I went to a Chicago Bulls game a couple of weeks ago with my friend Phil and during a 40-point rout of the hapless Sacramento Kings, we started talking about health care. Sad, I know. But with a 20-point lead at halftime and Da Bulls' superstar point guard Derrick Rose resting on the bench, it was hard to stay focused on the game. Plus, Phil and I are both in our 40s, so after touching base on the kids' schools, the start of t-ball and Little League practice, home repairs and Libya, what was left?
I asked Phil, who's been in health care communications for more than a decade, if he likes his primary care doctor. I happen to be in the market for one. True confession: I haven't seen my primary care doctor for at least two years. True confession II: I falsely claimed I would schedule an annual physical just to get a prescription renewed. I've grown less enamored with the practice over the years for a variety of reasons and have been using retail clinics for routine illnesses and a specialist for a chronic condition. As an aside, my allergy-asthma doctor would not renew a prescription without actually seeing me for my annual appointment. She was wise to my crafty ways of avoiding doctors.
Phil has a doc he likes, but astutely noted, "I have nothing to really judge him against, or a solid basis for that opinion." In a Yelp-like review, Phil rattled off some positive attributes: the doctor takes time to explain things, he listens, it's relatively easy to get an appointment, and so on. As Da Bulls' bench players widened the score, we had a deeper conversation about how and why patients choose a provider.
To be sure, highly educated health care consumers can look up quality indicators on Hospital Compare or at the Joint Commission's website, or on any of a dozen other public databases. But we also know that many, if not most patients rely on recommendations from friends and family. As we've reported in H&HN over the past year or so, that conversation is now extending to Facebook and Twitter. Reviews are also being posted on such sites as Angie's List, Yelp and even Zagat. Often the recommendations are based on, shall we say, softer measures, rather than concrete quality metrics.
The patient experience will only grow in importance during the next few years. Under CMS' proposed value-based purchasing regulation, HCAHP scores will be incorporated into a hospital's overall ranking, and thus impact Medicare reimbursements. But that's not all. An article in our forthcoming April issue looks at how some hospitals are beginning to assess the patient experience across the care continuum. Officials at these hospitals understand that as health care becomes more integrated, and they are held more accountable, what happens to a patient post-discharge is extremely important. They've expanded their patient satisfaction surveys to understand how care coordination is being managed.
This isn't to minimize a provider's top priority—to provide safe, effective and quality health care. But we need to keep in mind the impact satisfaction has on a provider's reputation. I am loyal to my allergy-asthma doctor because she is responsive to my needs, she spends time explaining things to me, she's proactive in getting me to do follow-up appointments and she e-prescribes to the pharmacy. I can't say the same things about my primary care doctor's practice, which is why someone else will be getting my business. I welcome your thoughts.
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