Patient Satisfaction: Can Academic Medical Centers Compete?

“Practices need to strive to obtain scores of all 5s to differentiate themselves from being good to being great. It is this differentiation that makes patients return despite other inconveniences,” she said. “Moreover, many hospital incentive plans reward physicians based on their overall percentile and not their mean score.”

The ‘Halo Effect’

Why are academic otolaryngology practices inspiring more patient loyalty even as otolaryngologists in community practice do better on scores relating to access and service? To some degree, it’s probably a “halo effect” from the academic setting, said Brian Nussenbaum, MD, the Christy J. and Richard S. Hawes III Professor and vice chairman for clinical affairs in the department of otolaryngology at Washington University School of Medicine in St. Louis. “People who come to academic medical centers may view their doctors a little differently because they’re at the place that’s No. 5 or No. 8 on the U.S. News & World Report top hospitals list,” he said. “And more patients at an academic center have conditions that require tertiary care, so they have been referred there by a community provider in the first place.”

Meanwhile, customer service has been much more historically part of the business model for community physicians than in academic centers. “While, on an individual basis, I think most physicians pride themselves on [having] concern for their patients no matter where they practice, in large academic medical centers there may be a substantial administrative hierarchy that can sometimes can be divorced from the patient,” said Myles Pensak, MD, the H.B. Broidy Professor and chair of otolaryngology at the University of Cincinnati. “Physicians with an ownership in their practice are much more attuned to inherent patient dissatisfiers like cancellation rates, bump rates and office delays, which are much more common in larger systems.”

Dr. Nussenbaum said that the patient satisfaction scores in his practice are very similar to what the Laryngoscope study found. “Where we have problems are in areas that the individual practitioner has little control over: ease of parking, were you able to find your way to the office beforehand and so on. Some of these things we can work to control as physicians, such as staff attitudes, but others are facility issues we can’t do much about.”

His department focuses attention on the survey metrics that are specific to patient care and that the doctor has control over: caring and respect, ability to communicate, explanation of tests and procedures, how well the patient’s concerns were addressed and willingness to return and recommend.