Enhancing Patient Satisfaction: Identifying Physician Candidates with High Patient-Satisfaction Tendencies
March–April 2007
In today’s evolving health care environment, patients are more knowledgeable, more involved, and more responsible for their health care costs. Because of this, their expectations regarding their health care experience are higher than ever before. At the heart of this health care experience is the human moment — that one-on-one interaction between the patient and their doctor. Investing in an environment that supports this interaction and delivers a positive patient experience is key to improving patient retention, increasing patient referrals, reducing the risk of malpractice, improving productivity, improving morale and professional fulfillment, and improving patient compliance.1
But, what do patients want from this experience, and how can a practice know that it is hiring a physician who exhibits the behaviors that deliver a more satisfying patient experience? To answer these questions, the Procter & Gamble (P&G) Healthcare Consumer Institute® conducted extensive research with physicians by collaborating with several medical groups: the Cleveland Clinic (Cleveland, Ohio), HealthCare Partners (Los Angeles, California), and the Jackson Clinic (Jackson, Tennessee). We hypothesized that physicians who exhibit high patient-satisfying tendencies could be identified based on how they answered a series of questions. Our research focused on developing these questions and identifying their associated behaviors in order to predict physician responses. From the research insights, the Physician Interview Tool was developed and validated.
What Do Patients Want?
In the P&G Satisfaction and Loyalty III Study,2 a large national study with over 5,500 consumer respondents, patients revealed what they are seeking from their physician interactions. The top attributes are included in the chart below.
As you can see from the attributes listed in the chart, patients want their physicians to listen to and understand them. From the patients’ perspective, if their physician “does not know me, then how can they provide me with the best diagnoses and treatment.”3 The literature also confirms these findings; studies have revealed the following: “patients are most satisfied by interviews that encourage them to talk about psychosocial issues in an atmosphere that is characterized by the absence of physician domination”4 and “patient satisfaction was highest in the psychosocial pattern.”5 These studies reinforce the correlation between patient satisfaction and patients’ ability/opportunity to share their story with their doctor within the scope of their visit.
ATTRIBUTE
|
IMPORTANCE
RATING*
|
| Takes time to listen to what patients have to say |
92 |
| Makes decisions in the patient's best interest |
92 |
| Very good at diagnosing/treating any problem |
91 |
| Explains fully what he/she will be doing, puts patients at ease |
91 |
| Asks questions to understand patients' conditions |
91 |
| Is a health care professional patients can trust |
91 |
|
| *Importance Rating Scale: 0 to 100, with 100 representing the highest level of importance |
Identifying High-Satisfying Physician Candidates
As a physician interviewer, how do you know that the candidate you are considering exhibits behaviors that facilitate enhanced patient satisfaction? This is a question that has been grappled with by many physician recruiters. It is common during the interview process for physicians to be assessed on attributes such as academic qualifications, residency/fellowship training, credentials, teaching experience, publications, references, organizational fit, and, often times, the interviewer’s gut reaction to the candidate. Whereas these are important and do play a role in evaluating a candidate, they do not address areas that help an organization deliver a high-quality patient experience. According to Vance Brown, M.D., (chair, Department of Family Medicine, Cleveland Clinic; medical director, Strongsville/Brunswick) such areas include professional competence, a passion for continual improvement, the ability to work well with others, a strong work ethic, and a high productivity drive with effective communication skills.
The Physician Interview Tool
The Physician Interview Tool is a resource system that helps to identify physician candidates with high patient-satisfaction tendencies. The tool’s modular design complements a typical physician interviewing process that focuses on understanding the clinical competencies and organizational/cultural fit. The tool is designed to be administered by individual interviewers or interviewing teams, takes about 15 to 20 minutes per candidate to conduct, and provides a consistent process and standard that enables an overall evaluation of a physician candidate.
The tool was developed and validated in four research phases using both qualitative and quantitative methodologies. One hundred and ten physicians participated in the research, and all interviews were videotaped and analyzed. Each phase was designed to understand the behaviors and validate the questions used to identify high patient-satisfying physicians. The final phase also focused on evaluating the Training Module’s effectiveness in preparing physician interviewers to use the tool.
The Physician Interview Tool has three components: 1) the key traits and their associated behaviors; 2) the assessment process; and 3) the training process for physician interviewers to effectively use this tool. In research, multiple traits were identified and clustered into key themes; the associated behaviors (approach, words, and phrases) were then linked to that theme. This produced a robust and efficient series of questions with their associated behaviors. One of the interview questions, for example, is: “Tell me about a recent patient interaction that went well, and why was it successful.” The behaviors interviewers are looking for surround the physician’s approach to the patient. If a physician discusses the patient as an individual versus a condition, then their answer correlates with physicians who consistently receive high patient-satisfaction scores. Secondly, the assessment process assigns a numerical evaluation score to a candidate’s response, so their responses are evaluated in comparison to an ideal scale versus other candidates. This helps standardize the interviewing process across candidates. Thirdly, the training process focuses on understanding the research insights, utilizing the tool, and practicing with the tool via a role-play process to ensure effective execution.
The Results
The results from the Physician Interview Tool’s validation research were very strong. The tool received a 72% exact-match rate between the quintiles of a physician’s actual patient-satisfaction scores and the interviewing team’s predictive assessment. The vast majority of non-exact matches varied by only one quintile with a bias toward the physician scoring better than what the interviewers predicted; thus, it indicated that the tool both accurately predicts patient satisfaction and does not overestimate a physician’s performance in this critical domain. The tool was also validated from a usability perspective; during the fourth phase of research, the physician interviewers made the following observation: “The experience [with using the tool] validated what we learned in the training module.” From this process, we also learned that the tool was applicable across physician specialties: family practice, internal medicine, pediatrics, cardiology, podiatry, and psychiatry.
The Physician Interview Tool was developed based on research insights and has proven to be efficient and effective to implement. This tool provides a novel approach to enhancing patient satisfaction by identifying physician candidates with high patient-satisfaction tendencies.
1 Brown et al. Patient Satisfaction Pays: Quality Service for Practice Success. Aspen Publications: 1993; 9.
2 Procter & Gamble. Patient Preferences & Perceptions
Manual, March 2005, 3rd edition; 58.
3 Procter & Gamble. Physician-Patient Interaction Study, 2004.
4 Bertakis et al. “The Relationship of Physician Medical Interview Style to Patient Satisfaction.” Journal of Family Practice 1991 Feb; 32(2); 135–6.
5 Roter et al. “Communication patterns of primary care physicians.” JAMA 1997 Jan 22–29; 277(4): 350–6.
Source: Jennifer Soto is a senior manager in customer marketing with the Procter & Gamble Healthcare Consumer Institute,® an organization dedicated to helping health care providers improve the patient experience through in-depth consumer understanding. For more information on the study and
its methodology, please contact her at soto.jj@pg.com.
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