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Patient-centered care starts with physician communication

July 28th, 2011

by Steve Wilkins

The first experience patients are likely to have with your hospital is not in an ER visit or inpatient stay. A patient's first experience will most likely be in one of your primary-care physician offices. That because a person is 10 times more likely during a year to end up in the physician's office for a routine visit than they are to require an overnight hospital stay.

As a hospital marketer or patient experience officer this should raise an interesting question. How well do your physicians--particularly your primary-care physicians--represent your brand?

[More:]

Take "patient-centeredness." Lots of hospitals these days are promoting themselves as providing patient-centered care. You know ... when the hospital and its staff try where possible to be sensitive to and honor the wishes of patients. Patient-centeredness is a hard enough "sell" to patients in the hospital inpatient setting and an even tougher sell in physician offices.

The fact is that most physicians, with some exceptions, are anything but patient-centered in their interaction with patients. Take the way physicians and patients tend to communicate with one another. An estimated two-thirds of physicians employ what is known as a physician-directed or paternalistic style when talking with patients. This is when the physician asks the questions, interrupts the patient as needed, and only provides information the physician thinks the patient needs and is capable of understanding.

The sad thing is that most patients have gotten used to and, in some cases, like being told what to do and how to think by their doctor. It just the way things are. This attitude is perhaps why so many patients consistently give their doctors high marks on global satisfaction surveys dealing with communications. Patients are so used to way things are that they cannot conceive of a better way of doing things. It's also been shown that dissatisfied patients don't bother filling out satisfaction surveys. If they did, what they would say is that their doctors have communication habits like my doctor:

  • Doesn't listen
  • Ignores my opinion
  • Talks down to me
  • Always seems rushed and inattentive

So what are hospital marketers and patient experience officers supposed to do about physician-patient communications?

  • Don't put too much stock in global patient satisfaction surveys that barely address physician-patient communications
  • Conduct dedicated communication surveys, focus groups, and communication audits of individual physicians to assess the real scoop when it comes to the quality of doctor-patient communications
  • Teach patients how to do a better job of communicating with physicians
  • Provide continuing education training and tips aimed at improving the patient-centered communication skills of physicians

In 2012, the quality of the physician-patient experience will make up about 30 percent of Medicare hospital reimbursement. Individual physician reimbursement will be affected as well.

Smart hospital marketers and patient experience officers should consider ways to leverage these changes in Medicare reimbursement, as well as the myriad of pay-for-performance initiatives, to make sure the patient's first impression of your hospital is outstanding!

Stephen Wilkins, MPH, is principal and founder of Health Messaging, which focuses on enhancing the quality of physician-patient communications with a goal of improving patient safety and outcomes, increasing adherence and satisfaction, and reducing costs. He blogs about the communications gap that can exist between patients and their physicians for Mind The Gap.

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