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Consider the patient experience perspective
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Orthopedic surgeons focus on the evaluation and treatment of patients with musculoskeletal problems. After years of training and continuing medical education, we are often personally satisfied with our abilities to accurately identify a specific condition, and then apply the most effective treatment.
Typically when we know the diagnosis and treatment has been well-supported by evidence-based research or consensus among experts, we expect the results will be associated with greater than 80% patient satisfaction and significant improvements in function. We anticipate patients happy with the results. However, in the new era of increasing medical consumerism, achieving a good outcome has become increasingly less effective at defining the result desired by patients.
There is a rapid expansion of efforts to improve the patient experience throughout the entire medical care continuum. The perspective of a paternalistic delivery system, where physicians are completely trusted, respected and implicitly valued for their decisions and provided care, has evolved to a more shared-decision model whereby patients want enough information to make their own decisions, or at least have an equal contribution to the final plan of care. Patients have been asked to shoulder the burden of health care expenditures to the point that many feel entitled to get the care that they want, not necessarily the care offered by surgeons. As patients have multiple health care options, they have become more experienced consumers with a desire for personal and subjectively valuable interactions with their health care providers.
Anthony A. Romeo
As politicians, insurers, academicians and health care providers work to define “value,” they also have become increasingly aware that we are now in an era of patient experience. A significant assessment of value from the patient’s perspective is their overall satisfaction with the entire continuum of care — from first evaluation to conclusion of treatment. The challenge for physicians is to understand what comprises the patient experience and how we improve our abilities to deliver the entire package of expected care.
Measure patient experiences
Defining a best patient experience is difficult and currently without consensus. Some ideas include patient-centered care; customized care that has excellent customer service and an emphasis on positive-attitude providers who are willing to serve as needed; and simply creating tranquil environments for healing. Hospitals are currently under scrutiny to collect data measuring the patient perceptions and experiences through the Hospital Consumer Assessment of Healthcare Providers and Systems, and then use this data to support improvements in patient services and quality of care. This is even more challenging for orthopedic surgeons given the pain that normally occurs after many surgical interventions and patients’ pain management experiences and expectations.
As there is no consensus on the core components of “patient experience,” it is difficult to agree with how to measure it; therefore, making it difficult to institute practices to satisfy all. Many practices, surgicenters and hospitals take the five-star hotel approach. Upgrading the facility’s physical appearance, renaming waiting rooms to reception areas and providing hospitality training to front office staff have become increasingly common. In addition, efforts are made to brand various institutions or practices so patients have an immediate recognition of their desired value-based care. Other methods include providing more available services, such as evening and weekend office hours or orthopedic practice-associated urgent care centers.
Provide consistent, excellent care
All of these efforts are admirable and many would say necessary, especially to compete for patients who have choices about not only where to receive orthopedic care, but also how much they are willing to pay for it. However, all of these well-intentioned consumer-based enhancements are still upstaged by one simple patient-based selling point: consistent, excellent orthopedic care. It has been said, “Patients don’t care how much you know, until they know how much you care.” It is also likely true that no matter how many superficial patient experience attributes are added to a practice, the ultimate patient request is valuable orthopedic care. This most important attribute creates lasting emotional and physical connection with a practice and leads to the return visits and referrals that grow a practice, reputation and brand.
Providing a better patient experience within your care environment requires a team approach, beginning with the first interaction with the office. Patient experience movement is about the methods, environment and operations needed to provide reliable, affordable and safe care. This approach is only part of the process to improve patient experience. In fact, we should not be calling it “patient experience” because the majority of people do not think of themselves as “patients.” It is truly a person or human experience. It is the way we would want to be treated in everyday life.
Orthopedic surgeons and staff need to provide a professional appearance and courtesy toward potential patients. Many will spend a significant percentage of their income on health care each year, and they are increasingly educated consumers when it comes to the selection of providers. All members of the practice need to portray a sense of competence so patients and family members trust they are going to receive excellent care. Each patient in the office is part of a larger family unit, and all will be affected by this person’s response to health care. We should encourage family members to be available for support and involvement in the care plan.
Humanize the interaction
The patient should sense that the staff and the surgeon are proud of their achievements and abilities to provide valuable care. However, we cannot let our accomplishments substitute for a personal relationship with patients. Eye-to-eye contact, listening without interrupting and having a scribe available, so as to focus on the patient’s concerns instead of documentation and administrative responsibilities, all help humanize the interaction.
During this face-to-face interaction, the patient needs to sense your passion for providing great orthopedic care along with a great patient experience. Passion, combined with trust, are the ideal emotional attributes to build a valuable human experience that patients are willing to pay for and remain loyal to for future orthopedic needs.
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- Anthony A. Romeo, MD, is the Chief Medical Editor of Orthopedics Today. He can be reached at Orthopedics Today, 6900 Grove Rd., Thorofare, NJ 08086; email: orthopedics@healio.com.
Disclosures: Romeo reports he receives royalties, is on the speakers bureau and is a consultant for Arthrex Inc.; does contracted research for Arthrex Inc. and DJO Surgical; receives institutional grants from AANA and MLB; and receives institutional research support from Arthrex Inc., Ossur, Smith & Nephew, ConMed Linvatec, Athletico and Miomed.