Why Patient Satisfaction Surveys Need Context

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In my present job I do try to not only satisfy my patients but also make them happy. Why?  Because my patients pay me a monthly fee to be their doctor (and I genuinely want to be a good doctor).  The job is great and I am one year into it and I can truly say that my direct primary care business is a success.  I am happier than I have ever been being a doctor. I bring this up because I recently read about a survey of a million patients in 7800 practices in England showing that “patients were least satisfied with family doctors who were frugal with antibiotic prescriptions.”  Even better,  the amount of antibiotic prescriptions a practice gave out was a leading predictor of its patient satisfaction ranking. All this was published in the British Journal of General Practice. This is no surprise to me but it is a great reason that OTHER practices cannot use quality metrics like patient satisfaction surveys. It forces doctors to use inappropriate antibiotics or other medications.  So how does this relate to me?  Well, I think that I give LESS antibiotics than I ever have given in my career.  The reasons are many:

  • I can truly spend time listening and examining a patient, which makes my diagnosis more accurate
  • I know my patients and they trust me
  • If the infection is viral I spend a lot of time educating them on why antibiotics won’t work and may actually hurt them and their own good bacteria (microbiome)
  • I spend time going over the best OTC products for symptom control
  • They have my cell number and email to get in touch with me if symptoms change
  • I email all my patients when a new viral URI seems to be hitting the local community so they don’t even need to come in

The key metric above is time.  I have it and other doctors don’t.  In summary, patient satisfaction means everything to me as patients will leave if they don’t like my practice.  Time = patient satisfaction.  For employed docs, who have no time. using these surveys as a way to bonus doctors is a mistake and leads to bad care.

 

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