The Value of Patient Surveys

When asked to respond to a survey in the offi ce, patients may not answer honestly.
When asked to respond to a survey in the offi ce, patients may not answer honestly.

Do you know that the top three things that are important to patients in urology practices are a doctor's courtesy and friendliness, how well a physician explains someone's medical condition, and whether or not a doctor involves a patient in decision-making?

These are the findings of a recent survey of urologists by PRC, a health care research firm in Omaha, Neb. Janna Binder, PRC's Director of Marketing and Public Relations, noted that survey findings are not hard clinical data, but they can useful to a practice.

“It is a little more warm and fuzzy type of stuff,” she said. “Patients can't really evaluate clinical skills; they assume overall that their doctor is good clinically. What they do know is how they are treated as people. That's really what these surveys go into.”

A patient's comfort with his or her physician can affect the clinical aspect of care, however. According to PRC surveys, the better the patient's experience, the more likely they are to comply with clinical instructions, Binder said. Data from a nationwide 2009 consumer loyalty study of 1,000 adults found that patients don't follow their doctors' orders because the instructions weren't easy to follow, medications had adverse effects, or the patients just chose not to.

“The percentage that followed all instructions are much more likely to perceive the care delivered by their physicians as excellent,” Binder said. “It's the excellent physicians who have a higher percentage following their instructions … something that a patient satisfaction survey would report.”

Patient surveys are now required to be performed by nursing homes and hospitals to receive payments from Medicare. They aren't mandatory for other providers, but experts say they may be within the next couple of years. Even if they aren't compulsory, they may provide useful information that can improve your practice.

What's available

Surveys can be administered through an organization like Binder's, but they can also be found online at no cost. The one used by the Centers for Medicare and Medicaid Services is called the Consumer Assessment of Healthcare Providers and Systems, (CG CAHPS for physician groups) and can be found, along with instructions for operation, here.

Patient satisfaction surveys can be administered by handing them out, e-mail, regular mail, or by phone. Alan Jackson, president and CEO of The Jackson Group Inc. in Hickory, N.C., said phone surveys provide the “best, most comprehensive data” because they are more likely to get a larger representation of your population.

They are also more expensive to have administered. If you decide to distribute surveys yourself, you want to improve your chances of getting more solid responses.

One piece of advice is not to hand out survey questionnaires during a visit. Binder said a patient will feel that it is not anonymous and won't want to answer honestly. If they take it with them, they probably won't remember to mail it back in. Jackson recommends mailing or e-mailing them to patients instead, with the knowledge that e-mail surveys probably won't reach older patients.

Getting the most from surveys

The questions on a CAHPS or other survey are a great start, but you might want also to add queries that are more specific to your office. Pediatric urology patients may have different needs than adults, for instance. The CAHPS survey asks about demographics—age, education, overall health, and so on. If you are using a survey other than the CAHPS, you will should ask about age and gender. This will help you break down the data to see if there are subsets that you aren't serving as well as others.

The effort also has to be from the top down. Binder recommends having a practice manager as well as one physician champion the effort, maybe even by showing the staff his or her scores to get the ball rolling.

“If top management and physicians embrace it, it will be accepted, everyone will use it,” Binder said. “If they say it's the next fly-by-night thing, it is just a waste of money.”

Finally, don't be discouraged by low marks. If you can benchmark against other providers (the CAHPS site has a database of information for comparison) you can identify where scores tend to dip. Some areas, like cost, are always rated low.

“There's about 5% to 10% of the population that are just not happy people,” Binder said. “But in general, patients do love their doctors and their staff. [Physicians] will probably be pleasantly surprised.”

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