Blog | Thursday, October 16, 2014

Engaging patients


Patient satisfaction is hot. Major payers, including the federal government have linked hospital payment to institutional performance on patient surveys of their experience with care, and are poised to do the same with physician payments. There is a proliferation of commercial websites for patients to offer up their reviews of physicians and to check out the ratings already there. An entire industry of consultants has appeared to help institutions improve how patients experience the care they provide. Hospitals and health systems, including our own, have hired Chief Experience Officers.

I think that this is generally a good thing. We have traditionally paid too little attention to how patients actually experience the care we provide, and it is pretty hard to make that experience better without actually asking patients and their families. I would be more enthusiastic about these efforts if we spoke less about “patient satisfaction” and more about “patient engagement.”

As I have written previously, I think that “satisfaction” is a pretty low bar. Patient engagement, however, is a much higher goal of establishing a therapeutic partnership with patients. It is not just about making sure that they were, as the patient satisfaction surveys would have us assess, spoken with in a way they could understand, or treated with courtesy and respect. It is about making sure that we have made it possible for them to be active and effective in their own care. A really eloquent statement of what that ought to look like is available here. It is written as an open letter from a patient to a “new doctor” and we would all do well to follow her advice. I recommend you read the whole thing, but her main points of advice to us are:
• Seek first to understand, then to be understood;
• Join a system or create a practice that prioritizes coordinated care;
• Recognize that being a patient and being part of the health care environment is not my job; and
• Learn from me.

I know it is not easy to organize our systems of care to achieve these goals, but it really seems to me we ought to try. What do you think?

Ira S. Nash, MD, FACP, is the senior vice president and executive director of the North Shore-LIJ Medical Group, and a professor of Cardiology and Population Health at Hofstra North Shore-LIJ School of Medicine. He is Board Certified in Internal Medicine and Cardiovascular Diseases and was in the private practice of cardiology before joining the full-time faculty of Massachusetts General Hospital. He then held a number of senior positions at Mount Sinai Medical Center prior to joining North Shore-LIJ. He is married with two daughters and enjoys cars, reading biographies and histories, and following his favorite baseball team, the New York Yankees, when not practicing medicine. This post originally appeared at his blog, Ausculation.