Perception is reality. This is especially true in a patient’s experience of a medical practice.
Most patients have no reliable method of evaluating the care they receive, so they rely upon a proxy: How does the practice make them feel? If the practice makes them feel valued, respected, and cared for, they will infer that they have received good medical care, even when the outcomes are less than expected.
The patient’s perception has always been important in attracting and retaining patients, and in avoiding lawsuits and complaints to regulatory bodies.
With the changes in ambulatory healthcare reimbursements, patient perception is even more important.
Patient satisfaction scores will soon have a part in determining reimbursement rates for a physician, as will outcomes.
Patients who feel respected and cared for are more likely to be compliant with treatment plans, providing better odds of optimum outcomes. Patients, many of whom are now required to directly cover more of their healthcare costs, are also more likely to pay physicians they like and trust.
Many practices are installing coffee bars and Wi-Fi. I would argue that they are missing the point. High patient satisfaction with a medical practice has three main components:
1. Know what the patient wants and is not getting from the practice. The easiest, quickest and most cost-effective way to find out what your patients value is to have a staff meeting. Ask your staff to share the most common complaints. Many will be familiar, but some will surprise you.
Next, have the staff rank the complaints from most to least serious. Providers, especially physicians, should not participate in the ranking. Patients are far more candid in complaining to staff.
Tackle the top three to four complaints first. Understand that this is an iterative process. It is a good idea to have this particular type of meeting quarterly to measure progress and identify emergent issues.
At some point, you may want to implement surveys and comment cards. They have their place, but most practices can keep themselves well occupied on improvement efforts for years without resorting to the more sophisticated ways of gathering patient feedback.
2. Manage the patient’s expectations. A mid-20th century comedian said, “Success is getting what you want. Happiness is wanting what you get.” The goal here is to make patients happy. The practice will not be able to give them everything they want.
If you cannot give patients exactly what they want, e.g., walk in appointments with no waiting time, tell them what you can do. Make what is called a service promise. In fact, make a set of service promises. Post them on your website and in your waiting room. For example:
• If a sick patient calls for an appointment before noon, we will see the patient the same day. After noon, we will see the patient the next day.
• We will not call in antibiotic prescriptions without having seen the patient. We need to be as certain as possible that we know what is actually wrong.
• Phone calls to the office will be returned at the end of the current clinic session. For calls in the morning, that means between noon and 1:30 p.m.. For afternoon calls, it means between 5:00 p.m. and 6:30 p.m.
3. Consistently perform at or above the patient’s expectations. Most anger is a result of frustration, and all frustration comes from unmet expectations. Keep your service promises, and exceed them when you can.
Making explicit promises to your patients enables them to know when you have over-delivered, and they will give the practice credit for it.
One word of caution: Do not always over-deliver, because that moves the bar up and becomes the implicit service promise.
It is simple, and not really all that hard. Be aware of what the patients value; help them understand the necessary constraints on their wants; and don’t disappoint them.
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