Physicians have long been anticipating the move from fee-for-service pricing to value-based pricing. That era has finally arrived, and it's leading to a new focus on patient satisfaction.
Heraclitus was a Greek philosopher who was centuries ahead of his time. He espoused the philosophy that change was central to the universe. And his quote, “The only constant in life is change,” lives on today.
Want proof? Just ask physicians who are grappling with the industry’s move from fee-for-service pricing to value-based pricing.
“We’ve heard about that for years, and now I think that transition is in our laps,” says Fred Davis, MD, president and co-founder of ProCare, an organization dedicated to providing institutions and physician practices with programs aimed at increasing productivity while decreasing expenses. “And now it’s a question of harnessing the power of your practice.”
Training and Development
In harnessing that power, physicians need to look to create an environment in which patients feel attended to, responded to, and respected. Carole Lambert, MPA, RN, assistant vice president, Membership Review and Education, residents program director for the Cooperative of American Physicians, says that starts with medical practice staff.
“Having spoken with office administrators and with office staff over the past few years, how they feel about their work, how they understand their work, and how they have been trained or educated and mentored, makes a tremendous difference in the patient experience and the patient’s response to the experience,” Lambert says.
The key word there is “mentored,” and Lambert says that starts with the physician’s choice of office manager or practice administrator. What follows is a mutual agreement about values and behaviors, and making certain your office manager is alert to the kinds of things that either satisfy patients or turn them off.
“And then there’s ongoing monitoring, looking for ways to improve.”
It’s a team approach, echoes Davis, whose organization conducted a 15,000-patient study to identify the biggest determinant of patient satisfaction. What they learned was eye-opening.
“The biggest correlation for patient satisfaction was how well their phone was answered when they called, how courteous was the staff, how was the front office when you dealt with them, how was the waiting room, how was the receptionist, and did you feel the care team paid attention to your needs,” he explains. “Those patient experience features are tremendously important. And that brings you down to the person at the front desk. And sometimes the lowest paid people in the organization will have the highest impact with the patients.”
Chemistry and Dollars
Lambert explains that every time you introduce a new person into the medical practice, you change the dynamics. When you hire a new person, they’re coming into an existing culture. How will they fit in? Are they a good match?
“A new person changes the chemistry, changes the relationship dynamics, and that has to be attended to,” she says.
It’s team medicine, Davis says, and he believes it translates into dollars, either gained or lost, for the practice.
“We have this patient satisfaction module, 10 questions that we address with the patient right there in the clinic,” he says. “If there’s a problem, we can address it right there as opposed to waiting for the patient to file a complaint two weeks later.”
He equates it to going to a restaurant where you waited a long time for your order to arrive, or you were given the wrong order. In a proactive environment, the manager will come right to your table, take the amount of that entrée off the bill and throw in a free dessert.
“When you walk away from the restaurant feeling your needs were met, you’re probably going to go back and tell others about your experience,” Davis explains. “But if you have a waitress who just says, ‘Well, that’s too bad,’ you’re going to tell 30 people about the bad experience you had.”
Being able to remedy the situation while the patient is present, he says, is “good business, good medicine, and helps you build a strong organization where everybody feels vital.”
Lambert says one of the best places to start down the road toward improving care, increasing patient satisfaction, and boosting practice revenue is by talking to your staff. In a small- to mid-size practice, asking staff for their input, she says, is always enlightening.
“The physician is in a room examining the patient, so they lose track of what the work is like hour to hour,” she explains. “Soliciting staff input can uncover excellent ideas about where to begin and ways to do things better. Then you can begin to map out your strategy from there.”