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Archive for the ‘patient satisfaction’ Category

One of the big efforts to improve the quality of medical care in the United States is the implementation of electronic health records. By putting our medical charts into electronic media, doctors will have more uniform access to our health histories, can be given ticklers for important screening tests, and can be told of potential drug interactions with medicines that were prescribed by other doctors, along with many other potential benefits. You can learn more about the advantages [and disadvantages] of electronic health records on my Getting Better Health Care radio program: “Will the electronic medical record revolutionize health care?.

These benefits may help improve patient satisfaction, too.

However, electronic health records have the potential to negatively impact patients’ medical experiences.  DrScore.com research has shown that the No. 1 factor that drives patients’ satisfaction with their doctors is the patient knowing he or she is seeing a friendly, caring doctor.  If patients find their doctors buried in a computer screen, punching buttons and typing, it could take away from the sense that the doctor is providing the patient personal attention.

There are some things doctors can do to manage the situation.

  • First, don’t put the computer on one side of the doctor’s chair and the patient on the other.  If you do place things that way, the doctor has to  turn their back to the patient to see the chart, and that is simply not good for patients’ impressions of their doctor.  I know, because that’s how things are arranged in my new office!
  • The other thing that doctors can do, especially if their office is like mine, is to acknowledge the problem to the patient. Tell the patient, “These new electronic health records are helpful in so many ways, but one thing I don’t like about them is that I have to turn my back to you to look at your chart.  I hope you will understand and don’t mind.”  Comments like these let patients clearly know that they are being seen by a physician that cares about them and about their feelings.  Letting patients in on one of these little secrets about medical office functioning also lets them feel like they are a part of the process. And they are part of the process — they are the very center of it.

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In a discussion with doctors on the value of online rating, some doctors expressed the very reasonable concern that anonymous online ratings let people trash their doctor and their doctor’s reputation.  Doing that, some doctors said, is completely unfair, especially since patient confidentiality rules completely preclude doctors from responding.  There is a lot of merit to that thinking.
One doctor suggested that patients should be required to give their name when posting online, saying, “If I had something bad to say about a doctor, I’d be more reluctant to say it if I had to identify myself.”

That doctor is, in my opinion, absolutely right. HOWEVER, that is why DrScore makes the doctor rating process anonymous.

Doctors need patients to feel completely open to giving their doctors both positive and negative feedback on their medical experiences.  The negative feedback is a gift, truly a gift — one doctor I know called it a “teachable moment” — that we doctors can use to make our patients’ medical care experiences better.  I know it has for me.

It’s a scary prospect for some doctors, the thought that we should do everything we can to encourage patients — happy or unhappy — to give us online feedback.  But it should not be scary.  Doctors are so committed to and good at giving their patients great medical care that doctors with 10 or more ratings have average scores that are well over 9 out of 10.  The fact that so many people love their doctors should make it much easier and more palatable for us to accept the negative criticisms when they come.

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A very nice blog post described the difficulty in getting some doctors to recognize the importance of measuring patients’ satisfaction.  The blog post differentiated patient satisfaction from “clinical quality.”

While the blog post was right on the mark in many ways, differentiating patient satisfaction from quality of care may be a mistake.  Patient satisfaction is a critical dimension of the quality of medical care.  Sure, making the right diagnosis and prescribing the right treatment are essential elements of good medical care, but patient satisfaction is an essential element as well.  To achieve great medical care, patients must feel cared for.  The way to find out if that’s being achieved is to ask them.

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DrScore has shown time and again that doctors’ conventional wisdom about doctor rating — that only unhappy patients will rate their doctors online — is completely wrong.  The most common overall satisfaction score that patients give their doctors is a perfect 10.  The next most common score is 9.  Of doctors with 10 or more ratings, the average score is just over 9.3 out of 10.  And if a doctor wants to make the annual “America’s Most Loved Health Care Providers” in the United States, he or she will have to have a score well over 9.9 out of 10.

So. if so many people are so thoroughly happy with their doctors, why do we need online doctor rating at all?
First, the public wants to know (and doctors need the public to know) how well doctors are doing.  The newspaper is never going to publish a front page news story with a title like, “John Smith Sees Dr. Jones and Has a Wonderful Office Visit.”  No, if the newspaper publishes a front-page story about a doctor, It is most likely negative, leading people’s perceptions about quality of care to get quite warped.

Transparency is good for medicine.
Second, getting feedback from patients online is easy, efficient and helps doctors do what doctors want to do most: give patients great care. DrScore’s interactive survey makes it possible for doctors to get the detailed feedback they need — both positive and negative criticism —t o make their medical practice better from patients’ perspectives.

In all honesty, I don’t think Nordstrom’s or Disney would be happy with a score of just 9 out of 10, with one in 10 or one in 20 customers being distressed with their experience.  We in medicine can — and should — be aiming higher, trying to give all patients what they consider a perfect, caring medical experience.

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Happy Valentine’s Day and congratulations to our 2011 America’s Most Loved Health Care Provider: Roger Ernest, DO, a general surgeon in Sanford, NC. Please see our press release below for more on Dr. Ernest and our five runners’ up for America’s Most Loved.

 

DrScore Announces ‘America’s Most Loved’ Health Care Provider
General surgeon Roger Ernest, DO, is the highest-rated Provider of the Year

WINSTON-SALEM, N.C. (Feb. 11, 2011) — Valentine’s Day is a little sweeter for a general surgeon in Sanford, N.C., who celebrates as “America’s Most Loved” health care provider. DrScore.com, the online patient satisfaction survey and rating Web site, has named Roger Ernest, DO, with Carolina Crossroads Surgery PC, as 2011’s Health Care Provider of the Year.

 

“Dr. Ernest’s average rating of 9.93 out of 10 is truly exceptional,” said patient satisfaction expert Steve Feldman M.D., founder of DrScore. “His patients have given him a wonderful Valentine’s gift: their feedback. They have taken the time to go to DrScore.com and fill out a patient satisfaction survey. Feedback — whether it is positive or negative — is appreciated because it helps doctors improve patient care.”

 

Dr. Ernest received his doctor of osteopathic medicine degree from the Philadelphia College of Osteopathic Medicine in 2002 and completed his internship and residency at the UMDNJ School of Osteopathic Medicine.  He is board certified in general surgery, with a special interest in patients with breast cancer.

 

“We’re really proud of Dr. Ernest and his recognition,” said Doug Doris, CEO of Central Carolina Hospital in Sanford. “His commitment to his patients exemplifies the quality and devotion our entire medical staff provides to their patients.”

 

To date, approximately 190,000 DrScore online surveys have been completed in which patients answer questions on everything from signage in the parking lot and friendliness of the receptionist to how long they waited and how much time the health care provider spent with them. To be considered for “America’s Most Loved,” health care practitioners had to receive at least 20 ratings on the DrScore site during 2010. This year’s runners up:

 

  • Brian L. Pearlman, M.D., FACP, is an internist with Internal Medical Associates of Atlanta Medical Center in Atlanta Ga. Dr. Pearlman received his medical degree from the University of Miami School of Medicine and completed residencies at Baylor University Medical Center and the University of Texas Southwestern Medical Center.
  • James “Trever” Rester, M.D., is an internist with Lake Point Medical Partners in Royse City, Texas. Dr. Trever received his medical degree from the University of Texas Medical School and completed his residency at the University of Tennessee College of Medicine.
  • G. Neil Love, MD, FACOG, is an Ob/Gyn with Hilton Head Regional Obstetrics and Gynecology Partners in Hilton Head Island, S.C. Dr. Love received his medical degree from the University of North Carolina-Chapel Hill and completed his residency at the University of Southern California Medical Center.
  • Kathleen Moe, M.D., is a dermatologist with Frederick Dermatology Associates in Frederick, Md. Dr. Moe received her medical degree from Georgetown University School of Medicine and completed her residency at Georgetown University/Washington Hospital Center.
  • Joann Lutz, ANP, is an adult nurse practitioner with Oregon Medical Group. She completed a Masters program through Oregon Health Sciences University and is ANCC board certified.

 

“This year marks the first time a nurse practitioner has been in the top five runners up,” Dr. Feldman said. “This may reflect an important trend for medical practices as health care continues to evolve —everyone on the frontlines is vitally important in improving patient satisfaction.”

 

Increasing patient satisfaction directly links to quality of care issues such as following doctors’ orders and taking the prescribed medications — factors that ultimately lead to better patient health outcomes. “The comments on DrScore.com for all of these highest rated providers are very similar, especially with regard to overall communication and attitude, ” Dr. Feldman said. “Patients made comments such as: ‘Informative and with a personal and caring attitude.’ ‘Staff were attentive both to the patient and family.’ ‘Kind, caring and patient physician with warm, friendly manner. ALWAYS takes time to listen to you — I think he is the greatest and best doctor I’ve ever had.’

 

“All of our research has found that a good bedside manner and spending quality time with the patient is a critical component in patient satisfaction,” Dr. Feldman continued. “The best advice I can give doctors is to remind yourself — before you see each and every patient — that you want to make that patient feel cared for.”

 

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Suppose there was a story in the newspaper with a headline like this:

Pope calls for an end of Internet posting about rogue priests

And let’s suppose the article went on to say something like:

After meeting with the Council of Cardinals, the Pope called for ending Internet postings about rogue priests.  The Pontiff’s spokesman said that the Pope and the Cardinals agreed, after seeing a profusion of websites rating priests and posting comments about problems in the Church, that such posting was not only defamatory to priests and the Church but also unfair because priests were not permitted to respond to the postings or even to acknowledge that the poster was a parishioner.  The Pontiff’s spokesman decried the fact that only unhappy Catholics were posting material about their priests, giving people a very biased perception.  As a solution, an American Cardinal has suggested that the Church might try having church-going parishioners sign a contract in which the parishioner would agree not to post online any material about the priest or their church service.

Of course, this is just an exercise of the imagination.  But it is an interesting  to consider, particularly because many doctors have espoused contracts with patients as an answer to the “problem” of Internet rating of doctors.

The Internet is a tool, a powerful tool, which massively expands people’s ability to communicate, transmit and spread information and disinformation.  Doctors are rightly concerned about their reputations and the potential for Internet posts by patients (or by people claiming to be patients) to wrongfully accuse doctors of malfeasance, incompetence or greed.  But the genie is out of the bottle.
Doctors need not give up hope, however.  The Internet is an equally powerful tool to let the public know about the real quality of care that doctors are giving patients on a day-to-day basis.  By encouraging patients to rate their doctors online, doctors can give the public a much more representative view of what American medicine is like.  Doctors devote their lives to the quality of care they provide patients.  There’s no reason to hide. In fact, proposals to limit the public’s ability to communicate their experiences with their physicians are counterproductive, only making it look like doctors have something to hide.  Embracing online rating will help increase public awareness of the dedication of physicians to their patients.

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February — the month of Valentine’s Day and love. In the next week, we will be releasing who is America’s Most Loved Doctor, a doctor who had a significant number of ratings, along with the highest average rating, during 2010.

Last year’s America’s Most Loved Doctor was Thomas Selznick, DO, a family practitioner in Livonia, Michigan, with Livonia Family Physicians. His overall score was a 9.96 out of 10, and patient after patient described how ‘caring’ he was, how he takes time with the patient, listens and doesn’t hurry.

Who will be this year’s most loved doctor? I’ll give you a hint — it’s a doctor from the south this year, and it’s not a family practitioner.

Do you have a favorite doctor that you would like to see as America’s Most Loved Doctor for 2011? The way to do it is to provide feedback about your doctor through a DrScore.com survey. Rate your doctor and encourage other patients to rate him or her, too!

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President Obama’s 2011 State of the Union address was forward-looking. In the address, he mentioned the Internet six times, focusing much attention on American infrastructure, technology and our future economy.  The President said within the next five years, the next generation of high-speed wireless coverage will be deployed to 98 percent of all Americans.

At DrScore, we’re forward looking too.  Paper-based surveys of patient satisfaction are horse-and-buggy technology, expensive, time consuming and wasteful.  Online doctor rating has many advantages, including flexible, drill down survey methodology. As all Americans gain greater access and facility working online, the few barriers that remain to obtaining low cost, easy, high quality patient feedback through the Internet will quickly melt away.

DrScore is just one small facet of the future that President Obama shared with us: an economy that’s driven by new skills and new ideas.  Our success in this new and changing world will require reform, responsibility, and innovation.

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Are obstetricians and gynecologists more friendly and caring than other specialists?.

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Here is the latest press release from DrScore. This paper comparing patient satisfaction among different specialties was published by Dove Medical Press in January.

 

DrScore Researchers Find OB/GYNs Rate Higher than Other Specialists in
Caring and Friendly Attitude

Paper on patient satisfaction published by Dove Medical Press

WINSTON-SALEM, N.C. (Jan. 27, 2011) – Overall patient satisfaction ratings and ratings of doctors’ caring and friendly attitude are higher for obstetricians and gynecologists compared to other specialists, according to researchers at DrScore.com. The paper, Patient Satisfaction with Obstetricians and Gynecologists Compared with Other Specialties: Analysis of US Self-Reported Survey Data, (Isha Patel, Jongwha Chang, Jatin Srivastava, et al) was published in the journal Patient Related Outcome Measures by Dove Medical Press in January.

 

“There have been very few studies in the United States evaluating patient satisfaction across different specialties,” said patient satisfaction expert Steve Feldman, M.D., the founder of the online doctor review site DrScore.com. “Our research team wanted to see whether certain specialties had higher levels of patient satisfaction, and they found that obstetricians and gynecologists were 55 percent more likely to earn a high patient satisfaction rating and three times more likely to earn a good rating in caring and friendly attitude.”

 

The researchers utilized data from a national, validated, Web-based survey among 7,938 anonymous patients who rated their physicians according to satisfaction with treatment on the basis of their experience during their most recent outpatient visits. Patients rated physicians on a scale of 0 (not at all satisfied) to 10 (extremely satisfied). According to the study, when asked to rate their satisfaction with the physician’s caring and friendly attitude, the average rating for obstetricians and gynecologists was 6.65 and 5.86 for other specialists. Other key contributors to overall patient satisfaction include wait time and time spent with the doctor. Overall, patients waited a significantly shorter time for obstetricians and gynecologists (average 26.8 minutes) vs. other specialists (average 29.1 minutes). Patients also reported spending more time with their obstetricians and gynecologists (9.5 minutes) vs. other specialists (8.8 minutes).

 

The researchers concluded that patient satisfaction ratings associated with caring and friendly attitude were higher for obstetricians and gynecologists compared to other specialists and that doctors’ caring and friendly attitude plays a key role in patients’ satisfaction.

 

“Even though several factors influence patient satisfaction, adoption of factors like reducing waiting times, effective patient–physician communication and involving patients in the decision-making process should aid physicians in achieving optimal patient satisfaction results,” said Dr. Feldman. “The development of online doctor rating websites with a national scope has opened new vistas on the quality of health care delivery, offering researchers new ways to probe patient satisfaction and to identify new ways to enhance the medical care experience.”

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