Physician-patient engagement in need of improvement

It happens during many doctor appointments. A patient is sitting in the waiting room when a staff member or nurse asks why the person is there. Since, in most cases, the question was asked at the time the appointment was made, the encounter often leaves the patient wondering why the office doesn’t know the reason for the visit.

That’s a poor patient engagement that does not strengthen the bond between clinicians and patients, explained Stephen Dickens, senior consultant in organizational dynamics at State Volunteer Mutual Insurance Co. during a session at this week’s MGMA16 in San Francisco.

Remember, Dickins said, this is an era where provider reimbursement increasingly is influenced by what patients think of their providers and the value of the care given. Patients may not tell the doctor they are dissatisfied, but they will tell family, friends and the world through social media. And insurers, through the Agency for Healthcare Research and Quality’s Consumer Assessment of Healthcare Providers and Systems survey, are analyzing patient satisfaction data and incorporating that data into payment decisions.


What the staff should have said is that they reviewed the patient’s records and had a few additional questions to ask, which lets the patient know they aren’t flying blind. It tells the patient that caregivers are genuinely interested in their patients and promotes a culture where office visitors feel valued.

Dickens advises clinicians and their staffs to start looking at were process improvements can be made.

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Patient satisfaction and patient experience are not the same thing, said Dickens, who served in practices and hospitals for 15 years. Patients generally like their doctor and that is reflected in patient surveys. Doctors see good scores and think all is well in the practice. However, patients often are not pleased with the staff and general workflows and processes of the office.

“Create the feeling that you are focused on them,” Dickens said. “That includes effective communication—not what you think you said, but what the patient heard and thought.”

Scheduling is one area where patients can clearly see if they are being valued, he said.

Routinely, patients call for an appointment and are told when they can be seen, not asked about when the patient can come in. A patient may need a 20-minute appointment, but most appointments average 12 minutes and to get 20 would take six weeks. Dickens recently needed an appointment and was given a date and time when he couldn’t make it, so he called back and was given another date and time, which he also couldn’t make. Too many practices still operate administratively on what is best for them, not best for the patient, and that is reflected in the culture of the practice.

“What your staff does is just as important as what your physician does,” Dickens told the practice management professionals at the MGMA conference. “Patients assume everything being done is approved by a physician.”

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