A practice with discrepancies between patient and physician perceptions

Recently I interviewed the physicians, office staff, and a sample of patients from a specialty medical practice. The results were remarkable in the discrepancy presented between how physicians viewed their strengths and quality of service, and how office staff and patients did.

Specifically, the six physicians in the practice unanimously saw themselves as a community fixture, caring for two to three generations of people in the local area. They believed that they excelled based on their quality of care, communication, and personal attention to patients.

Patients had some different views. While pleased with the overall quality of care they received, they noted that:

– At least two physician are notoriously late for appointments, often causing patients to miss a few hours of work and have to reschedule. In this blue-collar community, missing work for a no-show appointment is costly and frustrating.

– Another physician almost never communicates to patients about test results in a timely manner. This keeps patients in a worried state while they wait to hear good or bad news.

– Patients and office staff complained about how hard it can be to reach their own physician for specific and important questions about procedures and medications.

– Patients complained about certain office procedures that caused them undue hassle and concern. These issues — like having to bring a complete medication list to each appointment — could easily have been avoided with a pamphlet answering common questions and concerns.

There are a few conclusions to draw from this case study:

1. There is often a gap between your “intent” and your “impact.” You may intend to provide exceptional service, but how you do depends on the impact you have on your patients. It is a good idea to survey patients from time to time to see how you are really doing.

2. Every multi-physician practice should set clear performance standards about communicating test results, timeliness, and other factors — and be sure that all physicians are providing consistent service.

3. Communication comes up again and again in our work as an issue. Patients expect timely communication about both the big and the little things, from test results and their treatment plan to what they need to bring to office visits.

4. Be open to feedback without getting defensive. In today’s environment, it is probably impossible to make everyone happy. But good management demands understanding patient perceptions and continuously improving the consistency and quality of their experience. “Getting better” is of course the ultimate standard from the patient’s point of view, but patients still expect to be treated with respect, dignity, and professionalism throughout their episode. In our experience, some physicians refuse to acknowledge that they can do better — and this does not help their standing in the community.

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