Not every doctor is a people person. For every physician with a pristine bedside manner, there is one that just doesn't quite connect with his or her patients. And while both doctors may have the same clinical expertise, we know which one is providing a better patient experience.
In the past, and for some organizations, in present day, hospital administrators have allowed these detached, grumpy, jargony, and spacey physicians to get by with their ways.
That's just how they are, the thinking goes. But now, with the patient satisfaction survey element of the pay-for-performance system built into healthcare reform, those physicians can no longer be left to their own quirky devices.
All doctors—young or old, personable or off-putting—can be taught to more effectively communicate with patients and improve their hospital experience.
The importance of patient experience training
All doctors at Tacoma, WA-based hospitalist group Sound Physicians receive initial and ongoing patient experience training. The 500+ physician group's Vice President of Patient Experience and Physician Development Mark Rudolph, MD, says patient experience training is vital on two levels:
- To educate doctors about the true patient experience mission
- To teach physicians the most effective communication techniques in order to achieve that mission's goals
The patient experience mission is not about making patients happy at any cost, Rudolph says. This false notion, rather, is a byproduct of the term "patient satisfaction" and the frequent comparisons to customer service concepts and practices.
"The real mission is to improve patient outcomes on a number of levels," he says. "I believe that decreased patient anxiety is a valid endpoint in its own right and when you combine it with increased patient understanding and compliance, it's truly a recipe for better patient experiences and outcomes."
Once physicians understand the true mission, leaders must then teach them how to reach those goals.
"The fact is, neither the patient experience mission nor these communication techniques were taught to us during medical school and residency," Rudolph says. "Physicians need to be given the tools and training to understand what they can say and do differently to improve the patient experience."
Learning to better communicate with patients
Sound Physicians follows The Studer Group's five fundamentals of patient communication and has used its concepts to create tools that give providers specific communication interventions that can be implemented at each stage of the patient encounter. Physician education begins at the time of hire.
"Providing education about the patient experience mission in a way that resonates with physicians is critical and sets the stage for meaningful adoption of best practices and innovative interventions that can truly improve the patient experience," Rudolph says.
"A constant focus on the core fundamentals of patient communication and the routine review of physician performance then serves to maximize the impact we can have on our patients' perceptions that make up their individual experiences."
Rudolph has found those simple acts of courtesy and the process of sharing information with patients account for the biggest patient experience gaps. Three simple steps can improve doctor-patient communication and decrease patient anxiety.
1.Introduce Yourself
"When entering a patient's room, it's not enough to politely ask a patient how they are doing," Rudolph says. "It's critical to acknowledge them by name and introduce yourself, particularly if you don't have a pre-existing relationship."
2.Sit Down
"Physicians often forget the value of sitting down when conducting patient encounters in the office and the hospital," he says. "Sitting down conveys that the provider is engaged and has adequate time for the patient."
3.Avoid or Explain Jargon
"Avoiding or explaining medical jargon is a critical piece of quality patient communication that many providers struggle with," he says.
"Knowing that it can be challenging to explain medical conditions and terminology to patients, it becomes that much more important to tackle perhaps the most important pearl of patient communication which is to verify patients' understanding and ask if they have any questions."
Learning to better communicate with physicians and staff
Sound Physician's patient experience training also teaches physicians to better communicate with other doctors, nurses, and hospital staff.
"Because we understand that our communication with other members of the patient care team is also critical to the patient experience, we educate our physicians and hospital nursing staff about the concept of 'managing up' and have specific tools that assist doctors and nurses in taking advantage of key opportunities to position one another in a positive light," Rudolph says.
Physician groups also review HCAHPS scores monthly or quarterly, depending on availability, as a mechanism for training and feedback. Physician leaders can then use existing educational tools to hone in on areas that appear to require further focus.
The hospitalists are also briefed on how the patient experience ties into current healthcare policy and its financial implications for the group's partner hospitals. Sound Physician leadership provides up to date education about the government's Value Based Purchasing program and the role that HCAHPS scores play in determining the program's impact.
Looking forward
In the near future, Rudolph would like to generate personalized patient experience feedback in order to make their physician training more effective.
Sound Physicians is currently conducting pilots of physician observation and coaching sessions where an observer is present for a patient encounter and then gives the physician feedback on their communication skills. Providers use an educational tool with suggested interventions for each step of the patient encounter. This is then used as an evaluation form by the observer.
"The feedback from participating physicians has been quite positive and the improvements, witnessed by the observers after the initial encounter, are often marked," Rudolph says. "We are hopeful that this practice will positively impact our survey performance."
Marianne Aiello is a contributing writer at HealthLeaders Media.