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How Much Should You Worry About Patient Satisfaction Scores?

August 27, 2018

How Much Should You Worry About Patient Satisfaction Scores?

By Jennifer Larson, contributor


What do your patients really think about you?

How do their opinions influence potential patients?

Do recent patient surveys point out any areas that need improvement?

How do patient satisfaction scores impact your daily practice?


These are all questions that physicians today must keep at the front of their minds, whether they own a private practice or are employed by a health system that is carefully monitoring patient feedback.


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Why patient surveys and patient satisfaction scores matter


When customers have a positive or negative experience at a restaurant or hotel, they can write a review on websites like Yelp or TripAdvisor where anyone can read their reviews and decide if they want to patronize those establishments or not.


The same thing now happens in healthcare. But when patients give a doctor or hospital a negative review, it doesn’t just affect their reputation and their patient prospects. It can and does directly affect the payments they receive—or don’t receive.


The Centers for Medicare & Medicaid Services (CMS) ties reimbursement to the results of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. For example, as part of the Hospital Value-Based Purchasing Program, CMS can withhold a percentage of Medicare payments if a hospital’s patient satisfaction scores don’t measure up.


Obviously, that’s a strong incentive for hospitals and providers to work hard to provide satisfactory care to their patients—and in doing so, to earn strong patient scores.  


Most importantly, it can inspire the delivery of better patient care.


“Striving for high patient satisfaction is important, valuable, and a crucial element of patient-centered care,” wrote Aleksandra Zgierska, David Rabago, and Michael M. Miller in a 2015 article for Patient Preference and Adherence. “[Quality improvement] initiatives that are responsive to patients’ needs can improve patient satisfaction; in turn, satisfied patients may have better treatment adherence and outcomes.”


How much to worry?


So how concerned do physicians need to be about their satisfaction scores, online ratings and patient survey results?


Orthopedic surgeon Barbara Bergin, MD, doesn’t think you can worry enough about patient satisfaction scores, even with a great record.  


“Patients look at reviews,” said Bergin, who practices in Austin, Texas. “I have at least one or two patients every day who tell me they chose me because of my ratings. There’s no possible way that extra attention to the care a doctor gives their patient can have a detrimental effect on the practice.”


Experts caution physicians of the risks of getting complacent. Just because they’ve achieved good satisfaction scores in the past doesn’t necessarily mean they’ll get continue to get high scores.


“Never take good reviews for granted,” said Bergin. “One bad review can really mess up your sleep patterns for awhile. Even a bad review of my partners is something to be concerned about; what affects them affects me.”


Changing your perspective about patients


One way for you and your staff to keep patient satisfaction high is to consider each patient not just a case that needs to be treated, but a valued customer, similar to a guest at a hotel.


Indeed, the healthcare industry can take cues from the hospitality industry in its efforts to boost patient satisfaction, said Stowe Shoemaker, PhD, dean of the William F. Harrah College of Hospitality at the University of Nevada Las Vegas. They can use strategies to improve process, value and communication in a model called the Loyalty Circle that’s used in the hospitality industry.


Shoemaker has consulted with healthcare organizations like MD Anderson Cancer Center to help improve patient satisfaction, using lessons and insight from the hospitality industry.


It starts with how well you know your patients, Shoemaker explained, because if you don’t know them well enough, you’re not going to meet their perceived needs. You can’t design your approach without really understanding your patients and what they’re going through during the time they interact with your practice, from the time they call for an appointment to the time they leave your office with a prescription.  


“Every patient population is different, and the patients that come to your practice may be very different than the patients that go to another practice,” said Shoemaker. “So the key thing to understand is what your patients want, what your patients’ pain points are.”


In fact, he noted, research shows that patients really want their providers to treat them like cherished family members.


“By having doctors treat patients like loved family members, those ‘loved family members’ are more likely to follow the advice that’s being given to them,” Shoemaker said.


Conversely, there are risks associated with not focusing enough energy on patient satisfaction—and not just risks for the patients. “The biggest risk is that your practice starts to decline,” he said.


Coping with the pressure


The intense emphasis on patient satisfaction scores or patient survey results may be better for patients.  However, it does have a downside. The emphasis has ratcheted up the pressure on physicians, which has decreased job satisfaction for many of them, according to a 2017 study in the Journal of General Internal Medicine. The study found that 78 percent of physicians believe that patients posting negative reviews online adds to their stress. This comes at a time when physician burnout rates are already uncomfortably high.


It is a hard situation, noted Bergin, because doctors are advised to not respond to negative reviews that are posted publicly, even the ones that are misleading or not entirely truthful, because of privacy law issues. “So we really feel helpless,” she said.


As a recent article in the American Osteopathic Association’s The DO noted, physicians may need to be proactive about coping with that pressure, which could include consulting with a trusted mentor, continuing to practice evidence-based medicine, and opening up communication with patients to discuss their experiences and your decision-making process.


Related content:

Feeling the Burn: Physician Burnout in America

7 Ways Physicians Can Reignite Their Passion for Medicine

3 Ways Social Media Has Changed Patient Care

Survey of America’s Physicians: Practice Patterns and Perspectives

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