I recently came across an article in the Journal of Urology that was trying to understand the determinants of patient satisfaction in the outpatient setting. They surveyed 500 patients over two months and asked questions about demographics, expectations regarding the time frame to obtain an appointment, appointment wait times, and the amount of time they expected to be spent with them, as well as expectations of being seen by a physician or non-physician such as nurse practitioner or physician assistant.
The article stated there is a mathematical equation for patient satisfaction which is defined by the “patients” perception of the care they receive minus the expectation of it.” Now, I read carefully through this article to try to get through their chi-square analysis of what contributes to patient satisfaction.
Their conclusions stated that patients expected to be seen by a physician on the first visit. They expected to have a 30-minute visit (regardless if they were a new patient or follow-up) and that any ancillary services (such as forms to be filled out) should be free of charge.
It made me think of the simplicity of the findings. Patients want to and expect to see a physician when they go to the doctor (just like you expect to see a mechanic when you go to a body shop), and they want you to spend time with them. A significant amount of time in today’s health care climate, since 15 minutes or less is a more accurate time frame being spent with patients.
This does not mean we may have to spend 30 minutes with patients to have them perceive it was adequate time or achieve patient satisfaction. Although time is constant, perception of time is relative.
For this, you can think of a time you were having fun with friends, and the 30 minutes “felt” like 10 minutes. But when you were waiting in the DMV line for 30 minutes, it “felt” like four hours had passed. The perception of time is always relative.
What could possibly warp our sense of time?
It can depend on the presence of the other person you may be interacting with. What is presence? It means to be fully present, hold space, be fully engaged, listen, look at the other person in the eyes and acknowledge them.
As Jack Kornfield wrote: “Sitting mindfully with our sorrows and fears, or with those of another, is an act of courage.”
It takes courage because it involves something that most of us find a challenge: having mindfulness and being present in the moment.
Mindfulness means being aware of both our external and internal states. Therefore, be aware of the external circumstance and events and pay attention to our thoughts and emotions.
This means when you are in front of a patient, it is not the time to let your mind wander about the last patient or what meeting you are supposed to be attending in two hours. It means allowing yourself to be present in the moment and giving careful undivided attention.
Have you ever felt someone truly was present for you? Have you noticed this is what children especially crave the most?
It is not expensive gifts or vacations, but even in those instances, you see them, hear them, listen to their frustrations, happiness and fears. It is leaving the phone and not texting, not checking notifications every two minutes but really paying attention. As Dr. Orfloff wrote in her book Intuitive Healing, “presence is being able to radiate love without saying a word.”
It is the same with a patient. You will not need to devise a complicated chi-square analysis to arrive at a basic conclusion. If you are curious about the non-mathematical secret to patient satisfaction, ask someone who routinely has high reviews.
What is their secret?
You will soon note that patients will “perceive” they were listened to and that you cared. How can you do that? Be present. Stop worrying about what happened earlier that day or what is happening next. Look them in the eye and listen. Stop typing and answering messages or pages during your time with the patient.
As Eckhart Tolle states, presence is “consciousness without thought.” It means you are there, but you stop the incessant thoughts of what you will have for dinner, if your shoes are too tight or if you forgot to call your aunt. You are just conscious, listening instead of indulging in useless thinking that does not serve your patient at that moment.
If you practice the skill of mindfulness with your patient and with everyone you interact with, you will notice that the quality of your relationships will be enriched.
Just being present will generate energy that by itself will be healing and will bring comfort. After all, what humans want is to be loved and listened to. Most of us in this fast-paced world have lost the art of truly listening. Listening will entail silencing the mind of the 60,000+ daily thoughts it has and just be present in the moment.
So, practice attention and presence. The quality of your relationships and your patient reviews will improve. It is worth it.
Diana Londoño is a urologist and can be reached on Twitter @DianaLondonoMD.
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