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Patient trust and satisfaction are outcomes of the medical visit, says Andrew L. Epstein, MD, a principal of HSC Associates, a Cambridge, MA-based consulting firm that specializes in the interpersonal aspects of care. He offers the following suggestions and examples of aligning an organization around improving those outcomes:
• Reward performance that enhances patient satisfaction.
If performance assessment goals center on productivity, then that will be focus of staff and physicians. "If they know patient satisfaction is a very high factor in their performance assessment, their performance will be affected by that," says Epstein. "They’ll be more likely to go that extra mile in terms of satisfying patients."
• Keep commitments to patients.
A 2 p.m. appointment is a commitment to your patient, baring a true medical emergency. "If I don’t see you until 2:30 or 2:45, you may be satisfied with the encounter, but your overall encounter will have been diminished," he says.
Of course, patients often call with urgent but not emergency problems, asking to see the doctor that day. Epstein, a former practicing internist, resolved the dilemma by setting aside time to see patients without scheduled appointments.
"I would see them between 5:15 and 6:15, but I couldn’t give them an exact time," he says. "I never had any complaints about that, and it took a huge burden off me because I wasn’t trying to do two things at once."
Other physicians may choose to set aside time during the day to see those patients, Epstein says.
• Create systems that respond to commitments.
At the end of the visit, you send the patient to the lab for tests, saying, "We’ll get back to you with the results." The patient may initially feel reassured, but then may become concerned by the following questions: Who are we? When will I hear? What if I don’t hear? Will I hear if the results are normal or just abnormal?
"A commitment is always made by one person to another person," says Epstein. "We’ll get back to you with the test results’ is not a commitment."
The patient may then call to find out about test results. "In a medical office, probably half the phone calls are around things like this, unclear promises," Epstein says.
In his practice, Epstein switched to a clear commitment: "I will receive the test results within 10 days to two weeks. I will mail you the results with a handwritten note on the bottom. I’ll call you immediately if there’s a problem you need to know about. If you don’t hear within two weeks, call my office."
The lab director designed a system that produced a paper copy of results with a peel-off patient label on the bottom. Epstein reviewed the results, wrote a comment, and gave it to a member of the clerical staff to mail.
As a result, patient phone calls to his office declined by 30%, Epstein says. "I had no idea 30% of the calls to my office were about lab results until I started this system," he says.