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Doctor’s Day is March 30. Here’s our latest press release for DrScore.com in recognition of the important role that doctors play in patients’ lives.

 

Patient Satisfaction: DrScore’s Three Simple Solutions for Improving Customer Service

Online physician rating website shares latest research for Doctor’s Day on March 30

WINSTON-SALEM, N.C.–(BUSINESS WIRE)–In recognition of Doctor’s Day on March 30 and the important role that physicians play in patients’ lives, DrScore.com is sharing three simple solutions to improving patient satisfaction. The tips are the result of an analysis of data from 180,000 patient satisfaction surveys on the DrScore.com online doctor rating website.

“It’s a fact: A patient’s health care experience does matter. Patient satisfaction is important in its own right, but it also improves the outcomes of a patient’s care,” said patient satisfaction expert Steve Feldman, M.D., founder of DrScore. “And at DrScore, the online ratings of patient experiences strongly suggest that there are three very important factors that contribute to patient satisfaction.”

1. Keep wait times short. DrScore’s data analysis found that 44 percent of wait times were less than 15 minutes, 34 percent were 15 to 30 minutes, 13 percent were 30 to 60 minutes, and 9 percent were greater than one hour. “There is a strong, statistically significant correlation between wait times and overall patient satisfaction,” Dr. Feldman said. He suggested the following to improve patient satisfaction in this area:

  • If wait times are consistently running longer than 30 minutes, doctors should look into their operations and find out if patients are being scheduled too close together or if there is another operational reason this is happening. “Making the goal 15 minutes or less is even better, particularly for primary care providers,” Dr. Feldman said.
  • Make the waiting room pleasant with plenty of good reading materials, coffee, etc. “Time goes by very slowly in an unpleasant waiting room,” Dr. Feldman said. “The best doctors don’t even call it a waiting room — they call it a reception area and do their best not to keep patients waiting.”

2. Spend enough time with each patient. “Patients tend to feel like 10 minutes or longer is adequate time to spend with the doctor, and the DrScore data shows that two-thirds of visits last this amount of time,” Dr. Feldman said. “We found that 23 percent of visits run five to 10 minutes, and 11 percent run less than five minutes. The statistics are clear: The longer a doctor spends with a patient, the more satisfied the patient tends to be with the visit.”

3. Make sure your demeanor is perceived as being friendly and caring. Patients need to have a sense of feeling cared for. “A caring and friendly attitude is far and away the most important variable that contributes to patient satisfaction,” Dr. Feldman said.

The DrScore researchers performed an analysis to determine the independent contributions of different variables such as age, gender, first or return visit, routine or emergent care, wait time, time with doctor and the doctor’s friendly/caring attitude. Wait time and time with doctor were statistically significant, but their contribution to overall satisfaction was small, each accounting for only about 10 percent of the variance in patient satisfaction. In contrast, the doctor’s friendly/caring attitude was the strongest contributor to patient satisfaction, accounting for more than three-fourths of the variance in patient satisfaction/doctor rating scores.

“Tips 1 and 2 don’t matter nearly as much as Tip 3,” Dr. Feldman said. “Every time, before a doctor walks into the exam room, he or she should pause and think: ‘How am I going to make this patient feel cared for today?’ And ‘how can I make sure they realize I am a friendly, caring doctor?”

About DrScore.com

Founded by Steve Feldman, M.D., DrScore.com is an interactive online survey site where patients can rate their physicians, as well as find a physician based on their service level preference. DrScore’s mission is to improve medical care by giving patients a forum for rating their physicians, and by giving doctors an affordable, objective, non-intrusive means of documenting the quality of care that they provide. For more information, visit www.drscore.com.

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One of the benefits of online doctor rating — a benefit to patients and doctors — is a transparency of medical care quality that will help people identify the bad doctors, the uncaring ones, the ones who, according to some patients, you wouldn’t send your dog to. Patients aren’t the only ones who know about these doctors.  Doctors know about them too. They have seen patients who were seen by these colleagues, and all of those patients were unhappy with the care they received.

I know that online doctor rating isn’t going to find many such doctors.  In fact, quite the opposite, online rating of physicians is going to show there aren’t nearly so many “bad doctors” out there as people think there are. Let me explain.

I’m a practicing dermatologist.  I see patients who have seen another dermatologist in town, maybe a dozen or so of that doctor’s patients.  Every one of those patients was unhappy with the care they received, and none of those patients received treatment that cured their condition.

Now that’s clear evidence the other dermatologist didn’t know what they were doing, right?

No, not right.  You see, every time that other dermatologist clears up his or her patient’s rash and gives his or her patient a medical care experience the patient is happy with, that patient continues seeing the other dermatologist and doesn’t come see me.  I  see that doctor’s outliers, the occasional patient who, for whatever reason, didn’t get better or who was unhappy.  I’m sure that the other dermatologist sees a few of my former patients too, only the ones whom I didn’t cure, only the ones who were unhappy with me.  Our observations give us a misleading picture of other people.

Well what about those doctors whose patients post comments like, “I wouldn’t send my dog to that doctor?”  That kind of comment does happen, and, sadly, I’m sure that’s the true opinion of the patient who makes that comment.  But those comments are generally not anywhere close to representative of what the vast majority of that doctor’s patients think.  I get comments like that at times (thankfully less often than I used to, having learned from patient satisfaction feedback what I was doing wrong).  I’ve been rated over 500 times on DrScore.com.  The average of those scores is 9.1 out of 10 (not bad, according to my mom).  Still, occasional patients give me a 0 or a 1 for their experience.  I know they may think everyone gives me a 0 or 1, that I’m a “bad doctor,” but the great majority of my patients think I’m a 9 or 10.  So far, that’s true for all the doctors with just 10 or more ratings on DrScore.

There may be “bad doctors” out there, but I suspect they are incredibly rare.  There weren’t any in my medical school class, and I have yet to meet one in person.  If there are any, I hope we do smoke them out with online ratings.  If they exist, maybe the online scrutiny will wake them up to the need to improve the quality of care they offer.

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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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A recent  AMA News article pointed out that most doctors can’t yet access medical records through their smart phone.

Wow …  I remember using a slide rule, needing a dime and a pay phone to make a telephone call, and being amazed at the new technology that allowed me to make a call by pressing buttons instead of turning a dial. Technology is advancing so fast that  it seems we have come to take for granted that we should have instant access to all sorts of information — even medical records.

Today, a friend gave me a sheet of little happy face stickers.  I wanted to get more, so I looked up the catalog number printed on the sheet, found them on Google in about 26 seconds, and had ordered them within two  minutes.  Amazing.  I’m sure it won’t be long before I can look up a patient’s lab test results — better yet, a graph of their current and past lab test results — within seconds from anywhere in the world.

It’s exciting to be a part of technological advances.  At DrScore.com, we make information on doctors easily available and accessible — right at  your fingertips.  You can search for doctors in your area by specialty, get their contact information and even see how they’ve been rated.  And how much does all this cost?  It’s free.

Ah, the modern world.  It may not be perfect, but we should count our blessings.

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Here’s DrScore’s latest news release on data collected about seniors rating doctors online. http://bit.ly/bBo7rg

Online rating of doctors is a relatively new thing.  DrScore, one of the first doctor rating Web sites, has now been collecting data for seven years.  Online doctor ratings are used by patients to assess what patients think of their doctors and, importantly, to give feedback to doctors on what doctors and their staff are doing well and what they can do better.

Older Americans are among the most frequent users of medical care.  In the United States, about one in four medical office visits are by patients 65 and older.*  Over half the medical office visits are by people age 45 and higher.  The quality of medical care is of prime importance to older Americans.

We analyzed data from the DrScore.com Web site to find out which patients are most likely to rate their doctors.  Most of the online ratings come from younger people.  While 55 percent of offices visits are by people 45 years old or older, these patients account for only 15 percent of doctor ratings.  Young adults (age 18-44) are about 30 times as likely to rate their visit to the office as are people 65 years of age or older!

There may be several reasons why older patients, the ones who would benefit most from enhancing the quality of medical care, aren’t participating in online doctor rating more often.  Access to the Internet may be one factor, though Internet access is rapidly increasing among seniors.  Another possibility is that seniors may have a different attitude about doctors than younger people do; many seniors may not feel it is there place to tell a doctor how they felt about the quality of the office visit.  If true, this is disappointing, as seniors have special needs that doctors need to be aware of.

Seniors know the importance of voting in political contests.  Rating doctors isn’t altogether different, as doctors need to hear seniors’ voices to know how to tailor their medical services to best meet the needs of their senior patients.

*Data on U.S. medical office visits were obtained from the National Ambulatory Medical Care survey performed by the National Center for Health Statistics.

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One of the issues with online doctor rating sites is that it is very much a one-sided affair.  In other businesses, if a customer made a complaint online, the business would be able to respond.  Not so on doctor ratings sites.  The patient privacy rules in the HIPAA legislation  preclude physicians from even acknowledging someone is their patient, so physicians have no ability to respond if they feel there is an inaccurate post about the care they offer.

This seems unfair to many physicians, and I do agree.  Fortunately, the vast, vast majority of patients are very, very happy with their doctors and their care.

The unlevel playing field problem is exacerbated by the possibility that someone with a personal grudge against a physician could purposefully try to harm the physician’s reputation.  It could be a competitor, an angry former spouse or a patient who felt vindictive for some reason.  While one advantage of an anonymous online feedback system is that it lets patients feel they can give fully open and honest feedback without risk of reprisal, anonymous systems have the potential for abuse, too.

Perhaps there could be a rules change that would let a physician respond if a patient opens the door to a discussion of the care they received. But I find that possibility to be unlikely, especially given all the benefits of strong rules about patients’ privacy.  Some physicians may consider other avenues, like those offered by Medical Justice.

But there is another approach, which  is to do what DrScore does: Don’t post open comments at all.

And actually, I think the best solution is to just get every patient to rate his or her doctor online.  That way, even if one patient does say something bad, the public can see what other patients think in order to determine if the negative comment was an outlier or was really representative of what the doctor was like.

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An August 3, 2010, article in The Washington Post discussed rating systems for doctors, pointing out that current doctor rating systems are “rudimentary” and “may not reliably reflect a doctor’s abilities.”  Well, yes and no.  When it comes to measuring technical aspects of diagnosis and treatment, there  is probably no reliable system that reflect a doctor’s abilities.  On the other hand, we have excellent systems, DrScore.com among them, that are able to reliably assess patients’ satisfaction with their care.

The Post article points out that the standard way to find a doctor is to ask friends and family members for advice or to trust a referral from another doctor.  These are very reasonable, albeit limited approaches.  Online systems that assess and report patient satisfaction are extensions of the “ask friends and family” approach.  These systems may not be a reliable measure of a doctor’s ability to make a diagnosis and prescribe an accurate treatment, but they are a reliable measure of how happy patients were with the care they received.

And that is something worth knowing.

A tremendous advantage of an online rating system like DrScore.com over the traditional friends and family approach is that the online data collection allows doctors to find out how they are doing, a critical tool to help doctors do what they want to do most — give their patients great medical care!

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