Relationships Impact Your Bottom Line

There’s a lot that goes into patient satisfaction, but a recent survey found that the physician-patient relationship is even more important than treatment.

According to the survey, conducted by Harris Interactive for The Physicians Foundation, of the 79% of respondents who reported being either extremely or very satisfied with their physician visits, 42% of them pointed to customer service as the reason for their satisfaction.

That may sound like a positive, but Laurie Puhn, a Harvard educated lawyer, mediator and communication expert who has conducted seminars for physicians on the keys to healthy patient-physician relationships, says satisfaction is all relative.

“What has happened is expectations have been lowered so much that patients accept less respectful environments,” Puhn says. “Patients accept being neglected and left sitting in the waiting room for two hours.”

The heart of the matter

Puhn says that patient expectations have been lowered because “we understand the pressures doctors are under.” Those pressures mean squeezing in double the number of patients, having less time to speak with patients, and more time for patients in the waiting room. So, if patients understand this, then there shouldn’t be a problem, right? Puhn disagrees.

“At the same time that our expectations have been lowered, the quality of the communication has lowered even more,” she explains, adding that there is a bright side to that dark cloud. “Expectations are so low that it doesn’t take a lot for a doctor to do enough to make his or her patients feel valued and respected.”

The place to start, Puhn says, is to make patients feel like they have a name, not a number; that they actually have lives. Doctors can do that by making small notes on a patient’s chart; notes that indicate the patient likes to play golf or that he or she has a 4-year-old at home with the flu. Then, the next time the patient comes in for an exam, the doctor can read that information on the chart in advance and ask, “Your daughter had the flu the last time you were here. How’s she doing?”

Acknowledge problems

Puhn suggests that if a patient has had to spend considerable time in the waiting room prior to their appointment, when the doctor encounters them he or she should ask, “How long did you have to wait?” And then, if the patient acknowledges the long wait, apologize to them and explain that it has been a very busy day.

“They’re not going to yell at you because you acknowledged the wait,” Puhn says. “They’re probably going to feel relieved that they’ve been acknowledged.”

And there’s evidence to back up that approach, says Puhn, citing a 2001 program launched by the University of Michigan Health System encouraging health workers to report mistakes and talk to patients about errors. The result of the initiative was a reduction in the number of lawsuits, as well as quicker dispute resolution and lower legal costs.

“If patients walk in with a chip on their shoulder from that wait time, they are not going to think as clearly or trust you as much,” Puhn says. “You will have worse information and a worse diagnosis.”

Acknowledging the wait, she points out, changes everything.

“Tell them there were a lot of unexpected situations that day,” she says. “Just give them a reason; any reason is better than no reason.”

Physicians are receptive

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Puhn, who is also the author of , says that physicians she has spoken with are receptive to improving communication with their patients.

“Physicians are very receptive, but I’ve found that the only way to make good communication a lasting theme is to develop policy around it within your medical practice,” Puhn says.

The goal, she adds, is to have a more peaceful practice, because in the end, that impacts the bottom line.

“When patient interaction is better it helps you as a doctor, it helps your patients and it helps you retain staff,” she says. “It helps everyone perform better, which will increase your profits. And profits are the point.”