Satisfaction scores seen as crucial to physician success

Consumers who have become accustomed to the customer-focused practices adopted by hotels, banks and retailers increasingly are judging physicians by those standards, according to consulting firm PwC.

The firm examined consumer opinions of health care customer service and compared it with other industries, using data from the firm’s 2012 Experience Radar survey. PwC surveyed 6,000 U.S. consumers online between May and July 2011.

PwC advises physicians and hospitals to try to win over customers with convenient, personalized, warm service — not only because it makes patients happy, but also because pay is at stake. Medicare and other payers now include patient satisfaction scores in pay-for-performance programs, and some insurers’ global payment contracts include bonus pay that is dependent not only on clinical quality scores, but also on how patients rate their experiences.

Physicians skeptical of tying pay to satisfaction scores have argued that what consumers want is not always what is best for patients. Doctors say basing pay on the happiness of patients creates incentives to do things like overprescribe antibiotics or run unnecessary diagnostic tests that patients demand.

But Mark Friedberg, MD, a Boston-based internist and researcher at RAND Corp., rejects that argument. There is no reason physicians can’t deliver the best care while also trying to give patients the best possible experiences, he said.

“I don’t think it’s unreasonable to ask clinicians to meet multiple goals,” he said. “It is possible for highly trained professionals to be excellent in all respects.”

Even when it isn’t tied to pay rates, customer satisfaction plays a huge role in attracting and retaining patients at a physician’s office or a hospital — even more so than price, which is the top consideration for customers in other businesses. PwC found that only 8% of consumers ranked price as the top factor in choosing a doctor or hospital, compared to 50% for health insurance, 55% for retail business, and 69% for personal travel.

Satisfied patients also spur additional business, to a greater degree than happy customers do for hotels, airlines or other vendors. The PwC survey showed that personal recommendations were 2.6 times more likely to influence a purchase in health care than in other industries. Nine out of 10 patients were willing to recommend a physician or hospital after a positive experience. Multiple studies by other researchers have found that online physician reviews most often are positive.

However, the PwC research also showed that an unsatisfactory experience — what the firm refers to as a “negative moment of truth” — is harder to reconcile in health care than it is in other industries. An apology and acknowledgement of a mistake or problem would be more likely to pacify customers who were angry about a bad hotel stay or purchase than a patient upset about a bad experience with a hospital or physician.

Vaughn Kauffman, principal and health care payer advisory practice co-leader at PwC, said physicians should focus on how to deal with those moments, including both private and public discussions of problems when appropriate.

“Those cases are going to exist,” he said. “The key is having a mechanism to engage and address that issue head-on.”