medicine. As a scholarly discipline, medical ethics encompasses its practical application in clinical settings as well as work on its history, philosophy, theology, and sociology. Six of the values that commonly apply to medical ethics discussions are:

  • autonomy – the patient has the right to refuse or choose their treatment. (Voluntas aegroti suprema lex.)
  • beneficence – a practitioner should act in the best interest of the patient. (Salus aegroti suprema lex.)
  • justice – concerns the distribution of scarce health resources, and the decision of who gets what treatment (fairness and equality).
  • non-maleficence – "first, do no harm" (primum non-nocere).
  • respect for persons – the patient (and the person treating the patient) have the right to be treated with dignity.
  • truthfulness and honesty – the concept of informed consent has increased in importance since the historical events of the Doctors' Trial of the Nuremberg trials, Tuskegee syphilis experiment, and others.

Values such as these do not give answers as to how to handle a particular situation, but provide a useful framework for understanding conflicts. When moral values are in conflict, the result may be an ethical dilemma or crisis. Sometimes, no good solution to a dilemma in medical ethics exists, and occasionally, the values of the medical community (i.e., the hospital and its staff) conflict with the values of the individual patient, family, or larger non-medical community. Conflicts can also arise between health care providers, or among family members. For example, some argue that the principles of autonomy and beneficence clash when patients refuse blood transfusions, considering them life-saving and truth-telling was not emphasized to a large extent before the HIV era.

Ancient world Edit

Prehistoric medicine incorporated plants (herbalism), animal parts, and minerals. In many cases these materials were used ritually as magical substances by priests, shamans, or medicine men. Well-known spiritual systems include animism (the notion of inanimate objects having spirits), spiritualism (an appeal to gods or communion with ancestor spirits) shamanism (the vesting of an individual with mystic powers) and divination (magically obtaining the truth). The field of medical anthropology examines the ways in which culture and society are organized around or impacted by issues of health, health care and related issues.

In Egypt, Imhotep (3rd millennium BCE) is the first physician in history known by name. The oldest Egyptian medical text is the Kahun Gynaecological Papyrus from around 2000 BCE, which describes gynaecological diseases. The Edwin Smith Papyrus dating back to 1600 BCE is an early work on surgery, while the Ebers Papyrus dating back to 1500 BCE is akin to a textbook on medicine. [50]

In China, archaeological evidence of medicine in Chinese dates back to the Bronze Age Shang Dynasty, based on seeds for herbalism and tools presumed to have been used for surgery. [51] The Huangdi Neijing, the progenitor of Chinese medicine, is a medical text written beginning in the 2nd century BCE and compiled in the 3rd century. [52]

In India, the surgeon Sushruta described numerous surgical operations, including the earliest forms of plastic surgery. [53] [ dubious – discuss ] [54] Earliest records of dedicated hospitals come from Mihintale in Sri Lanka where evidence of dedicated medicinal treatment facilities for patients are found. [55] [56]

In Greece, the Greek physician Hippocrates, the "father of modern medicine", [57] [58] laid the foundation for a rational approach to medicine. Hippocrates introduced the Hippocratic Oath for physicians, which is still relevant and in use today, and was the first to categorize illnesses as acute, chronic, endemic and epidemic, and use terms such as, "exacerbation, relapse, resolution, crisis, paroxysm, peak, and convalescence". [59] [60] The Greek physician Galen was also one of the greatest surgeons of the ancient world and performed many audacious operations, including brain and eye surgeries. After the fall of the Western Roman Empire and the onset of the Early Middle Ages, the Greek tradition of medicine went into decline in Western Europe, although it continued uninterrupted in the Eastern Roman (Byzantine) Empire.

Most of our knowledge of ancient Hebrew medicine during the 1st millennium BC comes from the Torah, i.e. the Five Books of Moses, which contain various health related laws and rituals. The Hebrew contribution to the development of modern medicine started in the Byzantine Era, with the physician Asaph the Jew. [61]

Middle Ages Edit

The concept of hospital as institution to offer medical care and possibility of a cure for the patients due to the ideals of Christian charity, rather than just merely a place to die, appeared in the Byzantine Empire. [62]

Although the concept of uroscopy was known to Galen, he did not see the importance of using it to localize the disease. It was under the Byzantines with physicians such of Theophilus Protospatharius that they realized the potential in uroscopy to determine disease in a time when no microscope or stethoscope existed. That practice eventually spread to the rest of Europe. [63]

After 750 CE, the Muslim world had the works of Hippocrates, Galen and Sushruta translated into Arabic, and Islamic physicians engaged in some significant medical research. Notable Islamic medical pioneers include the Persian polymath, Avicenna, who, along with Imhotep and Hippocrates, has also been called the "father of medicine". [64] He wrote The Canon of Medicine which became a standard medical text at many medieval European universities, [65] considered one of the most famous books in the history of medicine. [66] Others include Abulcasis, [67] Avenzoar, [68] Ibn al-Nafis, [69] and Averroes. [70] Persian physician Rhazes [71] was one of the first to question the Greek theory of humorism, which nevertheless remained influential in both medieval Western and medieval Islamic medicine. [72] Some volumes of Rhazes's work Al-Mansuri, namely "On Surgery" and "A General Book on Therapy", became part of the medical curriculum in European universities. [73] Additionally, he has been described as a doctor's doctor, [74] the father of pediatrics, [75] [76] and a pioneer of ophthalmology. For example, he was the first to recognize the reaction of the eye's pupil to light. [76] The Persian Bimaristan hospitals were an early example of public hospitals. [77] [78]

In Europe, Charlemagne decreed that a hospital should be attached to each cathedral and monastery and the historian Geoffrey Blainey likened the activities of the Catholic Church in health care during the Middle Ages to an early version of a welfare state: "It conducted hospitals for the old and orphanages for the young hospices for the sick of all ages places for the lepers and hostels or inns where pilgrims could buy a cheap bed and meal". It supplied food to the population during famine and distributed food to the poor. This welfare system the church funded through collecting taxes on a large scale and possessing large farmlands and estates. The Benedictine order was noted for setting up hospitals and infirmaries in their monasteries, growing medical herbs and becoming the chief medical care givers of their districts, as at the great Abbey of Cluny. The Church also established a network of cathedral schools and universities where medicine was studied. The Schola Medica Salernitana in Salerno, looking to the learning of Greek and Arab physicians, grew to be the finest medical school in Medieval Europe. [79]

However, the fourteenth and fifteenth century Black Death devastated both the Middle East and Europe, and it has even been argued that Western Europe was generally more effective in recovering from the pandemic than the Middle East. [80] In the early modern period, important early figures in medicine and anatomy emerged in Europe, including Gabriele Falloppio and William Harvey.

The major shift in medical thinking was the gradual rejection, especially during the Black Death in the 14th and 15th centuries, of what may be called the 'traditional authority' approach to science and medicine. This was the notion that because some prominent person in the past said something must be so, then that was the way it was, and anything one observed to the contrary was an anomaly (which was paralleled by a similar shift in European society in general – see Copernicus's rejection of Ptolemy's theories on astronomy). Physicians like Vesalius improved upon or disproved some of the theories from the past. The main tomes used both by medicine students and expert physicians were Materia Medica and Pharmacopoeia.

Andreas Vesalius was the author of De humani corporis fabrica, an important book on human anatomy. [81] Bacteria and microorganisms were first observed with a microscope by Antonie van Leeuwenhoek in 1676, initiating the scientific field microbiology. [82] Independently from Ibn al-Nafis, Michael Servetus rediscovered the pulmonary circulation, but this discovery did not reach the public because it was written down for the first time in the "Manuscript of Paris" [83] in 1546, and later published in the theological work for which he paid with his life in 1553. Later this was described by Renaldus Columbus and Andrea Cesalpino. Herman Boerhaave is sometimes referred to as a "father of physiology" due to his exemplary teaching in Leiden and textbook 'Institutiones medicae' (1708). Pierre Fauchard has been called "the father of modern dentistry". [84]

Modern Edit

Veterinary medicine was, for the first time, truly separated from human medicine in 1761, when the French veterinarian Claude Bourgelat founded the world's first veterinary school in Lyon, France. Before this, medical doctors treated both humans and other animals.

Modern scientific biomedical research (where results are testable and reproducible) began to replace early Western traditions based on herbalism, the Greek "four humours" and other such pre-modern notions. The modern era really began with Edward Jenner's discovery of the smallpox vaccine at the end of the 18th century (inspired by the method of inoculation earlier practiced in Asia), Robert Koch's discoveries around 1880 of the transmission of disease by bacteria, and then the discovery of antibiotics around 1900.

The post-18th century modernity period brought more groundbreaking researchers from Europe. From Germany and Austria, doctors Rudolf Virchow, Wilhelm Conrad Röntgen, Karl Landsteiner and Otto Loewi made notable contributions. In the United Kingdom, Alexander Fleming, Joseph Lister, Francis Crick and Florence Nightingale are considered important. Spanish doctor Santiago Ramón y Cajal is considered the father of modern neuroscience.

As science and technology developed, medicine became more reliant upon medications. Throughout history and in Europe right until the late 18th century, not only animal and plant products were used as medicine, but also human body parts and fluids. [85] Pharmacology developed in part from herbalism and some drugs are still derived from plants (atropine, ephedrine, warfarin, aspirin, digoxin, vinca alkaloids, [86] taxol, hyoscine, etc.). [87] Vaccines were discovered by Edward Jenner and Louis Pasteur.

The first antibiotic was arsphenamine (Salvarsan) discovered by Paul Ehrlich in 1908 after he observed that bacteria took up toxic dyes that human cells did not. The first major class of antibiotics was the sulfa drugs, derived by German chemists originally from azo dyes.

Pharmacology has become increasingly sophisticated modern biotechnology allows drugs targeted towards specific physiological processes to be developed, sometimes designed for compatibility with the body to reduce side-effects. Genomics and knowledge of human genetics and human evolution is having increasingly significant influence on medicine, as the causative genes of most monogenic genetic disorders have now been identified, and the development of techniques in molecular biology, evolution, and genetics are influencing medical technology, practice and decision-making.

Evidence-based medicine is a contemporary movement to establish the most effective algorithms of practice (ways of doing things) through the use of systematic reviews and meta-analysis. The movement is facilitated by modern global information science, which allows as much of the available evidence as possible to be collected and analyzed according to standard protocols that are then disseminated to healthcare providers. The Cochrane Collaboration leads this movement. A 2001 review of 160 Cochrane systematic reviews revealed that, according to two readers, 21.3% of the reviews concluded insufficient evidence, 20% concluded evidence of no effect, and 22.5% concluded positive effect. [88]

Evidence-based medicine, prevention of medical error (and other "iatrogenesis"), and avoidance of unnecessary health care are a priority in modern medical systems. These topics generate significant political and public policy attention, particularly in the United States where healthcare is regarded as excessively costly but population health metrics lag similar nations. [89]

Globally, many developing countries lack access to care and access to medicines. [90] As of 2015, most wealthy developed countries provide health care to all citizens, with a few exceptions such as the United States where lack of health insurance coverage may limit access. [91]

The World Health Organization (WHO) defines traditional medicine as "the sum total of the knowledge, skills, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness." [92] Practices known as traditional medicines include Ayurveda, Siddha medicine, Unani, ancient Iranian medicine, Irani, Islamic medicine, traditional Chinese medicine, traditional Korean medicine, acupuncture, Muti, Ifá, and traditional African medicine. [93]

The WHO stated that "inappropriate use of traditional medicines or practices can have negative or dangerous effects" and that "further research is needed to ascertain the efficacy and safety" of several of the practices and medicinal plants used by traditional medicine systems. [92] As example, Indian Medical Association regard traditional medicine practices, such as Ayurveda and Siddha medicine, as quackery. [94] [95] [96] Practitioners of traditional medicine are not authorized to practice medicine in India unless trained at a qualified medical institution, registered with the government, and listed as registered physicians annually in The Gazette of India. [94] [95] Identifying practitioners of traditional medicine, the Supreme Court of India stated in 2018 that "unqualified, untrained quacks are posing a great risk to the entire society and playing with the lives of people without having the requisite training and education in the science from approved institutions". [94]


Factors that Influence Intake to One Municipal Animal Control Facility in Florida: A Qualitative Study

Terry Spencer

1 College of Medicine, University of Florida, Gainesville, FL 32611, USA [email protected]

Linda Behar-Horenstein

Joe Aufmuth

3 George A. Smathers Libraries, University of Florida, Gainesville, FL 32611, USA [email protected]

Nancy Hardt

1 College of Medicine, University of Florida, Gainesville, FL 32611, USA [email protected]

Jennifer W. Applebaum

4 College of Liberal Arts and Sciences, University of Florida, Gainesville, FL 32611, USA [email protected]

Amber Emanuel

Natalie Isaza

6 College of Veterinary Medicine, University of Florida, Gainesville, FL 32611, USA [email protected]


The 20 Most Common Hotel Guest Complaints

The 20 Most Common Hotel Guest Complaints

When people think of hotels, they’re likely met with thoughts of a glamor-filled 5-star resort ran by employees with a permanent smile on their face and with a thorough knowledge of how to please each and every customer that enters their hotel.

While this may be what people envision for their hotel stays, the reality is that dealing with hotel guest complaints is a common issue for those working in hospitality and you’ll have to work hard to ensure the issues don’t hurt your brand.

One of the best ways of fighting these negative hotel complaints is by preparing for them so that they don’t occur in the first place or so you’re at least prepared to deal with the issue whenever it rears its ugly head.

“How in the world do I stop hotel complaints from happening when I don’t even know what they are yet!?”

Let me tell you how! You first have to adopt a proactive mindset versus having a reactive mindset towards your issues.

You then must finish reading the rest of this blog to figure out what the 20 most common hotel guest complaints are so that you can be prepared for some of the most common issues that will likely arise.

Along with reading the blog, you should also take a look at the features that come with Deputy. The workforce management solution that works to ensure all of your shifts are filled and that your team has reached sufficient levels of workplace communication. To see it in action for yourself, click on the link below to schedule your very own free trial.

1. Noisy neighbors

No matter what type of hotel you’re running, where it’s being run, or how big it is. You WILL have to eventually deal with guests complaining about noisy neighbors. This is troublesome for a variety of reasons. Your guests paid good money to stay at your hotel and getting some peace & quiet shouldn’t be too much to ask. In fact, it’s really the bare minimum of what’s expected of your hotel’s service.

To ensure you deal with it correctly, make sure to politely ask their neighbor to please keep their volume down because it’s bothering the other guests. Keep in mind that the noisy neighbors are still guests at your hotel and should be treated with appropriate respect.

2. No hot water

You get off your flight, finally get a car to take you to your hotel, and all you want to do is relax by taking a nice hot shower. You turn the water on and…it’s freezing.

This is a common issue that hotel guests have, and rightfully so. While it may initially come off as a “first world problem”, remember that your hotel’s job is to provide an environment that mimics what they’re used to. And that includes having hot water readily accessible.

If the issue isn’t able to be fixed, make sure to move them to a new room or consider calling in a plumber.

3. Small beds

I know, I know. The description very clearly states that the room comes with a queen and the guest is complaining that it’s too small. While this issue may be especially annoying, the reality is that many people may have unrealistic expectations on what a queen-sized bed (or any bed for that matter) should actually look like. Take the time to calmly explain that the beds are the correct size.

4. Dirty rooms

From roadside motels to 5-star luxury hotels, hotels of all types are susceptible to complaints regarding their cleanliness. Mistakes happen, so don’t spend too much time freighting over it. Just make sure to apologize profusely and to correct the issue while explaining to your staff where they went wrong.

5. Temperature of their room

No matter what you do to try and prepare, this issue will find a way to rear its ugly head no matter what. While one person may find the temperature to be perfectly suitable, another person may find that exact temperature too hot/cold. I wish there was a one fix solution for this, but there isn’t. Your best bet is to handle it by a case by case basis and revert back to the “I’m so sorry for the issue” response.

6. Customers not agreeing with hotel rules

If your hotel says there are no overnight guests allowed, then that means there are no overnight guests allowed. Don’t let a guest feel like they can make you budge on the issue or can complain their way around it. This goes for all of your rules. They exist for a reason, see to it that they’re followed.

7. No free Wi-Fi

People are so used to free wi-fi nowadays that whenever they’re in a place that doesn’t have it (especially a place they’ll be staying at) they tend to get frustrated. Similar to when customers complain about rules for your hotel, you shouldn’t feel obligated to give free wi-fi if it’s explicitly stated that there is none.

That said, you should really consider changing your policy to allow for free wi-fi. It’s 2019, and wanting free wi-fi shouldn’t be considered too much.

8. Rodents, roaches, & other unwanted guests

When people book a room for one person. That means they should be the only ones staying there. So if they come across a roach, spider, or *shudders* rat, you can expect to have a very big complaint coming your way. If you do find yourself in this situation, sorry to say but your best bet is to offer a full refund as well as offering another room for their stay.

9. Low-quality food

Ordering room service is a luxury that most people don’t experience regularly, so when they do order it, they expect nothing short of amazement.

So when the food comes up short, it only makes sense that the customers will leave a complaint. Bring all food complaints straight to the cooks as well as the waitstaff that are responsible for transporting the food to the customers’ rooms. Because if the complaint has to do with the food being cold, then it probably had to do with the way it was handled and transported.

10. Bad smells

This is pretty straightforward & is another issue where you can’t blame the guest for complaining. No one wants to be in a smelly room even for a few minutes, let alone for multiple nights. If you have this complaint come in, make sure it’s immediately addressed by having a cleaning crew go to their room and scrub it clean.

11. “This doesn’t match the website/brochure!”

A common complaint that’s left hotel staff scratching their heads for years is when a guest comes in and complains that certain aspects of their stay don’t match up to what was promised. When you dig deeper, you find that they’re really just mad because it’s raining outside when they envisioned their stay to be filled with bright blue skies.

The only way to deal with this is by holding back the sarcastic comments and being professional about the situation (saying sorry even when a sorry isn’t needed).

12. Unexpected fees

Hotels and vacations are expensive as it is, customers are not going to be happy having to pay more than what they previously had in mind. That’s why your hotel should be assured that you aren’t engaging in the practice of charging people more than what they previously thought they would be paying. This is starting to become more & more common within the hospitality industry and hotels that do engage in it can expect to face plenty of negative reviews informing potential visitors about the unexpected fees.

13. Issues with staff

An issue you’re bound to run into, no matter how well operated your hotel is, are issues that your customers experience with your staff. These problems can range from complaints regarding their attitude, not feeling like they’re doing everything they can, etc. This is a tricky area to maneuver because you don’t want to make the mistake of alienating your employees in an effort to please the customer, but you also want the customer to feel like their concerns are being heard.

Your best bet is to listen intently to the customers’ complaints while apologizing on behalf of the business and working to come to a resolution that you both can agree on. While this may lead you to have to offer free amenities on behalf of the organization, it’s still better than having the customer flood review sites with negative comments.

14. Not honoring reservations

In certain situations, hotels are in the practice of overbooking their rooms in an effort to maximize their profits. While this may be profitable, what happens is that people show up expecting a room and instead are told that there is no room available. To no surprise, this causes guests to be furious and demand an explanation as to why their rooms aren’t available.

If you find yourself in this situation, your best bet is to pay to put them up in a nearby hotel as well as paying to give them a free upgrade.

15. Faulty electronics

Just because people are on vacation doesn’t mean they’re also taking a break from TV, internet, printers, etc. If they’re room details that it comes with the above appliances, then they should work. Along with that, if your guests need to use it for business reasons, then an appliance not working can be a much bigger issue than expected. Set procedures in place to regularly check to make sure all equipment is working, as well as having someone on hand to fix the issue in case something goes wrong.

16. Less than stellar Free breakfast

Most hotels advertise a free continental breakfast to their guests. And while it may be free, that doesn’t change the fact that your guests are still expecting a high-quality meal to start their day. Many hotels make the mistake of skipping on quality just to save as much money as possible, which leads to low-quality meals that your guests are going to remember the next time they want to schedule a room at a hotel. Make sure to go over & beyond when it comes to your hotel’s breakfast so your guests aren’t stuck ordering takeout.

17. Staff not respecting a “Do not disturb” sign

A “Do not disturb” sign should be held sacred in all hotels. Your guests paid for the right to feel right at home and a big part of achieving that is having hotel staff respect there do not disturb sign whenever it’s presented. Speak with your staff about the importance of respecting the sign and ensure that each and every room comes equipped with one.

18. Theft of personal items

This is a very serious issue that shouldn’t be taken lightly. If a guest accuses a member of your staff of stealing their belongings, then you should have a set of procedures in place to handle the situation. If you don’t have procedures in place, then you should set them immediately. If this matter isn’t handled properly, then it can evolve into something much bigger if it’s left unchecked, and there’s always the possibility of a lawsuit. Practice due diligence to ensure your hotel is protected.

19. Not allowing pets

Once again, certain guests are always going to have issues with rules that are explicitly stated on your website and brochures. But that doesn’t change the fact that they’re your guests and still deserve the utmost respect. If a guest shows up with a pet to your hotel when you have a strict no pet policy, be sure to explain your rules regarding the subject and to even suggest nearby hotels that are pet-friendly.

20. Lack of complimentary supplies

By complimentary supplies, what I mean are things like shampoo, soap, hangers, etc. While you may be concerned with theft, it’s important to note that not having these available to your guests won’t score you any points with guests and will put a damper on your brand.

Last thoughts

Running a hotel is difficult for a variety of reasons. There’s a ton of moving parts and no matter how hard you work, it seems like there’s always going to be a customer complaining about something. To ensure you and your staff are adequately prepared, revisit this list to ensure you’re aware of all common complaints.

And if you find yourself spending all your time building your employee schedules when you should be spending it on bettering your business, click on the button below to start your free trial of Deputy. G2 Crowd’s highest-rated workforce management app.

Important Notice

The information contained in this article is general in nature and you should consider whether the information is appropriate to your needs. Legal and other matters referred to in this article are of a general nature only and are based on Deputy's interpretation of laws existing at the time and should not be relied on in place of professional advice. Deputy is not responsible for the content of any site owned by a third party that may be linked to this article and no warranty is made by us concerning the suitability, accuracy or timeliness of the content of any site that may be linked to this article. Deputy disclaims all liability (except for any liability which by law cannot be excluded) for any error, inaccuracy, or omission from the information contained in this article and any loss or damage suffered by any person directly or indirectly through relying on this information.


ZOOS & AQUARIA: WHAT ARE THE ISSUES?

There are tens of thousands of zoos worldwide, holding millions of wild animals in captivity.

Born Free is concerned that zoos can never recreate the complex environment that animals have evolved to encounter in the wild. Many animals suffer in captivity as a result.

ANIMAL WELFARE

Most of us feel uncomfortable seeing an animal behind bars in a barren, concrete enclosure. In recent years, some zoos have replaced their bars with glass, electric fences and moats, artfully incorporated into the landscaping. However, space for animals in zoos remains restrictive and bears minimal resemblance to natural habitats in the wild consideration most often seems to go into the visitor experience. Even in so-called safari parks, animals could spend most of each 24-hour period confined indoors.

Over the last 30 years, Born Free has conducted numerous zoo investigations and revealed that zoo enclosures are all too often woefully inadequate for the needs of the animals. As a result, animals can develop abnormal ‘stereotypic’ behaviours, develop medical problems, and suffer a lifetime of problems before dying prematurely.

In some species, welfare problems in zoos have been well-documented, such as lameness and behavioural problems in elephants, stereotypic behaviour and high infant mortality in polar bears, and abnormal behaviour in great apes. However, all the wild animals in zoos live lives of compromise: they have evolved mentally and physically to live very different lives to that in captivity. Animals are adapted to specific natural environments and to exhibit particular behaviours. In zoos they may not even experience the sky overhead. Birds may get no opportunity to fly. Mammals may not be able to climb or run. Being born in captivity does not remove their inherent instincts and needs.

Animals can pay a very high price in zoos for our entertainment.

ZOO CONSERVATION

Many zoos justify keeping wild animals in captivity on the grounds that it contributes to conservation. These claims generally focus on reintroducing animals back to the wild, maintaining populations of animals as an assurance against extinction, and/or funding conservation projects.

Zoos often claim they breed animals to ensure a secure population that could one day be used to return a species to the wild. However, studies have shown that the majority of species kept in most zoos are not threatened with extinction in the wild and very few animals kept or bred in zoos are ever returned to the wild. The relatively few zoos involved in reintroduction programmes do not justify the vast number of animals kept in captivity across the globe.

While some larger zoos may contribute funding to conservation programmes, this is by no means universal and represents only a small proportion of the money spent by zoos. Zoos are expensive to run and a great many are run for profit. Few people realise how little of their entrance fee may actually go to help conserve threatened species in the wild.
In contrast to what many people believe, zoos continue to take animals from the wild for their collections, including elephants and cetaceans (whales and dolphins).

Born Free is concerned that the conservation claims of many zoos are exaggerated, ambiguous and in some cases entirely unjustified. Maintaining animals on display in zoos is an inefficient way to generate funds for conservation and zoos may be a distraction from the real need to focus on genuine conservation activities in the wild.

ZOO EDUCATION

Zoos often position themselves as important centres for public education about wild animals and habitats. Zoos certainly offer the opportunity for visitors to see animals up close, but does seeing animals in this way mean that people learn anything meaningful, and does this change their behaviour to help protect animals in the wild once they have gone home?

We are convinced that seeing animals held in artificial environments devoid of their natural context does nothing to educate visitors about the species in the wild. Frequently, zoo visitors learn little more than how an animal behaves in captivity and leave with a distorted and inaccurate perception of the species concerned. In general, the priority for zoos is providing entertainment rather than education.

ZOO RESEARCH

Many zoos claim that they conduct research: studying animal behaviour and physiology, their response to environmental enrichment (or lack of) or visitor presence, or problems with reproduction in captivity.

People may assume that this research helps threatened species or habitats in the wild. But too often studies focus on problems created by captivity and how they affect animal welfare. Whilst some research may result in a benefit to the health and welfare of individual captive animals, these are studies that are only needed due to the existence of zoos and the many problems they create.

LEGISLATION

Across the globe, there is considerable variation in how zoos are regulated. In some countries, laws have been introduced, zoo inspection regimes established and licensing systems adopted, but elsewhere, there is often no form of even basic animal welfare legislation in place to protect animals. Legislation may also be largely focused on having the correct licences to operate or aimed at protecting public health and safety, rather than ensuring any specific animal welfare standards in zoos.

Several zoo associations exist that claim to hold their member zoos to higher standards of animal care and conservation participation. However, we are concerned that these associations exist primarily to represent their members’ interests. The associations do not have any legal powers and have little or no influence outside their membership. Furthermore, Born Free is concerned that membership of these associations does not necessarily guarantee good animal care.

Images: © B Jaschinski/BFF, © J McArthur/BFF


Watch the video: How to succeed in your JOB INTERVIEW: Behavioral Questions (July 2021).