Keeping Your Friends: How to Retain Patients

Greg A. Hood, MD


April 29, 2016

In This Article

How to Find Out if Patients Are Satisfied

Taking the pulse of your practice may be performed in a number of ways. The quickest, least expensive, and often most available method is to directly and personally interview patients. The downside of this is that these data are the most anecdotal and also the most capricious, based on the mood and mindset of the two conversants at the moment. Furthermore, when put on the spot, patients may have a natural reluctance to say what's actually on their minds for fear of the reaction or response. This point highlights the importance of phrasing specific questions in a way that, first and foremost, shows concern for the patient's time and well-being, and will typically be both the best received and the most informative. The same approach and considerations also apply to seeking input from your peers.

Focus groups can help overcome some of these biases. However, social pressures and "groupthink" are but two potential influences that can affect the results. The suggestion box is a way to get around groupthink as well as manners, but it typically motivates only the most aggrieved to respond and therefore isn't especially productive. The patient survey is generally the most accepted approach. Accordingly, it's one that has become increasingly accepted and increasingly expected within healthcare provider evaluations.

More useful, but still underdeveloped, is the concept of the trained, coordinated, and experienced "mystery shopper" who comes to your office under the guise of a new patient. The mystery shopper approach is the most balanced way to get feedback on more than just what's going wrong, as opposed to only hearing from those who leave your practice or complain. A trained, objective opinion is rare in healthcare practice assessments. To take this approach, however, you must be willing to hear the good and the bad, as the practice—and those involved in every step of patient operations—will be under a microscope. Structured services of this sort offer detailed and sophisticated evaluations because they come in with a plan and without subjective bias that's unavoidable with staff, family, or patients who are "invested" in the practice.

Trained with mental checklists, a sharpened eye for observation, and a background in marketing or public relations, mystery shoppers are capable of performing a comprehensive assessment. In addition to focusing on priority issues, they're able to see details that the accustomed eye no longer notices. If the shopper reports that your office, processes, and particularly your patient "touches"—the moments of interaction between your shopper and staff—are effective and polished, then there's no greater comfort.

Of course, in order to be effective, this "inspection" must be unannounced. If possible, it's best that you too are blinded to the shopper's identity.

However, just because the encounter will be unannounced, the content doesn’t need to be. You should review the questionnaire and protocols by which your practice will be judged. Feel free to request some specifics for the kinds of observations that are of pressing interest to you. You want an authentic assessment, but if it doesn't include your greatest concerns, then the value will be muted.

Don't be surprised if certain techniques are used in order to stress your system. A common example might involve the mystery shopper asking to move up her appointment as a special request, sometimes followed by a cancellation and request to reschedule. These and other requests aren't necessarily everyday occurrences but are ones that properly qualified, trained, and supported staff should be able to handle smoothly.

Requests to describe your credentials and qualifications can be very illuminating. Perhaps the most telling information that a mystery shopper records comes from the time spent in the waiting room, observing your patients. The conversations that the mystery shopper overhears or proactively engages in with patients constitute feedback that can't be gained so purely any other way. The shopper may choose to interrupt the charade at the point at which the physical examination begins. If this happens, preserving the illusion throughout the remainder of the check-out process is essential. Your staff's friendliness, courtesy, demonstrations of interest, professionalism, and competency will never be more genuine than in this style of evaluation.


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