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  • Patient feedback ratings impact on pay?

    Our private group monitors patient feedback ratings using press ganey formats.  First year out of fellowship 96% across all domains I thought things were all great, typically saw new patients 60 mins and returns 30 mins.  I started adding a few more patients in a day and this next year my number have fallen significantly. What gives? I always answer ALL questions and people tell me I am pleasant and explain things well.  Any ideas on making patients appreciate you without sacrificing your time and efficiency?

  • #2
    What do the survey results say?

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    • #3
      Most are numbers 1-10 rating, the few and occasional written patient comments are positive.  Never had a bad one written.  I work with chronic disease not all of which have fixes.

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      • #4
        What gives is that they’re fairly useless. Good satisfaction scores don’t correlate with good (and appropriate) patient care. The n for these are typically somewhat small compared to the number of patient encounters.

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        • #5
          The thing that frustrates me is that I feel that people who appreciate my work and value their time don't fill these out on average and those who are upset about their chronic pain use it as a way to vent.  Probably no way to make everyone like you even if you do good work.

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          • #6
            I would be hesitant to work with such a model. The most vocal patients are those with an ax to grind. It also promotes bad doctoring. Over prescribing of pain meds and antibiotics. Bad stuff.

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            • #7
              These patient satisfaction scores do drive me crazy.   They are always driven by a small "n" value that seems to me to be unlikely to be representative of overall patient satisfaction, the patients that are satisfied are not necessarily the ones who received better care, they are the ones who received what they wanted whether it be antibiotics, pain medications, etc.    I find that patients are usually oblivious to the actual quality of care they received. That being said, it is being included into more payment models from medicare and the insurance companies, and my previous hospitalist boss told me that there was data supporting its usage as a quality metric (patients who were happier with their tended to do better, but I'm not sure of any causality, never really looked at the data).  The data is already being used to increase or decrease payments to hospitals and facilities and I think that they are planning on incorporating more of it into paying physicians.   I remember hearing some studies suggesting that sitting down when talking to patients and showing empathy can influence their scores and perception of the care they received.

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              • #8
                I cannot tell you how many patients come to see me after going to the ER for something dumb like a URI.  Then they complain about the terrible care they got and had to "wait an hour to even be seen"  "they did not even do anything"

                I cannot imagine they are giving good reviews to our ER for what looks like to me was appropriate care.

                Being a stick to my guns sort of physician myself I get some bad reviews.  I tell people when when I think something is nonsense.  I should probably choose my battles better...

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                • #9
                  Honestly one of these on the way out would likely yield better results.

                   

                  Image result for push button feedback device

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                  • #10


                    What gives?
                    Click to expand...


                    Patients starting getting bills.

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                    • #11
                      I would specifically target patients who you know are having a positive experience. Give them the survey or survey link directly. Solution to pollution is dilution.

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                      • #12
                        Imo one of the biggest influencers of pt satisfaction is time spent with pt.. they love it.

                        Once you start being more “efficient” or just plain busy and start churning and burning more you better come up with other tricks to make pts like u or leave satisfied (

                        I don’t know what that is.. if I have a quick visit after going through everything and everything is hunky Dory I try to admit that but also state if they have anything else I’m all ears

                        “Well sounds like everything is going well. I realize that it makes it a little quick of a visit, but is there anything else that we haven’t discussed or any other questions or concerns u might have? From my perspective everything looks stable, so we will keep things the same.”

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                        • #13




                          Imo one of the biggest influencers of pt satisfaction is time spent with pt.. they love it.

                          Once you start being more “efficient” or just plain busy and start churning and burning more you better come up with other tricks to make pts like u or leave satisfied (

                          I don’t know what that is.. if I have a quick visit after going through everything and everything is hunky Dory I try to admit that but also state if they have anything else I’m all ears

                          “Well sounds like everything is going well. I realize that it makes it a little quick of a visit, but is there anything else that we haven’t discussed or any other questions or concerns u might have? From my perspective everything looks stable, so we will keep things the same.”
                          Click to expand...


                          The art of rushing them out the door without them feel like they are being rushed out the door.

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                          • #14
                            I couldn't care less about PG, honestly.

                            Hospitals / contract management groups care because something like 10% of the "quality" portion of reimbursement is tied to it.  Money is the only reason they care about anything.

                            There is date that shows that higher PG score lead to higher incidence of bad outcomes.  I'm a doctor, not a concierge.

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                            • #15




                              I cannot tell you how many patients come to see me after going to the ER for something dumb like a URI.  Then they complain about the terrible care they got and had to “wait an hour to even be seen”  “they did not even do anything”

                              I cannot imagine they are giving good reviews to our ER for what looks like to me was appropriate care.

                              Being a stick to my guns sort of physician myself I get some bad reviews.  I tell people when when I think something is nonsense.  I should probably choose my battles better…
                              Click to expand...


                              I appreciate you continuing that appropriate care. Sometimes if two physicians (including the patient's PCP) tell them that there's nothing to do for a certain set of symptoms besides supportive care then maybe they'll realize the ED doc wasn't a complete moron.

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