Physician/patient rapport concerns administrators
Physician/patient rapport concerns administrators
Would you like to know what your hospital administrator really thinks of your department? In a recent survey of hospital ED administrators, 40% of respondents reported concerns regarding physicians’ rapport with patients.
"There are a lot of administrators concerned about the way doctors treat patients," reports William Schumacher, MD, CEO of The Schumacher Group, a Lafayette, LA-based ED management firm that conducted the 1999 Emergency Department Staffing Survey. "People are starting to realize that the way patients perceive their care often parallels the quality of the care being delivered," he says.
Ask your administrator directly, "What level of confidence do you have in our physicians’ rapport with patients?" recommends Randy Pilgrim, MD, regional medical officer for The Schumacher Group and acting medical director of the ED at Biloxi (MS) Regional Medical Center. "If it’s less than desirable, it’s critical to explore ways your ED can enhance communications," he suggests.
The answer is not likely to lie in adding services or revamping the ED, he says. "To improve patient satisfaction, you need to deliver a consistent message that physicians have a patient service mentality. That will inspire confidence from your administrator."
Respect and a sense of the patient’s dignity are crucial to convey, he emphasizes. "If you’re effective at this, patients will more readily perceive that their problem was thoroughly addressed."
Concerns about physician interactions are best addressed by simple behaviors that convey respect to patients, Pilgrim says. Here are some examples of what physicians and other staff members can do:
• Routinely introduce themselves to patients.
• Shake hands and initiate eye contact when they ask what they can do for a patient.
• Sit down in the patient’s room.
• Communicate with family members as well as with the patients.
• Consistently explain delays to concerned patients.
Here are other key findings of the survey:
o Respondents are concerned about care given in the ED. More than 20% of respondents expressed concern about the professional competence, availability, and quality of care given in the ED. In fact, one in 10 administrators surveyed would choose an ED other than the one at their hospital if they were seriously hurt.
"This shows that despite the fact that ED physicians are better trained than ever before, in some cases, administrators still don’t have confidence in the care delivered in the ED," Schumacher says.
Patients are more likely to get a higher level of care at a large center with residency programs, which might account for some of the 10% of administrators who would avoid their own EDs, Schumacher explains. "Quality challenges still exist, but it doesn’t necessarily mean that the physicians are not providing good care," he says. "In reality, this is often not the definitive care that most of us would receive if we had a choice."
Taken alone, that 10% is a concerning statistic, says Pilgrim. "It may point to a deeper level of discontent than expected, even though as managers, we interact almost daily with those surveyed [the administrators]."
The statistic demands a response from ED managers, according to Pilgrim. "Even if a high-level center was available, administrators would still be likely to go to their own ED if they had a basic confidence in the staff, the system, and communication they would experience in their own facility."
Could your administrator be among the 10%? Pilgrim suggests bringing the survey to your administrator’s attention. "Tell him or her, I am concerned about the numbers in this study. Do you think there might be similar concerns about our ED? If so, how can we address those issues?’"
o Most board-certified physicians are in trauma centers. The survey showed that hospitals with small EDs (under 9,000 patient visits a year) are much less likely to require that physicians be board-certified in emergency medicine. Only 5% of small hospital EDs require board certification, compared with 48% of larger hospitals.
That reflects the capability of larger hospitals to support a higher-paid physician, Schumacher explains. "It’s also the practice interest that the board-certified physician will have. These individuals want to go to a busy trauma center because it’s professionally challenging."
Primary care physicians still staff EDs in rural areas because those EDs can’t afford more qualified physicians, he notes.
o 82% of ED physicians have leadership roles. "We were surprised that so many ED doctors are involved in the governance of the hospital," says Schumacher. "ED physicians now realize that they have to do more than just show up and work a shift."
Quality care comes from the performance of a team, not just individuals, notes Schumacher. "That requires committing energy to develop a good process, as opposed to just putting time in." (To learn administrators’ views on expansion of the ED, see story, p. 70.)
For a free copy of The Schumacher Group’s ED staffing survey, contact:
• Jeff Curtis, The Schumacher Group, 580 Westlake Park, Suite 780, Houston, TX 77079. Telephone: (888) 890-3181 or (281) 531-8350. Fax: (281) 531-6830. E-mail: [email protected].
For more on the 1999 ED staffing survey, contact:
• Randy Pilgrim, MD, The Schumacher Group, 110 Rue Jean Lafitte, Lafayette, LA 70508. Telephone: (800) 893-9698 or (318) 237-1915. Fax: (318) 237-5095. E-mail: [email protected]. Web: www.schumacher-group.net.
• William Schumacher, The Schumacher Group, 110 Rue Jean Lafitte, Lafayette, LA 70508. Telephone: (800) 893-9698 or (318) 237-1915. Fax: (318) 237-5095. E-mail: [email protected]. Web: www.schumacher-group.net.
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