Ethics Forum: Patient Experience and Satisfaction

A growing part of the ever-changing healthcare landscape is measuring patient satisfaction. Hospitals and physicians, more and more, are being rated and ranked based on a patient’s experience – what they think of the care they get from their individual physician, what they think of their stay in a particular hospital. Reputations are at stake, as are reimbursements and payments.

Surveys and publication of patient satisfaction with providers of all kinds are growing in number. And they’re here to stay.

That was part of the message from the MMS Ethics Forum on Thursday, May 5 presented by the Committee on Ethics, Grievances, and Professional Standards as part of the 2016 MMS Annual Meeting.

The Forum, entitled Patient Satisfaction Surveys: Utility and Unintended Consequences, featured presentations from Thomas Lee, M.D., Chief Medical Officer of Press Gainey and former CEO for Partners Community HealthCare, Inc., and Allen Kachalia, M.D., J.D., a general internist and Chief Quality Officer at Brigham & Women’s Hospital. Below, are the main points from their presentations.

Ethics-Thomas-Lee

Dr. Thomas Lee

Dr. Lee recognized that patient measurement can lead to unwanted changes or unintended consequences, but also acknowledged that not measuring patient experience means “giving up on the idea of improvement.” The challenge, he said, was “to invest thought, time and energy in preparing people to receive data [of measurement], and it’s a challenge worth taking on.”

Patients are afraid, he noted, not just of their diseases or the therapies they may have to undergo, but of the lack of coordination by the medical community, that, as he bluntly stated, “we don’t have our act together” in caring for patients.

Dr. Lee, however, ended on a positive note. The keys to proper and well-accepted measurements, he said, are within our control: better care coordination, more empathy, and improved communication with the patient. The good news, he said, is that those drivers of patient satisfaction are consistent with the professional values of physicians.

Ethics-Allen-Kachalia

Dr. Allen Kachalia

Dr. Allen Kachalia said that legitimate issues exist in accurate measurement.  The rankings are based on inexact science, response rates are generally too low, financial incentives are motivating the wrong behaviors, and measurement is one more item for physicians to manage. Yet his message was clear: patient satisfaction and the public reporting of patient experiences are here to stay.  “All of us want to be the best,” he said, “but there’s no way to know if we are the best without measurement.” The key, he said, is to balance patient experience with quality of care. Physicians must “embrace measurement and be transparent,” Dr. Kachalia stressed, and “offer solutions to the poor metrics” that exist in measurement today.

 

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