Physicians: Get feedback from patients before (and after) they fire you

When patients leave your practice, how often do you find out why?

Most often, when patients make the decision to never set foot in a certain doctor's office again, they usually keep it to themselves, according to Dr. Anna B. Reisman. "We don't fire doctors loudly enough," the Connecticut internist wrote in a special piece for the Los Angeles Times, in which she admitted to recently replacing a disappointing doctor of her own with no explanation.

"I'm not saying that we should barrel into the office, waggle a finger and shout, Trump-style, 'You're fired!' But a sotto voce firing can be a missed opportunity to teach our doctors how to do their jobs more effectively," she wrote.

In her own primary-care practice, Reisman caught one such opportunity almost by accident, when one of her patients asked the practice office manager to be switched to another doctor in the group. Since there were no openings for several months, the dissatisfied patient agreed to see Reisman one more time. Baffled as to what she could have done wrong, she ultimately learned during that would-be final appointment that the patient felt she hadn't taken one of his symptoms seriously.

"I was able to reassure him that I had not blown it off and apologized for giving the impression that I had," Reisman wrote. "Thanks to the office manager, we had another chance. The results were good: Our relationship was mended, and he stuck with me."

But patient relations don't need to be left up to chance. There are proactive ways practices can more effectively address such misunderstandings. Reisman suggests that practices solicit written feedback from patients via twice-annual surveys. A simple form with a postage-paid envelope could allow patients to share their thoughts anonymously. To learn how to avoid repeating their most damaging mistakes, forms should have an option at the top of the page stating "I no longer go to this practice because ..."

When creating your survey, emphasize patients' actual experiences with your practice rather than their overall satisfaction, as a recent study published in the British Medical Journal indicates that this approach yields a more reliable assessment of performance.

To learn more:
- read the full article in the Los Angeles Times
read the HealthDay News piece via DoctorsLounge
- here's the BMJ abstract