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Embedding Patient Satisfaction in Direct Primary Care

By
2020-09-19
A healthy patient may be the goal, but a happy patient is also one who will remain loyal to your practice. So while direct primary care physicians should have a primary goal of patient health, they should also be cognizant of the overall patient experience.

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Patient Visits & Patient Loyalty

The data shows that patient loyalty is engendered through face-to-face interactions.

Isaac French, DPC Product Manager at KPI Ninja, found that the number of visits patients had in their first year, regardless of health or age, determined the likelihood that they would renew their yearly subscription.

Specifically, patients who visited the clinic at least once per year showed a 37% increase in renewal rate over those who did not visit the clinic at all. This means that DPC doctors have the chance to retain patients and engender loyalty based largely on one-on-one visits (Isaac French: Factor’s Impacting Member Retention).

Patient Satisfaction: A DPC Doctor’s Perspective

Dr. Emilie Scott of Halcyon Health, after several years working for a large HMO group, was prompted to start her own DPC practice despite her fear of stepping out on her own. Frustrated with “good intentions with poor execution” and tired of the trust between doctor and patient constantly being undermined, she looked to DPC as a solution to the erosion of patient care and satisfaction.

Scott, in her years as a fee-for-service physician, recalls finding herself in frequent lose-lose situations when attempting to care for patients who were oftentimes disillusioned by the healthcare system. Because they function in an insurance-based model, Scott asserts that FFS doctors are pulled in two different directions at the cost of disservice to both patient and practice:
  1. Focus on the patient: By spending more time fostering the connection between doctor and patient, physicians risk alienating other patients in need, disappointing administrators who expect adherence to strict schedules, and putting financial strain on the practice.
  2. Focus on the EMR: By spending more time checking boxes on EMRs, ordering tests that “buy the physician more time” and make the practice money, and writing referrals, physicians never foster the doctor-patient relationship. FFS doctors, when primarily focused on EMRs, could also run the risk of misdiagnosis. When the patient is not given proper time and space to speak freely, important medical information leading to proper diagnosis might never be revealed.

Patient Satisfaction: The Patient’s Perspective

Press Ganey Associates, in their analysis of drivers of patient satisfaction, found that clinical competence is actually assumed by patients. Surprisingly, they found that the top driver of patient satisfaction was not whether patients recovered, but whether they felt like they were treated as people.

Similarly, in “A Case for Compassion,” a post-discharge survey analyzing over 185 unsolicited positive compliments about hospital care, only 4 discussed clinical competence. Instead, 120 of the 185 responses mentioned compassion, kindness, and empathy, revealing clearly what patients value in their experience with a provider.

Despite the difficulty in measuring these outcomes, there are practical steps to improving patient experience in DPC. Dr. Eric Miller of Paladina Health recommends that DPC doctors put these Patient Experience Principles into place:
  • Define the success of your DPC practice by patient loyalty, not satisfaction.
  • Value courtesy more than efficiency. Ask yourself: Does the staff go above and beyond for patients? Are they encouraged to do that instead of striking things off a to-do list?
  • Measure to improve, not to impress.
  • Take Action Concept on the Mechanism of Metal Cogwheels.Empower every employee to say YES. All staff should aim to solve problems on the spot. Service recovery can “turn a disgruntled customer into a raving fan.”
  • Hardwire excellence into your staff.
    • Build a culture of service, encouraging your staff to ask questions like, “Is there anything else I can do?”
    • Hardwire service actions such as calling patients to check on them after a new diagnosis or a medication change.

The DPC Difference: Aligning Doctor and Patient Values

Using the DPC monthly subscription model, physicians can decide how much time and attention their patients need without the onus of check boxes and insurance-based decision making. Each patient and the context of his or her ailments can be evaluated and treated on an individual basis:
  • The single mother whose child is sick with pneumonia can come to the clinic, receive a diagnosis, and get access to antibiotics without even having to stop at the pharmacy.
  • The 80-year-old patient who needs more time to move from the waiting room to patient room can now be seen and heard without the rush.
  • The 40-year-old with a broken ankle can get an x-ray, pay only $40 for an image, go online alongside his DPC physician to consult with an orthopedic surgeon, and get a boot ordered from Amazon, all at the DPC clinic and for a fraction of the cost.
Patients can meet with the DPC doctor at the clinic or consult with him or her through text or email. “Healthcare happens outside the office” as well as inside, and patients with quick questions can simply avoid the drive to the office and speak to their DPC doctor on the phone.” (Dr. Emilie Scott: The Physician Experience: Contrasting Insurance-Driven Healthcare with DPC).

Patient satisfaction, therefore, is fostered through convenience, instant-access to care, and safe discussion. Furthermore, with Direct Primary Care, physicians can realize efficacy and find purpose in their day-to-day interactions with patients, trusting that patient satisfaction will be the natural outcome.

The Outcome for Patients and DPC Providers

When the patient-provider relationship is built on the aforementioned principles, the result is shared-decision making, mutual understanding, and trust. This is where patients will find the compassion and empathy, uniquely embodied in Direct Primary Care, that they’re looking for.

Tags: Patient Perspectives, Physician Stories

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