Physician ratings can help identify missed opportunities

Mirrors reflect, and give us pause for reflection.  Not always eagerly sought after or welcome, this reflection does not always reinforce the image one has of oneself.  For a physician, publicly-posted patient ratings that contradict the doctor’s perception of his or her standard of care can be jarring.

Through “How Does Your Doctor Compare?”, the physician practice rating collaboration between Massachusetts Health Quality Partners (MHQP) and Consumer Reports, patients can access information about medical practices, but, perhaps even more importantly, physicians and their staff can gain insights about the patients’ experience with their practice.  Learning how patients feel about the interactions can help healthcare professionals understand how to improve the relationships they are working to build.  And studies show that improving those relationships improves health outcomes — the shared goal of both patients and their doctors.

The MHQP report, released at the end of May, includes survey responses from 47,565 adult patients of diverse backgrounds regarding 327 group medical practices.  While the majority of the practices included in the survey earned top ratings across several criteria, a few issues stood out as needing improvement with a greater frequency than others.  Most of these reflect the respondents’ desire for care to be more patient-centered and holistic. Of those surveyed:

  • 36% of patient responders scored their physician’s practice a 1 or 2 (with 4 being the best score) on the issue of how well the doctors know them.
  • 61% reported that their doctor did not ask whether there was a period of two weeks or more when they felt, sad, empty or depressed.
  • 44% rated their doctor’s knowledge of them as a person, including values and beliefs that are important to them, as less than “excellent.”
  • 32% said that their doctor did not ask about things in their life that worried them or caused them stress.

This information indicates that a sizable number of people expected more from their medical practitioners than they felt they received.  For a doctor, knowing where his or her practice stands with regard to these issues is valuable information.  Once past the initial disappointment of less than stellar ratings, a serious attempt at self-reflection can help a physician  identify missed opportunities and chart  the necessary changes  to act with more genuine interest, care, and respect for each patient.  The goal to more fully engage patients requires planning, practice, and more than a little fortitude.  How to create and carry out this action plan is beyond the scope of this blog post, but the self-awareness to do so is certainly the first step. It is not an easy task.  A recent New York Times article by Dr. Pauline Chen cited a study identifying that even well-educated, well-to-do patients have trouble asking their physicians questions about treatment options or expressing their medical preferences and values.

Ensuring patients feel like full partners in their care will mean taking the steps of actively listening and asking patients what they think, not only about a particular healthcare issue they are experiencing, but about their overall experience of the practice. Physicians’ intentions to provide quality, personalized care are frequently thwarted by harsh realities dictated by forces from within as well as outside of the medical profession. The mirror image of the patient experience provided in surveys like the MHQP report reminds professionals to have the conviction to live up to their personal standards for good patient care and the courage to ask the right questions to ensure that they are doing so.

Sandra O. Gold is the founding President and CEO of the Arnold P. Gold Foundation.  The foundation’s objective is to help physicians-in-training become doctors who combine the high tech skills of cutting edge medicine with the high touch skills of effective communication, empathy and compassion.

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  • Steven Reznick

    In our practice we hand out a patient satisfaction survey designed by a professional research firm. The form is placed in a self addressed envelope and stamped. There is room for written comments. The respondent can remain anonymous or sign it. The information you receive is outstanding and helps you identify needs you are not meeting or strengths you were not aware you had. We give it out annually.

    • The Gold Foundation

      Bravo to you, Dr. Reznick! Your comment
      illustrates how reflection can lead to action. Your survey not only
      informs you about how your patients experience care in your practice but expresses
      your desire to better meet their needs. Would you be willing to share with
      other readers a few of the questions in your survey that you found most
      illuminating in identifying patient perceptions that you were then able to

    • Simon Sikorski MD

      Steven, how about giving a survey on iPad with every follow up visit?

  • southerndoc1

    Payments to docs in Massachusetts can vary as much as 300% for the exact same service, depending on negociating clout. Until the playing field is leveled, comparative ratings like this are meaningless.

    • The Gold Foundation

      Certainly payment schedules for time and services to patients
      hinder or help doctors to implement patient-centered care. All doctors face, on a daily basis, the
      challenge of reimbursement disparity and its effect on the use of office time. Research
      data that demonstrates the positive impact of thorough medical histories and compassionate,
      empathetic relationships on patient outcomes could, if brought to the attention
      of third-party payers (and the patient public), provide a strong argument for better and more
      equitable reimbursement policies as well as improve patient-centered care.

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