Reflections on embracing this growing priority in healthcare
UH Clinical Update - November 2017
By Cliff Megerian, MD, President, University Hospitals Physician Services
As I look back on nearly 30 years as a physician, I think not only about how the profession has changed, but also how much I – and many of us – have learned about the art of physician-patient interaction.
This wasn’t something addressed in medical school, not even a decade ago. The emphasis has always been on the clinical side of medical care, and it always will be. But in recent years our personal interactions with patients have become much more important – and there is plenty of research, reported in many medical journals, that shows us why.
Do patients remember the clinical care pathways we use? Unlikely. Do they recall how our medical expertise helps them? Perhaps, in the ‘big picture’ sense. But what lingers most vividly is their memory of how they felt. Were they seen, were they heard – and really listened to?
When patients think they and their questions were not really addressed -- or worse, dismissed -- they will not forget. Research has shown that negative experiences have five times the emotional weight of a positive experience.
Some years ago, I adapted my behavior with patients to include all the actions we know patients care about.
- Sitting down at the bedside or in the exam room and introducing yourself by name.
- Greeting the patient by his or her name, and making eye contact (not looking at a chart or laptop.)
- Asking the patient this question, “What is your biggest concern today?”
Survey after survey of patients have shown how important these practices are, and how well they work. As I began making these changes, I saw my patient scores rise significantly.
Many of you may already been doing this, and my hat is off to you. You don’t need advice from me. But let me assure all physicians that it is personal contact that improves a patient’s experience. That is something we want, and not just because it drives up our scores. Who wouldn’t elect to have a patient report a more positive experience while under our care?
For all healthcare systems, patient satisfaction has become a priority. That’s why UH and most hospitals now have a Chief Experience Officer. At University Hospitals, Joan Zoltanski, MD, MBA, assumed the newly created post in January 2016. Our patient and system’s scores last year reflected the effectiveness of her work – and that of our clinicians.
Now, a confluence of factors is making patient experience an even more significant priority.
First, Nov. 30 marks the deadline for the collection of patient experience data from 2017. Last year, UH as a whole received excellent scores for patient experience, so we set this year’s goals somewhat higher. Dr. Zoltanski’s data shows that we are on an upward trajectory for this year, though we still have a ways to go to meet the targets we have set for in-patient and out-patient satisfaction – and only a few weeks to do so. The employees who support your practice have been working hard with you on meeting these metrics.
Second, MACRA – which took effect this year – is changing the way Medicare pays doctors by tying reimbursement to quality. It’s considered the single largest regulation driving the business model for healthcare providers, moving the payment model to value-based medical care. MACRA is designed to link patterns of reimbursement to the improved outcomes, quality and preventive care for our patients.
And a third factor is UH-specific. As you know, our new agreement with Medical Mutual of Ohio opened in-network access to all UH physicians and hospitals for all of Medical Mutual’s 650,000 members in Northeast Ohio. It’s up to us, as physicians on the front lines, to win over these members as new UH patients. The initial experience that they have with UH is crucial to earning their confidence and loyalty.
Congratulations on the success of your personal quest to connect with your patients and create for them a positive memorable experience.