Patient-Centered Care Begins With High Quality Doctor-Patient Communications

The first experience patients are likely to have with your hospital is not in an ER visit or inpatient stay.  A patient’s first experience will most likely be in one of your primary-care physician offices.  That because a person is 10 times more likely during a year to end up in the physician’s office for a routine visit than they are to require an overnight hospital stay.

As a hospital marketer or patient experience officer this should raise an interesting question. How well do your physicians–particularly your primary-care physicians–represent your brand?

Take “patient-centeredness.” Lots of hospitals these days are promoting themselves as providing patient-centered care.  You know … when the hospital and its staff try where possible to be sensitive to and honor the wishes of patients.   But when it comes to patient-centeredness, “walking the talk” is a hard in in physician offices and even tougher in the hospital.

The fact is that most physicians, with some exceptions, are anything but patient-centered in their interaction with patients.   Take the way physicians and patients tend to communicate with one another.   An estimated two-thirds of physicians employ what is known as a physician-directed or paternalistic style when talking with patients.   This is when the physician asks the questions, interrupts the patient as needed, and only provides information the physician thinks the patient needs and is capable of understanding.

The sad thing is that most patients have gotten used to and, in some cases, like being told what to do and how to think by their doctor.   It just the way things are.   This attitude is perhaps why so many patients consistently give their doctors high marks on global satisfaction surveys dealing with communications. Patients are so used to way things are that they cannot conceive of a better way of doing things.   It’s also been shown that dissatisfied patients don’t bother filling out satisfaction surveys.   If they did, what they would say is that their doctors have communication habits like my doctor:

• Doesn’t listen
• Ignores my opinion
• Talks down to me
• Always seems rushed and inattentive

So what are hospital marketers and patient experience officers supposed to do about physician-patient communications?

1. Don’t put too much stock in global patient satisfaction surveys that barely address physician-patient communications
2. Conduct dedicated communication surveys, focus groups, and communication audits of individual physicians to assess the real scoop when it comes to the quality of doctor-patient communications
3. Teach patients how to do a better job of communicating with physicians
4. Provide continuing education training and tips aimed at improving the patient-centered communication skills of physicians

In 2012, the quality of the physician-patient experience will make up a sizable percent of Medicare hospital reimbursement.  Individual physician reimbursement will be affected as well.

Smart hospital marketers and patient experience officers should consider ways to leverage these changes in Medicare reimbursement, as well as the myriad of pay-for-performance initiatives, to make sure the patient’s first impression of your hospital is outstanding!

That is my opinion.  What do you think?

This post is a reprint of a guest post I wrote for another excellent blog Hospital Impact. 

Patient Engagement Or Long Office Visit Wait Times – You Choose

Recently I found myself sitting in a retinal surgeon’s office.  I was there as a new patient.  I wanted to get a second opinion…with the intent of switching doctors for an upcoming surgical procedure.

As I was filling out my forms I would listen to established patients as they would register at the front desk and ask if the doctor was running behind.  Nothing is really private in waiting rooms…everyone I am sure was listening for the reply.  The receptionist whispered that the doctor was running 2 and ½ hours behind.   Yikes!

Eventually I was ushered into an exam room where a Medical Assistant did her “new patient” thing and confirmed the long wait to see the doctor.  The MA administered some medication to dilate  my eyes for the medical evaluation and had me wait in an area where you could see (and hear) all the action.   The first thing I noticed was how quickly the doctor was moving quickly between patients.  He was clearly very busy…too busy as it would turn out.

The Unintended Consequences of Long Waits

I was a bit surprised at how the waiting and clear demands on the physician’s time affected me.   After all I have written about physician-patient interactions for some time now.    Here’s what I mean.

Beginning  several days prior to my visit, I had begun making a mental list of what I wanted to discuss with this physician.  I mentally checked off my “visit agenda” along with the questions I wanted to ask.  I was prepared to get the most out of this visit come hell or high water.   But the longer I waited, and the more tired I got just sitting there, I started eliminating agenda items and questions from my list.  This guy was way too busy.

I did eventually see the doctor but by the time I finally got to talk…I had significantly narrowed down my list of questions and concerns.   I didn’t want to take up anymore of this doctor’s time than I had too.  I was surprised at myself – I am not normally one to so easily giving  up on things I want to learn.

The Point?

It occurred to me that long wait times not only have a negative impact on patient satisfaction…but they also impact the quality of care.  Here’s how.   The long wait caused me to limit:

1. How much information I gave to the doctor in the interest of economy of time
2. The number of questions I had about my upcoming procedure.

Don’t get me wrong I am not blaming the doctor for my reluctance to take up his time.  What I am saying is that my experience showed me how a long wait inhibited my normally proactive health behavior to the point where it could easily had consequences beyond my satisfaction with the “office experience.”  By the way, I was so turned off by this busy specialist that I am going back to my original surgeon.

My Suggestion

Everyone recognizes that “waiting” is inevitable in most doctors offices. However, physicians that actually want to encourage patient involvement in the office would do well to go out of their way to:

1. tell patients upfront when they sign in that the doctor is running behind
2. acknowledge (I didn’t say apologize) long wait times when they occur
3. encourage patients to fully describe the reasons for their visit, including their symptoms, and ask all their questions without feeling constrained about taking up the physician’s time.   Not only will you have a more satisfied patient but you will also make a better diagnosis and encourage great patient adherence.

That’s my opinion. What’s yours?

Poor Doctor-Patient Communication Is Closely Linked To Non-Adherence

I am a big fan of Infographics.  They are a great for turning otherwise complex data into practical information.  Here’s an Infographic I built to describe the “disconnect” that often occurs between physicians and patients and the impact of adherence.