Menu

Patient satisfaction surveys

Home The Lounge Patient satisfaction surveys

  • childay childay 
    Participant
    Status: Physician
    Posts: 1072
    Joined: 01/09/2016

    …We are not talking about what you might want in a doc, we are talking about the median patient… the vast majority of patients. The people at the grocery store or on the bus or watching Masked Singer right now.

    Click to expand…

    Did you really just like your own posts?  LOL

    Seriously if anyone wants to hate themselves, just get a secret shopper video of yourself interacting with various types of pts, it will be painful.

    Click to expand…

    Have you actually done such a thing recently?  Haven’t had to do something like that since med school / residency.  Might be very revealing but only if I didn’t know it was happening..

    I think the difficulty is knowing when and how to vary your usual interactions, and for which patients to do so.  Obviously not all pts want a detailed biochemical discussion of whatever, by the nerdy library person doctors all are (except myself of course who is totally cool).  Conversely, most of us would want just such a discussion.

    A secondary issue, not to get all psychiatrist on here, is to recognize your own natural reaction to certain patients, and whether that is helpful or impairing your interactions.

    #178526 Reply
    MPMD MPMD 
    Participant
    Status: Physician
    Posts: 2598
    Joined: 05/01/2017

    This isn’t really a question of medical skills… it is just basic people skills. You could also say it is basic sales skills.Maybe try reading 48 laws of power by Greene, How to win Friends and Influence People, or any number of books on image, impressions, and social skill. Work on your persona and your social skills. You will probably be surprised how fast you can make progress… and how it helps you many more places than just at work. GL

    Click to expand…

    I have read all of those books but I really disagree that managing patient expectations and satisfaction is basic people skills, particularly in challenging encounters with potential secondary gain issues.

    If someone pays to come see you (or doesn’t pay before anyone even goes down that road) with a specific thing in mind it is really a crapshoot whether they can leave satisfied without it. It doesn’t boil down to physician experience of emotional intelligence. When was the last time you wanted something bad enough to go see someone about it, didn’t get it, and left happy?

    Most of this equation plays out on the patient side regardless of how charming the doctor is or tries to be. I am a big fan of learning basic people management and it has served me well in multiple settings but the lessons in Carnegie’s book are not going to help you much in the exam room.

    #178528 Reply
    Zaphod Zaphod 
    Participant
    Status: Physician, Small Business Owner
    Posts: 6327
    Joined: 01/12/2016

    We havent had it recently but yes we used to get them periodically, you notice things you just wouldn’t. You never knew it who it was of course, or it wouldn’t work.

    Really shatters any illusions you may have.

    #178537 Reply
    IntensiveCareBear IntensiveCareBear 
    Spectator
    Status: Physician
    Posts: 243
    Joined: 12/22/2018
    … When was the last time you wanted something bad enough to go see someone about it, didn’t get it, and left happy?
    Most of this equation plays out on the patient side regardless of how charming the doctor is or tries to be. I am a big fan of learning basic people management and it has served me well in multiple settings but the lessons in Carnegie’s book are not going to help you much in the exam room.
    Click to expand…

    I believe that good social skills always matter. They don’t always make everything turn out roses, but they will never hurt outcomes. Many judges or police or coaches or docs or etc etc are constantly in the position of delivering bad news, correcting people, etc. Some of them are likable in the way the go about their business, and many are not. Delivery style for recommendations/criticism and being a generally likable personality is the difference.

    Setting up good rapport and trust and then having the patient choose to decline the recommendations offered (patient breaks rapport) yet reinforcing politely that they are in control and that choice is fine is much different from refusing their request with presumptuous and dry explaination (doc breaks rapport there… if it was ever well established in the first place). In both cases, the patient didn’t get their adipex or TRT or narc or whatever, but it was their choice and they were in control by declining in the former method while the latter had the doc refusing and controlling them, possibly embarrassing them. It is all in perception.

    Like all the books say, you will generally run the smoothest, with anyone (patients or dates or friends or family or strangers), when you stay in general agreement. It essentially boils down to a classic “give control to get control” thing. Most sales reps and attorneys get this, but a relatively low percentage of docs do… a high percentage just can’t resist their instincts to prove themselves right and teach teach teach. I generally just let patients (or whoever) think they are dictating the interaction. If they’re a talker, I will ask a few open ended questions and then keep them flowing as long as it stays positive (try to divert it back if they get negative). If they are a listener, it is easy to have a few basic positive things to discuss from the news or recent events.

    As was mentioned, observing other docs (or yourself) or good/bad sales interactions in general is often the best way to learn. Some 10min visits turn into basically a debate with loss of rapport and disagreement almost from the onset, and others are like a pleasant discussion and socialization between teammates with general rapport and agreement… and a soft medical or sales suggestion near the end (sandwiched with praise and encouragement for optimal effect). The orig poster even hints his general understanding yet hesitance to implement this concept of going along to get along (rapport) when he says he is a people pleaser to his wife but not in general. Being agreeable and having sales skills does not mean being a doormat, but you have to pick your spots. GL and good points all around; enjoy the weekend guys

    "Hmm, that sounds risky." - motto of the middle class

    #178546 Reply
    Avatar Panscan 
    Participant
    Status: Resident
    Posts: 1143
    Joined: 03/18/2017

     

     

    Edit: to OP when I do urgent care shifts (rare now) and deal with the “here for abx” complaint I would usually just be really direct and say something like, “my experience is leading me to think that your goal for today is to get an antibiotic rx, I don’t think that’s appropriate and I think it’s potentially harmful but I also recognize that you can go to Walgreens and just get them. if you want to make this quick just tell me that’s why you’re here and let’s just discuss the risk/benefit of that particular issue.” If they told me they were going to go straight to WG if I didn’t give them rx I would usually just write it and then document that I clearly advocated a “wait and see” strategy like we sometimes do w/ OM in kids.

     

    Click to expand…

    What antibiotics can you just go to walgreens and get without a prescription?

    @ENT I do try that.  It does work sometimes.

    @peds to the point as always and I do agree.  I am surprised with how many patients who do not get along with me for these reasons stick with me and expect a different outcome next time.  I guess changing physicians must be more of a pain then getting what you think you want.

    @zaphod I agree they do very little to improve our ability to provide care but I am hoping to improve my ability to communicate.  Because if they truly understand what I understand then there would be no argument.  I do not think there is an answer but I thought it might be a good discussion.

    Click to expand…

    WG minute clinics

    Click to expand…

    Is that your problem to worry about though? Like if they’re going to do that, it’s not your responsibility

    #178548 Reply
    CordMcNally CordMcNally 
    Participant
    Status: Physician
    Posts: 3041
    Joined: 01/03/2017

     

     

    Edit: to OP when I do urgent care shifts (rare now) and deal with the “here for abx” complaint I would usually just be really direct and say something like, “my experience is leading me to think that your goal for today is to get an antibiotic rx, I don’t think that’s appropriate and I think it’s potentially harmful but I also recognize that you can go to Walgreens and just get them. if you want to make this quick just tell me that’s why you’re here and let’s just discuss the risk/benefit of that particular issue.” If they told me they were going to go straight to WG if I didn’t give them rx I would usually just write it and then document that I clearly advocated a “wait and see” strategy like we sometimes do w/ OM in kids.

     

    Click to expand…

    What antibiotics can you just go to walgreens and get without a prescription?

    @ENT I do try that.  It does work sometimes.

    @peds to the point as always and I do agree.  I am surprised with how many patients who do not get along with me for these reasons stick with me and expect a different outcome next time.  I guess changing physicians must be more of a pain then getting what you think you want.

    @zaphod I agree they do very little to improve our ability to provide care but I am hoping to improve my ability to communicate.  Because if they truly understand what I understand then there would be no argument.  I do not think there is an answer but I thought it might be a good discussion.

    Click to expand…

    WG minute clinics

    Click to expand…

    Is that your problem to worry about though? Like if they’re going to do that, it’s not your responsibility

    Click to expand…

    It becomes a major problem with future interactions. I can’t tell you the number of people that come in to the ED that says “but Dr. So and So usually gives me a z-pack” or some variation of that. As soon as they say that, I know we’re never going to see eye to eye. Inappropriate prescribing (antibiotics and other meds) benefits nobody.

    “But investing isn’t about beating others at their game. It’s about controlling yourself at your own game.”
    ― Benjamin Graham, The Intelligent Investor

    #178551 Reply
    Avatar Dont_know_mind 
    Participant
    Status: Physician
    Posts: 987
    Joined: 11/21/2017

     

     

    Edit: to OP when I do urgent care shifts (rare now) and deal with the “here for abx” complaint I would usually just be really direct and say something like, “my experience is leading me to think that your goal for today is to get an antibiotic rx, I don’t think that’s appropriate and I think it’s potentially harmful but I also recognize that you can go to Walgreens and just get them. if you want to make this quick just tell me that’s why you’re here and let’s just discuss the risk/benefit of that particular issue.” If they told me they were going to go straight to WG if I didn’t give them rx I would usually just write it and then document that I clearly advocated a “wait and see” strategy like we sometimes do w/ OM in kids.

     

    Click to expand…

    What antibiotics can you just go to walgreens and get without a prescription?

    @ENT I do try that.  It does work sometimes.

    @peds to the point as always and I do agree.  I am surprised with how many patients who do not get along with me for these reasons stick with me and expect a different outcome next time.  I guess changing physicians must be more of a pain then getting what you think you want.

    @zaphod I agree they do very little to improve our ability to provide care but I am hoping to improve my ability to communicate.  Because if they truly understand what I understand then there would be no argument.  I do not think there is an answer but I thought it might be a good discussion.

    Click to expand…

    WG minute clinics

    Click to expand…

    Is that your problem to worry about though? Like if they’re going to do that, it’s not your responsibility

    Click to expand…

    It becomes a major problem with future interactions. I can’t tell you the number of people that come in to the ED that says “but Dr. So and So usually gives me a z-pack” or some variation of that. As soon as they say that, I know we’re never going to see eye to eye. Inappropriate prescribing (antibiotics and other meds) benefits nobody.

    Click to expand…

    There’s only one thing worse than being Dr. Candyman and that’s having to see Dr. Candyman’s patients after he retires or goes on extended leave.

    MPMD MPMD 
    Participant
    Status: Physician
    Posts: 2598
    Joined: 05/01/2017
    Panscan wrote:Is that your problem to worry about though? Like if they’re going to do that, it’s not your responsibility

    Strictly speaking probably not. I def got the most patient complaints of my life when I worked in urgent cares and it was almost always from people with URIs who felt that they needed either amox or azithro.

    I guess in my mind it was an attempt to prevent further madness. It wouldn’t take you much effort to convince me that this wasn’t my peak as an emergency physician.

    Urgent care work is actually pretty hard. Most people come to the ED with the understanding that they will endure some waiting, chaos, and discomfort. None of that is expected at an urgent care especially given that they always operate cash on the barrel-head.

    #178560 Reply
    q-school q-school 
    Participant
    Status: Physician
    Posts: 2640
    Joined: 05/07/2017

     

     

    Edit: to OP when I do urgent care shifts (rare now) and deal with the “here for abx” complaint I would usually just be really direct and say something like, “my experience is leading me to think that your goal for today is to get an antibiotic rx, I don’t think that’s appropriate and I think it’s potentially harmful but I also recognize that you can go to Walgreens and just get them. if you want to make this quick just tell me that’s why you’re here and let’s just discuss the risk/benefit of that particular issue.” If they told me they were going to go straight to WG if I didn’t give them rx I would usually just write it and then document that I clearly advocated a “wait and see” strategy like we sometimes do w/ OM in kids.

     

    Click to expand…

    What antibiotics can you just go to walgreens and get without a prescription?

    @ENT I do try that.  It does work sometimes.

    @peds to the point as always and I do agree.  I am surprised with how many patients who do not get along with me for these reasons stick with me and expect a different outcome next time.  I guess changing physicians must be more of a pain then getting what you think you want.

    @zaphod I agree they do very little to improve our ability to provide care but I am hoping to improve my ability to communicate.  Because if they truly understand what I understand then there would be no argument.  I do not think there is an answer but I thought it might be a good discussion.

    Click to expand…

    WG minute clinics

    Click to expand…

    Is that your problem to worry about though? Like if they’re going to do that, it’s not your responsibility

    Click to expand…

    It becomes a major problem with future interactions. I can’t tell you the number of people that come in to the ED that says “but Dr. So and So usually gives me a z-pack” or some variation of that. As soon as they say that, I know we’re never going to see eye to eye. Inappropriate prescribing (antibiotics and other meds) benefits nobody.

    Click to expand…

    There’s only one thing worse than being Dr. Candyman and that’s having to see Dr. Candyman’s patients after he retires or goes on extended leave.

    Click to expand…

    could not be more true.

    the guy with the highest patient satisfaction scores was a cardiothoracic surgeon.   every patient no matter what got the “90% chance you die, 10% chance I can save you, rest up to jesus” line.  twenty years later their eyes still mist when they talk about that guy.  I was like he gave you some amoxicillin for possible bronchitis, but whatever.  or he saved me from a lifetime of agony.   you aren’t going to treat my life threatening pain with the same narcotics?

    I wonder if specialties color the experiences and comments.  have to imagine they do.

    #178569 Reply
    Drop it into MD Drop it into MD 
    Participant
    Status: Physician
    Posts: 440
    Joined: 09/20/2018

    Wow this really took off when I was away from my computer for half a day haha.

     

    I do agree this is mostly people skills not medical knowledge.  I feel that I have pretty good people skills and I get a lot of good feedback but unfortunately most of those patients do not fill out the survey and just those with a bone to pick do.

    We do not have any minute clinics out here.    I am somewhat rural so our urgent cares are hospital owned and sounds like they do a better job with antibiotic stewardship.

     

    Ad Docs we are used to excelling and I think I just found a place that I am just going to have to expect some “bad grades.”  I do agree with whoever said that if your patient satisfaction scores are 100% you are probably doing something wrong.

    Thanks for all the comments.  I have a lot to think on.

    #178581 Reply
    Liked by Kamban
    Zaphod Zaphod 
    Participant
    Status: Physician, Small Business Owner
    Posts: 6327
    Joined: 01/12/2016

    Wow this really took off when I was away from my computer for half a day haha.

     

    I do agree this is mostly people skills not medical knowledge.  I feel that I have pretty good people skills and I get a lot of good feedback but unfortunately most of those patients do not fill out the survey and just those with a bone to pick do.

    We do not have any minute clinics out here.    I am somewhat rural so our urgent cares are hospital owned and sounds like they do a better job with antibiotic stewardship.

     

    Ad Docs we are used to excelling and I think I just found a place that I am just going to have to expect some “bad grades.”  I do agree with whoever said that if your patient satisfaction scores are 100% you are probably doing something wrong.

    Thanks for all the comments.  I have a lot to think on.

    Click to expand…

    Nothing wrong with wanting to improve. We have to remember a lot of life is about perception, and substance matters a lot less in everyday things, much more than we’d like to admit.

    You cannot make everyone happy, its impossible and wrong. Some people are abusers of the system and have zero desire to do anything but get their way or manipulate. Some have other pathologies. Unfortunately some of them have learned the ratings game works wonders. You have to blow it off, but it is hard. I stopped looking at reviews and such years ago, and I cannot care less about a bad pt/review. Im more than happy to never see them again or whatever, but part of that is in my field its easy I guess.

    I actually like when pts say dr. x usually does such and such, Im always like well…why arent you at dr x? Nmp.

    Pts are never going to fully understand what you understand. Remember all the effort and years of life getting to where you are today? If there was a way to distill that in 15 minutes I’d be pretty pissed off. It will never happen. Smarter, educated pts may be able to reason along with you and trust your process, but you cant make them doctors. This is a losing tactic and easily a source of frustration for both in the encounter.

    Your job in this arena is to learn how to express what you know at a level that the pt will understand and buy into. This will be slightly different for different kinds of pts.

    #178582 Reply
    Avatar StarTrekDoc 
    Participant
    Status: Physician
    Posts: 2130
    Joined: 01/15/2017

    Most here are parents. Patient physician relationship is not different.

    Style is own preference and some take a stronger tighter role vs engagement vs rolling with it position.

    I actually pattern my practice much like how we practice our parenting. I use that in my discussions with patients too.

    Have to say, building rapport over time makes discussions a lot easier…especially the hardest ones like end of life and surgeries or family issues or interventions on abuse.

    That’s very different from the art of no on one offs like narcs and Abx to folk who have set expectations coming in the door.

    #178588 Reply
    Liked by q-school
    Avatar Kamban 
    Participant
    Status: Physician
    Posts: 2573
    Joined: 08/01/2016
    I feel that I have pretty good people skills and I get a lot of good feedback but unfortunately most of those patients do not fill out the survey and just those with a bone to pick do.

    Click to expand…

    Even though I do not have Press Ganey or any patient surveys due to my solo practice I run into the same problem. My happy satisfied patients almost never post on the Google / Vitals / healthgrades sites. Thus on a search for specialists in my field in my town / city I never make it to the first ( and sometimes even 2nd page)  of the search pages. I have only 5 rankings in 20+ years of practice. Luckily except for 1 dissatisfied patient who posted ( I tried to save him money but no good deed goes unpunished) I have 5 star reviews.

    Most of my satisfied patients are elderly and rural and not savvy about tech or posting reviews. So I have to depend on word of mouth for my referrals.

     

    #178614 Reply
    Avatar Panscan 
    Participant
    Status: Resident
    Posts: 1143
    Joined: 03/18/2017

     

     

    Edit: to OP when I do urgent care shifts (rare now) and deal with the “here for abx” complaint I would usually just be really direct and say something like, “my experience is leading me to think that your goal for today is to get an antibiotic rx, I don’t think that’s appropriate and I think it’s potentially harmful but I also recognize that you can go to Walgreens and just get them. if you want to make this quick just tell me that’s why you’re here and let’s just discuss the risk/benefit of that particular issue.” If they told me they were going to go straight to WG if I didn’t give them rx I would usually just write it and then document that I clearly advocated a “wait and see” strategy like we sometimes do w/ OM in kids.

     

    Click to expand…

    What antibiotics can you just go to walgreens and get without a prescription?

    @ENT I do try that.  It does work sometimes.

    @peds to the point as always and I do agree.  I am surprised with how many patients who do not get along with me for these reasons stick with me and expect a different outcome next time.  I guess changing physicians must be more of a pain then getting what you think you want.

    @zaphod I agree they do very little to improve our ability to provide care but I am hoping to improve my ability to communicate.  Because if they truly understand what I understand then there would be no argument.  I do not think there is an answer but I thought it might be a good discussion.

    Click to expand…

    WG minute clinics

    Click to expand…

    Is that your problem to worry about though? Like if they’re going to do that, it’s not your responsibility

    Click to expand…

    It becomes a major problem with future interactions. I can’t tell you the number of people that come in to the ED that says “but Dr. So and So usually gives me a z-pack” or some variation of that. As soon as they say that, I know we’re never going to see eye to eye. Inappropriate prescribing (antibiotics and other meds) benefits nobody.

    Click to expand…

    right. I am all for not giving abx for viral illness. My point was that what another provider would do doesn’t really effect what I decide to do. If they’re going to decide to do something inappropriate thats on them

    #178688 Reply
    Liked by Zaphod

Reply To: Patient satisfaction surveys

In case of a glitch or error, please save your text elsewhere, clear browser cache, close browser, open browser and refresh the page.

Notifications Mark all as read  |  Clear