A Visit to One of Your Employed Physicians May be the First Exposure Patients will have with Your Hospital. What Kind of “Patient Experience” will They have?



Steve Wilkins

Guest Post by Steve Wilkins
Now that over 50% of physicians are employed by hospitals, this is question that is on the minds of progressive hospital executive teams. With good reason. Patient-reported outcomes, including satisfaction and loyalty, are going to play an increasing role in determining how much hospitals and physicians are paid. This means that astute hospital marketers will be able to build a strong business case for investing in programs aimed at creating superlative ambulatory and inpatient experiences for patients.

But Our Physicians Already Have High Patient Satisfaction And Loyalty Scores

Health care executives should take little comfort in the high patient satisfaction and loyalty ratings found uniformly with just about every physician. Generally speaking, “one can assume that the quality of care is, actually, worse than surveys of patient satisfaction (suggest)”according to Avedis Donabedian, MD, the father of today’s quality movement. Donabedian goes on to say that “patients are, in fact, overly patient; they put up with unnecessary discomforts and grant their doctors the benefit of every doubt, until deficiencies in care are too manifest to be overlooked. “

Just look at the quality of physician-patient communication, a key ingredient of the “patient experience” in the physician’s office.

• In only 26% of the visits are patients allowed to complete their opening statement (agenda) without interruption (by the doctor); in 37% the physicians interrupted; and in 37% physician never asked about the patient’s visit agenda.
• Studies suggest that patients do not express their health concerns, expectations or opinions in up to 75 percent of physician visits principally because their doctor never asked.
• Primary care physicians typically spend less than 60 seconds informing patients how to take new medications…or why.
• Primary care physicians and patient disagree about the diagnosis, treatment, and cause/severity of their condition over 50% of the time.
• Over 50% of patients walk out of their doctor’s office not understanding what they were told, including why or how to take their medications.

For their part, patients today are hard pressed to rate the effectiveness of their relationship with their doctor. The evidence conclusively shows that poor physician-patient communications is the norm rather than the exception. As such, most patients do not appreciate all the ways in which their doctor could in fact do a better job communicating with them.

Why Is Any Of This Important?

Simple. In the near future, your hospital and physicians will be paid according to things like how well they communicate with patients. More importantly, high quality physician-patient communications is highly correlated to improved outcomes, fewer hospital re-admits, fewer medical errors, improved patient compliance and increased patient satisfaction and loyalty.

So if you marketing team is looking for a simple and effective position strategy, consider improving the way your physicians and patients talk to each other. This strategy is so simple no one else in your market will be able to figure out what you are doing. But that’s OK…because your patients will sure see the know!

Steve Wilkins, MPH is the author of Mind the Gap.  His posts appear regularly on Better Health Network, KevinMD.com  and the Wall Street Journal Online Edition.   Mr. Wilkins, and his company Smart Health Messaging, focus on developing evidence-based solutions for improving the quality of communications between physicians and patients...and in so doing, improve safety and outcomes, increase adherence and satisfaction and reduce costs. www.healthecommunications.wordpress.com

High Performing Hospitals Don't Leave Patient Experience to Chance

Last week, I posted a story about a hospital where parking attendants from an outsourced management company were less than sympathetic to a visitor who had spent the night by the bedside of her best friend’s dying child. The incident underscored for me the importance of alignment and accountability across an organization – including independent contractors and vendors – to deliver on brand experience and customer service expectations.

Brand experience is not created by accident. Well, at least great brand experience is not. Establishing and communicating brand service standards clarifies for employees – and contractors – the specific actions and behaviors that are expected of them in delivering great customer service and generating customer loyalty. High performing organizations define and frequently communicate the standards of excellence required to create experiences that are meaningful and valued by patients and their families – and lead to achievement of the health system's business objectives.

Kristi Peterson is a consultant (and long-time colleague) that has helped hundreds of organizations address organizational alignment to service standards. She left this comment on last week’s post – I wanted to share her advice for building accountability into your contracts with outsourced service providers. Writes Kristi:

“A poignant story that makes a very important point. It also hinges on a major concern of mine, thus an editorial comment first. We get so caught up in collecting patient satisfaction data (and feeding on percentile results) that the voice of the customer isn't heard. The numbers do the talking. The relative impact of contracted service providers on the experience is overlooked. It is challenging to capture meaningful feedback on some of these services (such as the one featured). The last thing that's needed is another survey to monitor the performance. Who experiences the customer's frustration, disgust and dismay? Employees. It's important to collect their ideas.

In terms of holding contract service providers accountable for contributing to the patient/customer experience - build into your contracts/reviews the expectations that they will:

1. Regularly capture feedback from front-line employees (e.g., "What procedures/policies create confusion, inconvenience, dissatisfaction for customers?") and internal departments/stakeholders (as appropriate);
2. Reinforce employee communication/service skills through training/coaching;
3. Adopt and hold their employees accountable for your service standards;
4. Report at least quarterly one service improvement they have instituted; and that 
5. Executive/manager representatives of contract service firm will regularly visit to watch, listen to, touch and smell your customers. That's the only way they can get a taste...correction, if they mystery-shopped their own services, they would get a better taste of what the service experience is really like, for customers and employees alike!

We should all spend time being underground bosses.”

Amen, Kristi.

Kristi Peterson consults on customer experience, patient satisfaction and leadership effectiveness. She was a pioneer in the movement to raise customer service standards in hospitals and establish the link between patient satisfaction and employee engagement.  You can contact Kristi at kristi@kristinepeterson.com.

Hospitals Must Hold Private Contractors Accountable for Delivering on Patient Experience

Just before the holidays, a colleague received word that her best friend’s two-year old daughter had been found unresponsive in her crib. She was revived and rushed to the hospital with life-saving measures underway. But the news was not good. The child had gone without oxygen for too long.

My friend, Chris, dropped everything to get to her best friend’s side. She sat in the hospital with the anguished parents for the next 24 hours, watching an endless parade of doctors and nurses running tests, conducting evaluations, trying to comfort the hopeful mother and father. Sadly, the little girl died.

I can’t begin to imagine the depth of grief that the parents and four-year old brother of this young girl are experiencing; just seeing the raw pain etched in Chris’ face brought me to tears as well.

The doctors and nurses in our hospitals are cast in these real life dramas every day. And, occasionally, despite their most heroic efforts, some patients don’t survive. But the intensity of their clinical efforts combined with caring and compassion, are essential to healing the wounded hearts of the families and friends left behind.

A child’s death is not the ‘patient experience’ we want to address in our brand and patient satisfaction discussions, but it was nonetheless the ‘experience’ that this family endured. They will remember the kindness of the staff.

When Chris reluctantly left her friends’ side to return home to her own family, she walked to the hospital parking garage (which is run by an outsourced contractor) to retrieve her car only to learn from the attendant that “this lot closed at 6 pm.”

“Can I just get my keys?” asked Chris. “I need to go home.”

Learning that the keys were sent elsewhere at 6 pm, she treks in the frigid evening air to another building on an unfamiliar campus to retrieve keys from another attendant that began to lecture her about the rules and regulations of the parking garage.

“Can you cut me a break?” she pleaded, “I’ve been with a dying child.” Then she got her keys, walked back to the garage, and drove home to hug her own kids.

The moral of the story? Everyone, from the highly specialized doctor to the parking attendant, creates experiences that live in our customers’ memories. When a parking attendant is inconvenienced rather than sensitive to the harried, worried, hurried, sad or pained needs that characterize families and visitors of the hospitalized, he or she tarnishes your brand. Outsourced operators that touch patients and visitors need to be held to the same expectations of customer care, concern and service.

Your Brand is What You Do; Not Just What You Say You Do

In this brief and well-articulated essay (Make Your Product Work for Your Brand, CMO Strategy), author Steve Beck (VP Strategy, Organic) drives home the point that brands today are built more powerfully through the experience that consumers have with your product or service. 

One of my favoritie quips, "It's not McDonald's saying their food is healthy, it is McDonald's putting healthier food on the menu. In the past, the whole world of positioning was really simple. You targeted an audience, articulated a promise and then communicated the heck out of it. You created advertising. Today everything is an advertisement -- starting with what it is you are selling."

Brand experience doesn't happen by accident; it happens by design.