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Big returns:
are waiting room or mailed surveys best?
A mail survey is more effective
because it's truly anonymous and not filled out
in the hustle and bustle of a busy office. However,
they don't come cheap. Studies in business journals
show a typical response rate is one for every
five mailed. If you're shooting for a statistically
useful 200 or more responses you'd have to pay
over $500 in postage alone. It's cheaper and easier
just to leave a comments box with a stack of surveys
in your waiting room and encourage patients to
fill one out. Just be prepared to sacrifice a
bit of accuracy for convenience and cost-savings.
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"I was shocked to find out how
many of my patients hate country and western music,"
laughs a Calgary solo FP. This bit of trivia came to
his attention after he had his patients fill out a "satisfaction
survey" in the waiting room. Among more serious comments,
a couple dozen respondents strongly suggested he ought
to change the radio dial.
The MD got on the path to surveying
his patients after an evening out at a local watering
hole with a group of fellow docs. The physicians spent
half the night griping about the ratings they were getting
on the popular RateMDs site. Chagrined, a few admitted
they'd never given much thought to making visits a pleasant
experience for patients. "Why do they care so much about
stuff like how 'nice' we are?" wondered our solo FP.
The next day, he recounted the
conversation to his daughter, an MBA student. "Dad,"
she said, "of course it matters!" She pointed out that
savvy business owners strive to find out exactly what
their clients want — and then deliver. She reminded
him about his complaints about patient compliance and
no-shows, and guessed that satisfied patients would
feel bad about skipping appointments, and might even
follow his advice a bit more. (A quick Medline search
told him her assumption is backed up by several studies.)
She helped him devise a quick survey patients could
complete while waiting to see him (see "Popping the
Questionnaire, right, for sample questions).
Apart from concerns about his musical
taste, some more serious complaints were aired. One
patient complained that the practice nurse often left
the exam room door open while giving her her allergy
shots, in plain view of the waiting room. "I could have
been getting methadone shots!" wrote the clearly miffed
patient.
Happily, the lion's share of feedback
the physician received was positive. "Some of them said
things like 'Just asking us what we think tells me you
care,'" he says.
LEARNING
FROM OTHERS
A study in the 6 May 2006 edition of the Annals of
Internal Medicine found that doctors who were deemed
good communicators were more likely to get good overall
marks from patients, the technical quality of care received
didn't hold anywhere near as much sway. A survey is
a good place to start communicating.
It is true that doctors can get
by just fine running their practices without patient
input, but failing to take your clientele's concerns
into account represents a wasted opportunity. Doctors
and patients share many mutual concerns and what's good
for your patients is, more often than not, good for
your practice.
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Popping the questionnaire
When you design your patient
survey you should pick one approach and stick
with it. Your best bet is the classic five-point
Likert scale (eg "Strongly disagree"; "Disagree";
"Neither agree nor disagree"; "Agree strongly";
or "Agree"). That makes your data easy to tabulate
and gives you a far clearer picture of what people
think than a simple yes-or-no question. However
it's essential that you leave space for written
comments — that's where our Calgary doc learned
the most.
The questions themselves
should be simple and focus on the three things
that truly matter: quality of care, access and
patient dignity.
QUALITY Quality of
care is the trickiest of the three because patients
so often don't know whether or not a condition
is difficult to treat. Nevertheless asking a broad
question like "How satisfied are you with the
performance of Dr —?" can be very helpful.
ACCESS Access is a
real hot-button issue and one that's sure to garner
some passionate comments. Here you can fly trial
balloons for concepts like same-day booking —
"Would you prefer if our clinic offered appointments
the same day you called? (Please note, you might
have to be more flexible about what time of the
day you come in)."
DIGNITY Questions
related to patient dignity can be very telling
as well. Ask them things like "Have you been treated
with courtesy and respect by the receptionist(s)?"
and "Do you feel your doctor is a good listener?"
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PATIENTS & PRACTICE
