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A satisfying practice results from satisfied patients
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Historically, health care providers – optometrists included – have always been very focused on objective outcomes. We like our patients corrected to a crisp 20/20, intraocular pressures in the low teens and tear break-up times greater than 15 seconds. We work hard to achieve these goals and consider ourselves successful when we do so. This is for good reason, as attaining these outcomes often results in a happy patient. Often, but not always.
We have all had the misfortune of caring for a LASIK patient who is miserable despite a postoperative visual acuity of 20/20. Or, an exceptionally well controlled glaucoma patient whose eye drops wreak havoc on their ocular surface. And, the vexing dry eye patient whose symptoms persist despite a robust tear film. Successful treatments? You bet. Satisfied patients? Hardly.
Michael D. DePaolis
The “disconnect” between what appears to be objectively successful and subjectively satisfying has long been an enigma. On one hand, we reliably measure success by simply assessing whether the treatment has met certain time-honored outcome metrics. Satisfaction, on the other hand, is not so easily understood. It is complex, nebulous and influenced by so many intangibles – the sort of stuff we are not very good at measuring and, therefore, stuff we have not always paid much attention to. Until now.
It is not by accident that patient satisfaction is gaining traction throughout health care. The U.S. Food and Drug Administration is leaning more toward patient satisfaction metrics in its evaluation of new drugs and devices. Patient satisfaction scores are playing an increasing role as health care payers move toward pay-for-performance programs. In addition, satisfaction assessments have become pervasive in social media as patients decide whether to “like” our practices. The reality is that it is here to stay, and our job is to understand, measure and strive for higher levels of patient satisfaction.
Granted, as optometrists we “get it.” We have long known that improving vision and eliminating ocular pain often result in a satisfied patient. However, as it turns out, that might not be enough. It turns out communication is vital. Just how well we explain things, set and manage realistic expectations, and demonstrate compassion might – in the patient’s mind – be every bit as important.
Perhaps this is no more evident than in the refractive surgery arena. After a decade of robust growth, LASIK procedures leveled and then declined. While this was undoubtedly influenced by a stagnant economy, it was also the result of an extremely small, yet very vocal, group of dissatisfied LASIK patients.
Not to be deterred, the refractive surgery community embarked upon an ambitious journey to: identify preoperative metrics associated with suboptimal outcomes, thereby resulting in better candidate selection; develop newer technologies to ensure a safer surgical experience; better educate patients and establish realistic expectations … before surgery; and measure patient satisfaction in a meaningful way. So, how is all of this working? Patient satisfaction ratings are at an all-time high, and procedures were up in 2013, as we report in “LASIK patients report high satisfaction rate in FDA outcomes study”.
I imagine you, like me, became an optometrist because working with patients to improve vision – and lives – is tremendously satisfying. And while we have always measured these things objectively, it might be time to take a closer look from our patients’ perspectives. My guess is that we are going to find our satisfaction is pretty closely aligned with theirs.