The Right and Wrong Way to Survey Patients

“And the survey said…”

With all due respect to the television game show Family Feud, the above phrase could soon make its way into more medical practice offices. That is, if physicians take heed to a recent New England Journal of Medicine opinion piece that argues patient satisfaction surveys, if done correctly, could prove extremely valuable to physicians.

That, of course, begs the question, what is the wrong way to do a patient satisfaction survey?

“When you ask patients to fill out a survey, they are giving you their time, their energy, their thoughts,” says Ann Latham, president of Uncommon Clarity, Inc., a Massachusetts-based consulting firm. “So, the absolute worst thing you can do is to not take action based on their input. If they give you feedback and then they come back later and all the same things are wrong, they will be madder at you than if you had not asked at all for wasting their time.”

Making real changes

Latham stresses the importance of not collecting data from patients simply for the sake of collecting data. Two key pitfalls of patient surveys are they ask stupid questions or the questions are too vague.

With the former, Latham says you shouldn’t ask questions that provide information you can’t use. For example, don’t ask patients how they would rate the practice’s on-time performance. If you know there’s a problem with on-time performance, why ask the patients?

As for being vague, Latham recalls walking into a meeting where organization executives were busy thinking up questions to ask on a survey.

“I asked, ‘What are you going to do with this information? What are you trying to learn?’” she says. “And they had no answer. There was complete silence for about 20 seconds, and then they went back to generating stupid questions. They just wanted to dream up things to ask rather than trying to figure out what they were willing to change or what they hoped to change or what they were trying to accomplish.”

Making real changes is the key, Latham says. If patients provide useful information and the practice is able to act on it, it creates a sense of partnership.

“They’ve helped you, you’ve helped them, and everyone is happier,” she explains. “But don’t pretend you’ve done something if you haven’t. [The change] has to really make a difference.”

Two ways to start

Latham says that patient surveys can take one of two approaches. They can go from the general to the specific, or they can start with specific questions. For example, if a physician knows what things he or she wants to improve — areas that are potential problems — then you can survey to find out from customers what solution they would prefer.

“You’re starting with the good knowledge of what the situation is, and you’re collecting input on that situation,” Latham explains. “That can be very specific, and, yes, the knowledge of the practice can be helpful. But if you’re starting on the [general] end you might be wondering what your clients think of you.”

In that case, Latham suggests not throwing every question in the book at them. Start with higher-level questions and then figure out what to zero in. And don’t ask everyone.

“Ask a couple of dozen people, and when you start getting the same answer over and over again, why do you need 100 people to tell you if 12 people give you the same answer?” Latham says. “You could ask people who walk in the door, ‘What’s the one thing about this practice that you’d like us to change?’ If you think about learning rather than surveying everyone you’re likely to come out with more useful information.”

Where to start?

Latham believes that focus is important. Wholesale changes at a medical practice are not going to happen all at once. In other words, you don’t need an abundance of information, just one or two things that would make a big difference for patients.

“It’s very possible that if you start out by just examining your own practice and talking to your own employees that you can get a real good sense of what are the couple of things that would make the biggest difference to your patients,” Latham says. “If you get the office staff together, my guess is they would come up with a good, short list pretty fast.”

And where possible, ask open-ended rather than simple “yes” or “no” answer questions.

“The yes/no rankings won’t give you much information,” Latham says. “They might tell you where some problems are, but they won’t tell you what to do about them. Open-ended questions will help you get more to the heart of the problem.”