Stretched Resources Don't Excuse Poor Patient Service

What is the main reason physicians get poor online reviews from patients?

It's a question that undoubtedly many physicians probably are asking themselves as they scour angry patient tirades on Yelp, Google, and other sites. A recent study in the Journal of Medical Practice Management says it's all about customer service.

Researchers used software to analyze 35,000 online reviews of doctors and found that only 1 in 25 patients who rated their provider with two stars or fewer on a review website were unhappy with their physical examination, diagnosis, treatment, surgery, or health outcome. On the flip side, 96 percent of patients said their complaints had to do poor communication, disorganization, and excessive delays in seeing the physician.

Ron Harman King, CEO of Vanguard Communications, a marketing and public relations firm for medical practices, recently spoke with Physicians Practice about the findings of the study. Part one of the interview covered the research's specific conclusions and why the waiting room is more important than the examination room for physicians, when it comes to online reviews. Excerpts from part two are below.

Physicians Practice: How should physicians use rating information - obviously this is not the area that they were trained in?

Ron Harman King: This is one more way to look at what they do through the patient's eyes. They should use it as a reminder that as much as medicine is a profession, it's also a service. Doctors are not just scientists and clinicians, they are providers of healthcare. We need to remember that patients expect the care in healthcare, not just the science that will heal them. So much emphasis in my experience is put into the science. Making people well and better. That's what patients hope for and expect. But I think they expect equally to be treated with respect. That includes looking at your organization through the patient's eyes. The doctors are there for patients, not the other way around. These are not difficult problems to address. The main thing is just keeping the patient fully informed and training your staff and building a culture that reinforces patient communication and courtesy.

I point to the Ritz Carlton, they call it the golden standards. There are 12 standards Ritz Carlton uses to invest in the customer and be as supportive as possible. That's not hard to do as an organization, but you have to turn around a ship that's been headed in one direction for a long time. The tradition of medicine has been patients are made to wait and everything was done according to the convenience of the provider. It's a different world now and it's much more of a consumer choice.

PP: Is the answer in technology or is it in staffing - or both?

RHK: I think it's 95 percent in the culture. In my own experience, the physician is often more respectful and considerate than the staff. The physicians, I don't think, see what their staff does and says to patients. Personally, I've had to wait and the doc was apologetic when the staff was not.

A physician in private practice, who owns his own practice, has two choices. He can become both the physician and a practice manager, in which case he is in charge of setting the tone and establishing the culture. The second choice is he hires a professional who does that for him, while he focuses on medicine. Quite honestly, these days, I think the second choice is a far better option.

PP: How do lack of resources play into the picture? If you are stretched out, this becomes one thing that's easy to forget about.

RHK: Yes, this goes into the bigger picture of healthcare trends and economics. I don't mean to seem insensitive to the challenges of practicing medicine today. Costs are going up, reimbursements are going down. No question, it's getting harder to make a living in medicine. Despite that and the huge cost of education and training, physicians are well compensated ... so I don't think it's totally a losing proposition.

I'd also say these are the standards to which the world is expecting. It's like buying a car with four tires and a steering wheel. Somehow, all of us in the service business have to make the economics work to keep our customers happy. That's just a fact of life. This is something doctors don't like to hear, but they need to know they are in business. They aren't just in practice, they are in business. These are the standards of business. There is no way around it.

PP: Any advice you can give practices based on your study?

RHK: Try to get an outsider's view as much as you can. It's hard to know and to see from the exam room really what's going on in your business. Online reviews are an outsider's view. It really does give you useful feedback. I think short, customer satisfaction surveys are also extremely useful. Another way is to pay someone to be a surrogate patient. Do some mystery shopping. They call the practice and ask some basic questions. Also, there are management firms who can help with organizational design and staffing, to make sure you have the right people in the right chairs at your practice.