A study in the May issue of the Journal of Hospital Medicine1 may give hope to physicians and the hospitals where they work that they can learn the skills needed to improve the scores related to their interactions in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys.

The study used a variety of interventions to educate internal medicine residents on patient communication and satisfaction. Initially, they attended a communication conference and had real-time access online to the scores they received from patients. But the study authors found that those scores were reviewed only a couple times a year with supervisors, so they started directly emailing the results to both the physicians and their supervisors. In addition, there were three residents chosen each month for their standout performance on the surveys, which came with a small reward of passes for a movie and certificates for popcorn during the film.

Over the course of the year during which the project ran, the percentage of patients who responded positively to the three HCAHPS questions related to physician interactions increased by 8.1%, and the number of patients who said they would definitely recommend the hospital to friends and family increased by 7.1%.

The three questions are:

• Did your doctors explain things understandably?

• Did your doctors listen carefully?

• Did your doctors treat you with courtesy and respect?

The latter two questions had improvements that neared statistical significance, but the authors say it was the improvement in the first question that drove the overall improvement into statistically significant territory.

The authors postulate that having regular email coming to the physicians about patient satisfaction kept it front of mind, as did having a sense of competition. Previous work found little evidence that training sessions longer than what the doctors in this study participated in have much impact on patient satisfaction scores, so they discount the impact of their educational conference. It could be a matter of all the elements together, they note.

Given the increasing dollars that are at risk for hospitals that don’t do well in patient satisfaction, they suggest that training physicians in this area is a relatively inexpensive way to limit that risk.


  1. Banka G, Eddington S, Kyulo N, et al. Improving patient satisfaction through physician education, feedback, and incentives. Journ Hosp Med. May 2015. 10.1002/jhm.2373.