A Deeper Dive into Patient Experience

Recently, my blog on Patient Experience was re-posted on KevinMD. The comments that patients and providers made on the site were challenging, insightful and difficult to read at times.

So many providers, mainly physicians, are so incredibly angry about the idea of patient experience. They get red in the face and raise their voices as they talk about it. They get defensive and make all kinds of excuses about how the data collection methodology is wrong and how medicine is going down the tubes.

“Medicine. It’s not what it used to be. I don’t have time to deal with patient satisfaction when I am trying to see twenty patients a day…”

“So, now I just have to give a patient narcotics or order a test because the patient has all the power…”

“They just want me to use scripted answers. That is so disingenuous. I’m not a robot…”

“It’s not fair. I don’t have any control over how the front desk and the nurses treat the patient…”

After the post went up, I continued on my patient experience journey. I asked everyone and anyone that would be willing to talk about patient experience…

What do you think?… Why are the physicians so angry?… What would you do?… What are some of your best tips?

I discovered that as angry and emotional providers (typically physicians) become about the concept of patient experience playing a part of the Medical New World Order, they are genuinely passionate about their provider-patient relationships. In fact, often times they were sharing their best practices before I was able to ask the question. Overflowing with communication skills and techniques they had learned through the years, I realized we learn best from each other.

One of our surgeons told me, “Simple. Care, always be available, 24/7.. have a support staff that shares your values, and be the best, most informed and committed practitioner that exists… Simple.. Requires extraordinary commitment of time, administrative recognition by providing world class [care] and exceptional support staff… That is just the beginning..”

A primary care provider wrote, “For myself, the biggest thing is actually having a conversation with the patient.  I know it sounds funny, but so many patients tell me that they are so happy that I actually stopped, listened, and talked with them.  As with a normal conversation, we talked back and forth.  Trying to treat it as you and I could be talking right now.  I think so many of us get caught up in EMR that we forget the conversation piece.  We listen, exam, educate and then leave.  The two way part of conversation is gone.  Where I think I do well is that I am computer savvy. I can type and make eye contact at the same time.  I know that many of our providers cannot do this and it puts them at a disadvantage.”

A commenter on KevinMD wrote this after his/her angry rant: “On a slightly different note, it has been common wisdom that you should walk into the room and “listen to the patient” for a full 60 seconds before asking questions. This approach tends to create the impression that you haven’t reviewed the chart (and quite frankly in my experience rarely produces much in the way of useful information). Lately, I have been experimenting with introducing myself and then briefly summarizing to the patient what I have learned from reviewing their chart prior to entering the room, and I am teaching my residents to do this also. I am not sure I have really noticed too much of a difference, but it still seems like a sensible thing to do that we are not taught during medical training.”

Another commenter, a self-proclaimed patient experience expert, put it pretty simple: “That “aidet” script puts my teeth on edge to the point that I think I now need dental work. Here’s a pro tip from a globally-recognized patient engagement expert (me): talk to the patient in front of you as if that person was your brother, your mom, your sister, or your best friend. No need for saccharine, or scripts, just speak plainly and clearly while looking into their eyes at least 20% of the time. You’ll be A-MAZED at the outcome.”

In addition, I found several blogs in which physicians find solace, grace and will to continue on in the current healthcare environment, often pontificating on the greatness of their profession, other times lamenting the difficulty of navigating the massive and broken system we live in.

This neurosurgeon wrote about the humanity in medicine and a technique he uses to connect with patients. Beautifully written. Honest. True. I’ve gone back to read it a few times over.

One thing is for sure; as much as providers dislike the idea of being rated through a survey or a test, most providers genuinely care about their patients and the relationship they develop with their patients in their respective practices. As a leader and champion of the patient experience initiative in our Big Med Org, this is all I can ask. If providers value their relationships with patients, try their best to communicate clearly and effectively and show their patients they care, then what more can we ask of them?

At the end of the day, reimbursement from the majority of our payers will be affected by a value modifier (VM) in 2016, which directly correlates to our CG-CAPS scores. Patient experience isn’t going away. We will need to make the best of it. We will need to find a way to navigate that tide and adjust.

But, I have come to realize that we will do best if we learn from each other in that process.

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