Often times, people are seen reading a magazine or watching television in the waiting room and seem to want as little interaction with their doctor as possible. We tend to take the way doctors approach us with a grain of salt, focusing solely on satisfaction and less about outcome, but what if satisfaction could lead to better outcomes? Learning about the way doctors and patients interact can be a factor in determining the quality of treatment. Recent research shows that gathering data related to patient satisfaction can be beneficial in determining outcomes of treatments and understanding how to improve the healthcare system. In addition, there are some steps patients can take to improve their overall satisfaction, and consequently their treatment outcome.
Measuring Patient Satisfaction
Patient satisfaction can be difficult to measure in many cases, as there is no surefire quantitative way or any controls that can be set in place. If someone goes to the doctor and gives the doctor a rating of 5/10, not only might your experience with the doctor be different—depending on how the doctor is feeling—but your criteria on how you rate the doctor may be completely different as well. Your rating of 5/10 is not the same as others. Moreover, there is an inability to apply the scientific process—due to the absence of a completely satisfied or dissatisfied group of people—may influence the data. However, the HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey may be the answer to the subjectivity issue.
The HCAHPS survey was created with the intent of reaching three goals, an objective viewpoint in reviewing care, an initiative for hospitals to improve care, and increasing public accountability of hospitals within care. According to a study by the NIH, the survey collects many different types of information such as clarity of communication, cleanliness, and responsiveness to emergencies, allowing for hospitals to not only see how they are doing but also compare themselves to other hospitals. Patients are asked 27 different questions covering a variety of topic areas and the survey is available in a wide variety of languages and mediums such as mail, phone, and interactive voice. This survey is favored over other methods largely for its standardization. While we cannot control people’s criteria in judging doctors, we can control the level objectivity/subjectivity in which data is collected.
Hospitals can choose to supplement standardized objective surveys (like the HCAHPS) with their own methods as well—and often do. A study on Health Literacy (fluency in medical terms and dialogue) published in Family Practice paired standardized questionnaires with the Roter Interaction Analysis System (RIAS), which is a coding method used by doctors to record individual discussions with patients. By doing this, both individual and standardized data is available so that both the patient reflection and the actual in-person dialogue is reflected in the analysis.
Communication Communication and Communication
Everyone is familiar with the running joke of WebMD diagnosing almost every possible symptom as a life-threatening cancer. Patients who actively—and probably responsibly—take initiative show critical Health Literacy (HL) proficiency, and show more self-efficacy according to Family Practice. While there are a few drawbacks with these kinds of actions, such as if people consult the wrong source (i.e. Anti-vaxxers), participating in your own treatment can not only be beneficial to your own health but also foster a meaningful relationship with your doctor. There are three types of health literacy defined in this Health Literacy study: functional (fluency in reading and writing information), communicative (extracting and applying new information), and critical (accessing and taking initiative to find information). The study also states that patients which have a lower functional HL affected patients negatively and that patients with overall inadequate HL were more likely to be dissatisfied their physician’s communication.
According to Altarum, a company with extensive experience in military healthcare design and implementation, quality of communication matters most to patients which may encompass time spent assessing, politeness, and overall tone. However, the disparity exists due to the fact that providers and patients have different beliefs of what is important in treatment. Patients want quality treatment, yet physicians are more concerned with timely, factory-style treatment as opposed to tailoring to individuals. It must be noted that different groups respond to doctors differently, as there is a trend of older populations (65-80 year olds) reporting higher quality care than younger; culture and old-style systems of healthcare in which the doctor is more of an authority usually tend to resonate with older patients. Despite this, actions need to be taken from both parties, (1) patients need to brush-up and take initiative with improving Health Literacy, and (2) doctors need to understand what patients expect when interacting with them.
A recent and pressing problem that may prevent the latter step from improving is the fact that doctors are somewhat forced to think in a factory-style way. Doctors and nurses can experience physician burnout as their workloads increase day-by-day according to Elite Medical Scribes. Physicians are limited to fifteen minutes with their patients which can be detrimental to not only the patient-physician relationship but to the patient’s overall health as well. Thus, the system in which the physicians are confined to are also partially at fault.
Changing Outcomes for the Better
In the end, data obtained from researching patient satisfaction and the determinants of it are most useful in improving healthcare systems all over the world. In fact, the act of simply gathering data on patient satisfaction and quality of care can effectively but indirectly improve healthcare. As stated in the Organization for Economic Co-Operation and Healthcare’s Publication of “Improving Value in Healthcare”, researching effectiveness and treatment outcomes can help the government implement safety programs, monetary incentives, and quality improvement programs.
Research on patient satisfaction has led to many improvements within the healthcare system both in terms of treatment and preventative causes. In one instance, according to the Online Journal of Issues in Nursing, the creation of a portal for patients to access their personal health records not only led to more transparency and satisfaction but also the development of preventative measures for possible injuries in the future. There are also cases where a positive work environment and effective care coordination between physicians can increase patient satisfaction and consequently cost-effectiveness, outcomes, and more.
So next time you are in the doctor’s office, perhaps put down the magazine and focus on what you want to talk to your doctor about; as having a good relationship with your doctor and taking initiative to become literate in health topics may help you in the long run.
By: A. Lin
References:
Berkowitz, Bobbie. “The Patient Experience and Patient Satisfaction: Measurement of a Complex Dynamic.” The Online Journal of Issues in Nursing 21.1 (2016): n. pag. 31 Jan. 2016. Web. 9 Sept. 2017. <http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-21-2016/No1-Jan-2016/The-Patient-Experience-and-Patient-Satisfaction.html>.
Black, Cyndy, and Hendi Crosby Kowal. “Patient Satisfaction: A Key Factor In Healthcare Performance Assessment.” Altarum. Altarum Institute, 15 Nov. 2016. Web. 9 Sept. 2017. <https://altarum.org/health-policy-blog/patient-satisfaction-a-key-factor-in-healthcare-performance-assessment>.
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Kennedy, Gregory D., Sarah E. Tevis, and K. Craig Kent. “Is There a Relationship Between Patient Satisfaction and Favorable Outcomes?” Annals of surgery. 260.4 (2014): 592–600. PMC. Web. 9 Sept. 2017. <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4159721/>.
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“The Deteriorating Doctor-patient Relationship.” Elite Medical Scribes. Elite Medical Scribes, 15 May 2014. Web. 27 Sept. 2017. <https://www.elitemedicalscribes.com/improving-the-quality-of-patient-care/the-deteriorating-doctor-patient-relationship>.