Doctor Jack McKee had it all—fame, fortune, and glory. He was a highly successful heart surgeon who functioned in his own sphere, aloof from the rest of us mortals. But a nagging cough turned out to be throat cancer; suddenly the doctor became the patient, and the entire healthcare system looked very different.
You may remember McKee from the plot of the 1991 film “The Doctor,” starring William Hurt. The movie was based on a memoir by rheumatologist Edward E. Rosenbaum, MD, originally titled A Taste of My Own Medicine. Years ago, the story struck a familiar chord when it took a hard look at doctors who failed to make a connection with their patients.
Today we hear a lot about the importance of treating patients with empathy and compassion, but almost everything in “the system” seems to work against us. Under pressure to operate at maximum efficiency and productivity with fewer resources, physicians and support staff find it increasingly difficult to give patients the personal attention that keeps patients from feeling dehumanized: “They treat me as if I were just a number!”
Love it or hate it, the success of your medical practice will increasingly depend on a positive patient experience. The entire payer industry is trying to figure out how to effectively factor patient satisfaction into reimbursement schemes.
More importantly, patients who feel well served tend to be more compliant and conscientious in following treatment plans. Your clinical outcomes will likely be better when patients have a better relationship with their providers.
So what’s it like to be a patient at your medical practice?
“Walk a Mile in My Shoes . . .”
There’s nothing like being a patient (or a family member of a patient) to reveal the ordeals through which we put people every day. Sometimes the smallest errors can create significant hassles for the patients who depend on your clinicians and support staff for high-quality medical care and for help and guidance through the unfamiliar territory called “The U.S. Healthcare System.”
That point has been driven home for me over and over again in recent months as my wife and I have been dealing with medical care arising from her cancer diagnosis almost a year ago. We have found ourselves on a pathway strewn with obstacles like claim forms, requests for information, preauthorizations, patient scheduling issues, delayed adjudications and payments, HIPAA privacy policies, provider-to-provider communication glitches—all without a map to help us find our way. And considering my 30+ years in the industry, I should have some advantage over the average patient or family member!
For example: A few weeks ago, my wife’s oncologist ordered a CT scan to check on the progress of my wife’s treatment. Simple—right? The check-out clerk at the doctor’s office phoned in the order to the imaging center, which gave us an appointment two days out. I began to make arrangements to take my wife in for the test. The imaging center is part of the hospital in a town some 22 miles away—part of the health system that employs her doctor.
The next day, the oncologist’s office called to let us know it ran into a precertification problem with the payer, and asked to reschedule the scan a week later. We adjusted our plans accordingly, and took time away from work to keep the appointment.
Upon our arrival at the hospital, the check-in desk apologetically informed us that my wife wasn’t on the schedule. Staff members looked in the electronic health record and saw the doctor’s note ordering the scan at the facility, but she wasn’t on the schedule. The staff members continued to dig until they discovered that the CT scan had been scheduled at the hospital in our town, about five miles from our home!
We had not only wasted our time and gasoline driving to the wrong facility, but we had simultaneously become a “no-show” at the correct facility. As it turned out, the person who rescheduled the appointment failed to notice the place of service in the original order. It was a simple mistake—a minor oversight—but it complicated our day; cost us time, effort, and money; and raised our blood pressure unnecessarily.
Happily, the staff at the “correct” imaging center cheerfully worked us into the schedule and made us feel welcome and well-served. No one showed the slightest sign that we were bothering them with our scheduling mix-up.
Thanks to my years inside the industry, I completely understand how this situation developed. Imagine what it feels like for the uninitiated! Our familiar, day-to-day environment is a confusing, almost hostile world to patients who are already frightened about their health and their medical bills.
A Second Mile
God forbid you or a loved one has to endure a major medical episode in order to get a patient’s-eye-view of the American healthcare landscape! I wouldn’t wish that on anyone. But my family’s personal experience has helped me appreciate all the more how valuable it is for doctors, managers, and support staff to take time to observe closely the routine processes that patients endure day in and day out.
For example, take a bit of light paperwork or some reading material, and sit in your reception area for an hour or so. Watch and listen to what goes on at your check-in desk. Look at the furniture, the walls, and the ceiling. Look at the windows. Do things look clean and fresh, or shabby and worn?
Watch the interactions between staffers and patients. Are your people cordial, welcoming, and helpful, or short and snippy? Listen to comments among patients. Do they complain about long waits or confusing instructions? What’s it like to wait in your waiting room?
Move on to subwaiting areas and nursing stations. Try to see everything from a patient’s point of view. Spend some time near the check-out desk. Are instructions clear? How effectively do staffers ask for money? Do your employees portray openness to questions? Do they appear ready to serve?
You can use these techniques in nearly every phase of your practice operations. You might be amazed—shocked—at what you see and hear. (You might even be surprised at how well some of your employees and processes work, too!) But you will never see or hear anything if you don’t stop, look, and listen.
Once you’ve walked a mile in your patients’ shoes, you might find it a little easier to go that “second mile” to make sure each patient’s needs and expectations are met or exceeded. And without exception, the best-run practices I’ve seen have placed patient experience among their highest priorities.