The Satisfied Patient
Beyond quality medical care, many factors influence a patient's decision to stay with a particular practice or seek treatment elsewhere.
Most people have had an experience at a restaurant that has deterred them from going back. Maybe the server wasn’t friendly and attentive, the restaurant wasn’t clean, or the wait time for a table was too long. Whatever the hitch, it may not have even involved the food itself.
Instead, a less direct aspect of the experience may have ultimately cost the restaurant a customer. The restaurant business is not the only field where ancillary details drive customer satisfaction. The same is also true for the health care industry. Patients have expectations about their health care experiences that extend beyond good medical treatment, and the level to which those expectations are met often determines whether they stay with a provider or seek care elsewhere. This is increasingly true as patients become health care consumers — picking and choosing providers and practices.
Patients typically trust their physicians to be knowledgeable experts in diagnosing and treating their medical conditions. Therefore, they tend to rate their experiences less on the quality of the treatment and more on such details as a practice’s administrative processes, attention to patient comfort, and overall level of customer service, says Jonathan W. Berlin, MD, MBA, FACR, clinical professor of radiology at NorthShore University Health System in Evanston, Ill. Among other things, patients expect efficient and convenient appointment scheduling, the office to be clean and safe, minimal wait times to see their doctors, the office and medical staff to be friendly and empathetic, to be treated with respect, and to receive exam results as quickly as possible. “As the landscape shifts and people are more in charge of their health care in terms of spending more of their money on rising insurance premiums and deductibles and being empowered by access to information that allows them to distinguish among providers, those ancillary things are starting to matter more,” Berlin says.
Radiology practices and other health care institutions must meet those expectations to attract and retain patients. For radiologists, fulfilling those “added value” requests is particularly important as they attempt to further emphasize the value that radiology brings to the health care industry, as outlined in ACR Imaging 3.0TM, says Frank J. Lexa, MD, MBA, vice chair and professor of radiology at the Drexel University College of Medicine and adjunct professor of marketing at the Wharton School of the University of Pennsylvania in Philadelphia. “Imaging 3.0 is really about how radiologists can expand their role by providing value in the health care system,” Lexa explains. “And certainly part of that is about making patients happy, meeting and talking with patients, and being involved in making sure you and your department are providing great service. If you are doing those things, you should see increased patient satisfaction.”
While nearly every patient expects to be treated with respect and for the office to be clean, some patients weigh certain details of their experiences more heavily than others. For instance, though some patients want to be assured they are getting the latest technology and someone to explain how it works, others care less about the technology and more about the concierge-style aspects of the facility, such as whether the exam rooms are well decorated and inviting and whether coffee is available in the waiting room. “There’s no such thing as one size fits all,” Lexa notes. “You must provide great service from the medical side, but also you must provide the concierge service that makes patients who may not be focused on what goes into a great study or read happy too. The goal is to make as many people happy as you can.” He adds that the best way for a practice to determine whether it is meeting expectations is to conduct surveys of patients on a regular basis, either in hard-copy or digital format.
"Sometimes, as health care professionals, we lose focus of the fact that we’re in medicine to treat the entire patient." — James J. Finizio
Louise Bewley, 58, a resident of Leesburg, Va., is a health care consumer who researches providers and practices online and asks a lot of questions when receiving referrals for treatment. Bewley says that foremost she expects the office and medical staff to be friendly and thorough, taking the time to listen to her and address her concerns. “The office and nursing staff are equally as important as a good doctor because you contact them for scheduling, making payments, and ordering refills,” Bewley says. In fact, the caliber of the staff is so important that Bewley says she once left a particular practice because a member of the staff was repeatedly unfriendly. On the other end of the spectrum, Bewley says she recently encountered a radiology technologist at Radiology Imaging Associates (RIA), a practice with offices in southern Maryland and northern Virginia, who was so kind that she plans to return to that practice for future imaging as a result. “The technologist greeted me with such a warm smile and made me feel like I was a friend who she was really glad to see,” Bewley recalls. “She just had a very pleasant way about her that made me feel comfortable.”
James J. Finizio, center manager at RIA’s Landsdowne, Va., office and director of CT for the practice, says he and his staff follow motivational speaker and restaurant owner Bob Farrell’s credo, “Give ’em the pickle.” In other words, give costumers something extra that they don’t expect but will appreciate. Finizio says he encourages his team to treat patients like family members by greeting them with a smile and kind words, walking them to and from the waiting room, listening to them, taking the time to explain procedures, and treating them with the utmost respect. He also instructs his team to do whatever it takes to make patients feel comfortable — even if that means literally holding a patient’s hand during an exam. “Patients are often nervous, in pain, not feeling well, and fearful of the procedure or the results of the procedure, so you have to be careful to treat their anxiety as well as do the study,” Finizio says. “Sometimes, as health care professionals, we lose focus of the fact that we’re in medicine to treat the entire patient.”
As insurance deductibles and copays rise, many patients are also beginning to look for transparent pricing from practices and are using that information as they determine where to go for treatment. “Patients are newly expecting transparency in the true cost to them — what their out-of-pocket costs and copays will be for the services they need,” explains Michael N. Brant-Zawadzki, MD, FACR, executive medical director of physician engagement and of the Neurosciences Institute at the Hoag Hospital in Newport Beach, Calif., and adjunct clinical professor of neuroradiology at Stanford University. As cost becomes more important, Brant-Zawadzki suspects that most patients will want streamlined care without all of the once-popular frills such as warm robes and espresso machines, that may increase the price. “We’ve gone from a consumer-driven spa experience to a consumer-driven McDonald’s experience,” he says. “Patients are looking for very efficient care at the lowest cost possible — a utilitarian product as opposed to a high-end product.”
However, if health care moves toward tiered pricing, as some suspect it will, a niche will likely exist for patients like Bewley who would consider paying extra for a spa-like experience. “When I had young kids and things were a little tighter financially, I would have been concerned about going to a practice that charged more for all of the bells and whistles,” says Bewley, who currently pays a set co-pay regardless of where she goes for care. “But I can say at this point in my life, I would not refrain from going to a place that charges a little more for those additional comforts.” Lexa suspects that boutique facilities will be enticing to some patients under a tiered system, but that the ability to receive treatment sooner for an extra fee will have even broader appeal. “Waiting is extraordinarily anxiety provoking in some cases, so certainly people will pay to go to the front of the line,” he says.
While patients consider many factors when deciding where to go for health care, Berlin says the main things practices must do to attract and retain patients are provide high-quality medical care and exceptional customer service. To that end, radiologists can significantly impact patient satisfaction by meeting and talking with patients and engaging in their practices’ administrative functions to ensure patients’ expectations are met at all levels. “Radiologists should attempt to be as involved in their practices as they possibly can,” Berlin says. “As radiologists pay greater attention to the patient experience, patients are going to have a more positive view of their time with the radiologist, a more positive view of the radiology practice, and potentially a more positive view of radiology as a whole.” He says that is important, particularly given how critical radiology is to health care. “Most people who enter the health care system have some type of imaging, so if we can make a good experience even better, it benefits everybody.”
By Jenny Jones