Medical Practices Face Increasing Challenges as Patients Evaluate Value of Care
After two consecutive years of significant gains, patient satisfaction with medical practices leveled off in 2009, according to a new report by Press Ganey.
The 2010 Medical Practice Pulse Report: Patient Perspectives on American Health Care provides feedback based on the experiences of 2.7 million patients treated at more than 11,000 locations across the nation in 2009.
"One of the challenges facing medical practices in the coming years is the need to improve patient perception of care as the likelihood of public reporting and pay-for-performance emerge," said Lisa Cone-Swartz, vice president of satisfaction products at Press Ganey. "Actions like being more sensitive to patients, decreasing wait times and accessibility significantly contribute to patient satisfaction with medical practice services."
The report found that patients who spend less time waiting to see their provider are more satisfied with their office visit than patients who have longer wait times. While most patients expect some amount of wait time when they arrive, it is critical that patients perceive that the staff recognizes their time is valuable as they move through their visit. According to the report, one of the best ways for medical practices to decide where to focus patient satisfaction improvement efforts is to examine the Medical Practice Priority Index. The report found patients' top priorities were:
- Sensitivity of caregivers to patient needs.
- Overall cheerfulness of the practice.
- Overall rating of care.
- Comfort of exam rooms.
- Time spent waiting in the exam room.
To address these priorities, Press Ganey recommends the following improvement strategies for medical practices:
- Dedicate "on stage" and "off stage" areas for staff. Leader rounding and regular service audits can help ensure staff act in a professional manner while "on stage" with patients.
- Respect patients' time. When unanticipated waits occur, keeping the patient informed can mitigate the patient's dissatisfaction with the wait.
- Noting non-clinical patient information in the patient's file, such as hobbies, interests and family stories discussed during the visit can help build a relationship and may improve the patient experience. Electronic health records have a dedicated space to record social information.
- Consider having physicians begin each patient meeting with a question to the patient about what the patient wants to accomplish during the visit. If physicians can get patients to ask questions and voice concerns during the visit and address their feedback, it could result in fewer follow-up phone calls from the patient to office staff.
Other interesting points revealed by the report include patient perceptions related to waiting in the exam room and waiting room, as well as patient satisfaction with different aspects of interaction with medical practices and patient satisfaction by specialty. Key points from the report are listed below:
- Patients kept waiting for more than 10 minutes in the exam room report an 8.8 point drop in satisfaction (100-point scale) compared to those patients who waited 0-5 minutes.
- Patients kept waiting for more than 10 minutes in the waiting room report an 8.1 point drop in satisfaction (100-point scale) compared to those patients who waited 0-5 minutes.
- On average, patients waited 30 minutes to see their neurosurgeon, while optometry patients had the lowest average amount of wait time at 17 minutes.
- Oncology practices have the highest level of overall patient satisfaction, followed by cardiovascular practices, cardiology practices and plastic surgery practices.
- Among provider types, therapists have the highest patient satisfaction and the lowest average wait time. Nurse practitioners rank second in highest patient satisfaction and have the second-lowest average wait time, tied with physician assistants.
- Residents have the lowest patient satisfaction, coupled with the highest average wait time (26 minutes).
Patient satisfaction with medical practices may have even more significance with value-based purchasing (VBP) under Medicare. Although the Centers for Medicare and Medicaid Services (CMS) has until 2017 to implement a full VBP program for doctors, the transition will begin in 2011.
Press Ganey expects that a Clinician and Group CAHPS instrument (CGCAHPS) may be piloted by CMS by late 2011 to prepare for official data collection in 2012 and publication in PhysicianCompare.gov in 2013.
Press Ganey is encouraging medical groups to implement CGCAHPS in 2011.
The 2010 Medical Practice Pulse Report: Patient Perspectives on American Health Care is available at: http://www.pressganey.com/Documents_secure/Pulse%20Reports/MPPulseReport_11-2010.pdf
Press Ganey Associates, Inc.
Recognized as a leader in performance improvement for 25 years, Press Ganey partners with more than 10,000 health care organizations to create and sustain high performing organizations, and, ultimately, improve the overall health care experience. The company offers a comprehensive portfolio of solutions to help clients operate efficiently, improve quality, increase market share and optimize reimbursement. Press Ganey works with clients from across the continuum of care - hospitals, medical practices, home health agencies and other providers - including 50% of all U.S. hospitals. For more information, visit www.pressganey.com.