“We compile each practitioner’s ‘excellent’ rating in each of those domains and come up with an average score,” Dr. Nussenbaum said. There’s a pretty broad spread of ratings in the department: The provider with the lowest percentage of “excellent” ratings scored 50 percent, and the doctor with the highest percentage got an 89 percent rating.
Explore This IssueOctober 2012
“Interestingly, though, even those physicians with a low score on things like ‘effort to include patient in decision-making’ and ‘explanation of tests’ still had nine out of 10 patients say that they would recommend them or come back,” said Dr. Nussenbaum. “There’s a lot that we still need to figure out about these scores. What are the key domains that make people happy and willing to come back? That’s not clear yet.”
—Myles Pensak, MD, University of Cincinnati
Hospitals can’t afford to wait to fine-tune understanding of these measures before paying more attention to patient satisfaction. Dr. Nussenbaum’s institution has recently hired a “director of the patient experience.” His department just this year began to incorporate patient satisfaction scores into all faculty members’ individual reviews. “We’ve been reviewing these scores on a leadership level for about three or four years now, but this is the first year they’ve been incorporated into the annual faculty review,” he said.
“Increasingly, major medical centers are becoming attuned to these service expectations,” said Dr. Pensak. “Community-oriented practitioners have set a benchmark that academic centers should aspire to in terms of providing service excellence.”
An academic physician can’t move the parking lot closer to the office, but he or she can demand that the staff—nurses, paraprofessionals and administrators—show respect for a patient’s time and needs. “Physicians need to find a way to be involved with the administrative aspects of their practice and understand how these processes work in order to improve them,” said Dr. Chang.
“Hold your staff accountable and demand that they hold you accountable as well,” advised Dr. Pensak. “While an individual physician in a large medical center rarely has the power to influence on a grand scale, there’s no doubt in my mind that holding a system and its leaders accountable for driving optimal quality care is something that all doctors should do.”