About a year and a half ago, Carly Thanhouser went from working on ways to improve physicians’ practices to being a patient in one. The information her doctor gave her on her upcoming jaw surgery left her asking questions about her recovery.
“As an information seeker who had no idea about what was about to happen, I felt very left out there on my own to figure things out,” she said. “I’m someone who wants to know things and be as prepared as possible.”
Thanhouser, a behavioral scientist at the Office of Academic Innovation at the University of Michigan in Ann Arbor, said her physician never told her much about what would happen after her surgery. So, she prepared for more than a month in advance for what she thought would be a long, slow recovery. But on the day of the procedure, she found out that part of her treatment was to eat a steak the following evening.
“I had received a few pre-op instructions, but I wanted to know more about my experience from the time I woke up until I was functioning normally again,” she said. “I still have moments where I wonder if I’m still supposed to be doing my stretches.”
A physician-patient disconnect
While most physicians think they are listening well and providing patients with the information they need, Thanhouser and other patients might disagree. In a 2015 survey by the international consulting firm Prophet and GE Healthcare Camden Group, 300 providers were asked if they took the time to understand patients and explain things well. Fifty-one percent responded in the affirmative. In that same survey, only 34% of the 3000 patient respondents believed their doctors were doing this.
With ratings and online reviews to contend with, physicians need to think of patients as consumers with choices for care. In the Prophet survey, 42% of people surveyed said how they were treated was the most important component of a good office visit. Only 22% said it was the actual clinical aspects of a visit.
“What are the drivers of loyalty and increasing the likelihood a patient is going to come back or recommend them to friends?” said Jeff Gourdji, a partner in Prophet’s health care practice. “The number one driver we see in our studies is whether or not doctors and nurses take the time to listen to patients and make them feel listened to.”
Another major disconnect found in the survey was turnaround time on test results. Forty-eight percent of physicians thought they were doing a good job, whereas only 35% of patients felt that way.
“Doctors may be thinking 72 hours is good, but patients are like, ‘My god, 72 hours?’” he said. “If I took a test for something serious and had to wait that long, that’s going to create a lot of anxiety.”
It is this anxiety that can make for a negative patient experience, Gourdji said. For instance, patients often rate good parking higher than good food at a hospital. Food is important, but running late increases anxiety, which mars their experience.
Anxiety can be particularly high at specialist visits. Patients wait a long time to get into the office and know doctors have little time. But a physician who listens can relax patients and create a better overall experience, Gourdji said.
Specialists should also help patients coordinate with their primary care doctors. Gourdji said this is a major complaint he hears from patients, particularly those with more serious illnesses. Patients should not be taking information to the primary care provider.
“If [physicians] make sure the transitions are smooth, it can play a big role in helping create a connected journey,” he said.
Informing patients about the risks of surgery is not going to do much to build a good relationship with patients. Thanhouser recommends concentrating less on statistics and more on experiences.
“It’s not just about what is going to happen, but what it might feel like after a surgery,” she said. “People who know what to expect do a lot better.”
Thanhouser understands physicians are not always able to anticipate every need a patient might have, but more individualized care is needed. “Everybody experiences things differently,” she said. “To provide the best support, there has to be some level of personalization and an expectation-setting conversation” regarding their treatment, she said.
Time-crunched providers can look to products like Wolters Kluwer’s EmmiEngage for help on this front. The company creates informational materials for patients that explains topics like preparing for procedures, managing chronic conditions, and what they will experience during a hospital stay.
If outside help is not feasible, Thanhouser recommends collecting individuals’ stories and creating a database of their experiences. “Find out what they go through after a procedure that will inform the care team about what the experience really is and how it feels,” she said.
How to condense and disseminate that information can vary. Videos or handouts are good options. Thanhouser recommends providing something patients can refer back to after they leave the office or are recovering from treatment.
Most importantly, she urges physicians not to make assumptions about what a patient does and does not know. Thanhouser recommends using the same approach when meeting with her accountant at tax time.
“When they try to go over my information I tell the accountant, ‘Pretend you are talking to your 4-year-old niece when talking about this to me,’” she said.