I am actually a huge fan of patient satisfaction measures. I like having a way to follow how well we are doing, my staff and I.
In fact, I also don’t really mind having some portion of my income tied to these measures. There are some physicians that won’t care any other way and if there is one industry that needs to ensure compassion and satisfaction, it is the field of medicine.
Are there times those ratings are unfair? Absolutely. I have been burned by a patient before when it was completely, utterly unfounded. Who hasn’t? But I have learned quite a bit from them over the years and it has made me a better physician, even of it is painful at times.
However, I do not appreciate measures that are enforced inappropriately. For instance, when “likelihood to recommend practice” is used, is a great measure of how the practice is doing overall. But tying my income to “wait time at clinic” is absurd. Is the wait time itself the important part, or should we actually measure patient satisfaction about their wait time instead?
I do not want to practice medicine in a patient mill, moving on to someone new every 5-10 minutes. I don’t care how brilliant you think you are, you cannot practice good medicine this way.
I want to actually get to know my patients, develop a relationship with them. I want to address their six new concerns instead of limiting them to one or two and cutting them off. I would want to be treated that way myself and my satisfaction scores reflect that patients are happy waiting longer of they get to spend more time with their doctor and leave feeling like they actually got something done. I have some really great scores!
But now it doesn’t matter if my patients would highly recommend my practice. I have to keep their wait time down to under ten minutes. This is the only measure that matters because someone up there decided it was so. Never mind if I have to admit someone to the hospital or take a STAT report from a radiologist or call a patient family about someone’s concerns. Never mind if someone needs extra time because they are in crisis or because we have to do a procedure or because I am working a late arriver back in because they got stuck in traffic that wasn’t their fault. God forbid I am an OB or a surgeon under this mandate and get called away to an emergency at the hospital. Thank the Lord above that I no longer follow patients at the hospital myself because an ICU admit or a meconium delivery that required my attendance has been known to throw me off schedule before.
I have no intention of changing my practice style. I don’t ever intend to make patients wait and I always apologize if I do. But rest assured I am not making anyone wait because I am arranging my vacation or because I am playing Candy Crush. In fact, if the wait is egregious because of something awful (which is rare), we do offer patients to go shop or run errands. We can go ahead and draw blood so they can eat while they wait. Or any number of other flexible, creative things. But I will not bend and succumb to this silliness. Caring matters. It matters everywhere but especially in medicine. I will not be forced to stop caring for patients at the expense of five or ten minutes on a wait time and shame on anyone who suggests that I should!