For years, some of our nation’s savviest medical practice executives, managers, and physicians have examined their practice performance by analyzing critical data and comparing their own performance to statistical tracking of similar practices by specialty and size, usually obtained through practice management or specialty clinical associations.
These organizations have been collecting benchmarking data for years. This information enables practice management consultants and medical practice administrators and physicians to set goals and better manage performance from year to year in these specific areas:
- Productivity and efficiency;
- Profitability and cost control; and
- Revenue cycle management.
The Fourth Standard
You might be achieving best practice performance based on these factors, but recently a very important fourth standard has been added to the list, and it may be a game changer. It is patient satisfaction—giving your patients a high-quality, positive experience that meets and satisfies their needs. It starts with the image of the practice from the patient’s perspective on these key factors:
- The look and comfort of the office;
- How respectful and attentive physician and staff are;
- How well everyone communicates;
- Ease of access for visits; and
- Timeliness during the visit.
These are key factors that form patients’ opinions and determine whether they feel valued by their physician. Every aspect of the image of your practice and the patients’ personal experience is reflected in how they rate their level of satisfaction. If patients rate their care and service highly and believe they have been appropriately involved in the clinical decision-making process, they are likely to be more compliant and obtain better clinical outcomes, inevitably proving the case for whether a medical organization or facility is really patient-centered.
There is a shifting focus on the importance of the patient experience. When preparing to write The Patient-Centered Payoff, we conducted our own patient survey to determine how patients rate their experience with the physician’s office on seven key points:
- Ease of access for visit;
- Office décor updated and comfortable;
- Wait time during visit;
- Feeling valued and respected by staff;
- Staff wearing name tags;
- Physician communication; and
- Feeling that the physician likes or knows the patient.
If patients rate their care and service highly, they are likely to be more compliant.
Physicians almost always introduce themselves and shake hands (before Covid-19) the first time they meet patients—staff members rarely do, and this includes front office and nursing staff who are the first to interact with new patients in the office. These two scoring elements alone suggest staff members might be less committed to providing patient centered service than the physicians they work with, might be poorly trained in customer service, or don’t understand the importance of their role in the practice and the impact they have on the patient experience. It is crucial that staff members understand the importance of their interaction with patients and receive proper training. Often there is an assumption among the staff that because patients are there to see the doctor, the patients don’t care about their interaction with other staff members—staff members feel that they are unimportant members of the team. This kind of thinking can permeate a practice culture and inhibit staff from providing excellent customer service. A commitment to a patient-centered culture begins with physicians and other leaders within the practice. This commitment is demonstrated by how these leaders present and treat staff and whether they invest in training and team-building exercises. A first step can be as simple as dedicating a team meeting to reviewing your mission and discussing how each team member will support it through customer service. The results of our survey indicate that staff members are not communicating or expressing that the patient is valued as well as physicians are. This is further supported in a number of the case studies presented throughout this book.
The scores for access—how quickly a patient can get in to see the doctor—revealed that 40% of the respondents felt access was excellent, and 23% rated access as good. Seven percent of the practices did poorly with appointment access, and 30% were rated only adequate. This suggests that as many as 37% of patients wanting appointments are waiting an unreasonable amount of time to see their physician. This is an important metric because a delay in diagnosis and treatment can cause conditions to worsen and result in poor clinical outcomes, more emergency department visits, and increased healthcare costs. Another time-related issue important to patient satisfaction and well-being is timeliness, which reflects how long a patient waits once he or she arrives for an appointment. In our survey, 20% of the practices were rated excellent and 47% good, recognizing that many practices are efficient with scheduling and patient flow. However, 33% of the practices received a score that indicated they were just adequate or poor in timeliness. If you suspect that your practice is not meeting the access or timeliness needs of your patients, it may be time to call in an expert to evaluate your scheduling patterns, demands for access, and patient flow and provide solutions to these key performance issues.
We believe one of the most interesting findings of the survey is how medical practices are performing with the décor and comfort of the practice. Although only 17% of the practices scored an excellent, an unexpected 60% were rated as good. This is certainly not the case with the many hundreds of practices the authors have visited. We believe at least 50% of practices around the country have reception rooms that look shabby, lack comfort, are not sufficient in size, and often have tattered magazines and reading materials that are not appropriate for their patient demographics. It appears our standards are higher than those of the respondents, who may be more accepting of these issues. We do find that larger practices and health systems that own physician practices, as well as practices that offer elective services, fare much better, with facilities that are polished, fresh, and designed for comfort. This may be because larger systems and aesthetic practices have marketing and service departments that tend to better understand the importance of these issues and have the resources to dedicate to them. The tools found in this book can be applied to both types of organizations as well as smaller practices with limited resources in order to leave a stellar impression on your patients—and reap outstanding ratings.
Most organizations that have conducted patient satisfaction studies in the past have not scored indicators such as first impressions, condition of facility, and staff and physician appearance, and how these matters affect the patient. Determining if you are in the top 10 percentile with the image your practice portrays, understanding patients’ perceptions, and learning how patients view the experience in your practice are important, but it is more important that healthcare providers care enough to make the changes required to create the ultimate patient experience. Patient satisfaction is a game changer for the healthcare industry, and there are no exemptions. Whether you are affiliated with a healthcare system, hospital, surgery center, or medical practice, it is up to each of you to become a winner in this new game—and the clock starts ticking now.