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Posts Tagged ‘patient care’

In a January 21, 2013, issue of Forbes magazine, entitled “Why Rating Your Doctor Is Bad For Your Health,”  Kai Falkenberg described a downside to doctor rating, doctors giving patients care that the patient wanted but that the doctor didn’t think was needed, or worse, that was even harmful.  The article suggested that doctor rating may at times drive doctors to lean to heavily toward patients’ and their families desires, even when it wasn’t in the patient’s best interest.

It’s an interesting issue.  First, this article point out the power of doctor ratings to change doctors’ behaviors.  Presumably, there’s an upside to this, encouraging those doctors who are not fully meeting their patients’ needs to more fully address patients’ concerns from patients’ perspectives. For the most part, one would think that’s a good thing. 

Is it possible that doctor rating goes too far?   It is certainly true that more testing, more drugs, & more hospitalization are not always in patients’ best interests, and it may be — frequent or not — that some patients want and expect more treatment than they really need, more than would be beneficial, even so much that it would be harmful. 

Who should choose?  Is it better to have a system where the doctor takes responsibility for the final decision without pressure for not following patients’ wishes?  Would a system where patients decide — supported by a doctor who educates and provides counsel — be more appropriate?  The answers to these questions may come down to perspective, perspective shaped by concerns for patients’ autonomy, for their protection (even from themselves), and the costs of health care decisions and who is paying for those costs. 

Ratings can give doctors important feedback on how they are serving their patients’ needs (as seen from the patient’s perspective).  Overall, doctors have strong patient satisfaction ratings (on average, well over 9 on a 0-10 scale on www.DrScore.com), and a caring doctor who educates patients and gives them wise counsel is sure to have exceptionally good overall ratings.  What should a doctor do when a patient demands something that the doctor cannot ethically provide?  Should fear of a bad rating cause a doctor to mistreat a patient?  Obviously not!  In the instances where this is an issue, doctors should suck it up, stand tall and provide the best possible medical care, not worrying about one low rating among so, so many high ones.  The solution isn’t to give up doctor ratings but to encourage them, so that a fuller and more representative picture is publicly transparent.  The Internet has made this a part of the future of our health care system.

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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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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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Medicine is a science, but it is also a highly personal experience.

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I noticed on the back of a banker’s business card it said:

“Reliable, responsive, empathtic and competent service.”

We docs are trained to give competent service: the right diagnosis, the right medicine and skilled surgery.  But like the customers in a bank, our patients also deserve our attention to reliability, responsiveness and empathy.

Yes, medicine is a science, but it is also a highly personal experience.

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I have two amazing colleagues who specialize in skin surgery.  I send many patients their way, and uniformly those patients return telling me how awesome my colleagues are.

Just the other day, I asked one of these patients what was so special.  He said they were terrific, that everything about their office was terrific, that their nurses were terrific.  He loved the way they carefully explained everything they were doing and how the nurse held his hand during the procedure.

I’m sure the surgery was good, too, but what this patient noticed, what all patients notice, is personal care. If your physician provided great personal care for you, please tell him or her. Go to www.drscore.com and take the quick online survey to rate your physician.

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I lectured to physicians the other night about a new medication.  The event was held at a Ruth’s Chris steakhouse.  The food, facilities and service were all outstanding, contributing to a terrific event (the best part, of course, being the lecture I gave 🙂 ).  After the talk, I noticed a large sign place prominently in a hallway used by employees of the restaurant.

The sign said:

Ruth’s Non-Negotiable Traits

  • Optimistic Warmth
    We are stewards of hospitality who radiate genuine kindness and compassion while maintaining our positive outlooks!
  • Team Play (muy importante!)
    We, not I, Us, not Me
    We seek opportunities to make each other look good while exceeding our guests’ expectations
    Be very aware of all our guests
    We value each other
    Smile! Relax!

I think this message would fit very well in the staff lounge of our medical practice.

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