Don’t try to do a patient survey on your own

Takeout is better than homemade, say experts

Most practice administrators agree that you should conduct patient satisfaction surveys. And most could get their physicians and boards to agree to spend some money on one. But there are increasingly compelling reasons for outsourcing the surveys and paying an expert to write, conduct, and interpret the surveys.

Managed care organizations (MCOs) are becoming more insistent that you do surveys, says Rebecca Anwar, PhD, president and CEO of the Philadelphia consulting firm The Sage Group. "MCOs are very interested in patient satisfaction," she says. If your practice isn’t involved in managed care yet, this is a way to position yourself for that eventuality. "You can show MCOs that you are already involved in it."

If you are in a heavily managed care environment, doing a survey is a way to make sure that patients are happy, she explains. "You can be ahead of the game when the MCOs do their surveys. You won’t be surprised by the results. And if you need to, you can clean up your act before they survey your patients."

MCOs are less likely to take your efforts seriously, though, if you do the survey yourself, she adds, and the National Committee for Quality Assurance mandates that they be done by a third party.

Stan Joseph, president of the Atlanta-based consulting firm Cowan & Joseph, says that having someone in your organization take charge of such a project is looking for trouble. "They can’t be objective. There are also political issues. It’s hard to get staff to forget about their bosses when they do surveys. And it’s hard to honestly and objectively analyze your practice from the inside out. Your best bet is to hire someone to do it for you."

Anwar gives another reason: "Surveys that are done incorrectly are meaningless," she says. "You have to understand research methods, and most practice administrators aren’t trained in that area." (For more on various survey methods, see related story, p. 37.)

Without that training, she adds, you are likely to introduce biases of all kinds — from the construction of the survey instrument, to the sample selection, to survey administration, to analysis and interpretation. "You can’t just get a survey instrument and use it," she says. "There are unique aspects to every practice. These surveys are good starting points, especially if they have been beta tested and validated. But they have to be customized to the specific practice to get the most out of it. A family practice with one practitioner would be different than a 20 doc multispecialty practice."

The problem for a practice looking for someone to conduct a survey is that, unlike the medical profession, being a consultant doesn’t require any credentials. "There are good consultants and bad ones," says Joseph.

The best starting point to find someone is to ask colleagues who they have used, ask for references, and follow up on them, he says. You should also ensure that the people who will do the survey have worked with the medical profession before, and more specifically, that they have experience with practices like your own.

(For more information on how to pick an outside consultant, see Physician’s Marketing & Management, September 1997, p. 123.)

Joseph says you should look for a consultant who won’t just do the survey, but will provide advice on how to correct any problems the surveys uncover. "The docs want honesty from me. They want answers and action steps," he says. "You can go to any research company to get data. What you want is answers."

Anwar says the National Association of Healthcare Consultants in Washington, DC, can help you find consultants in your area who have experience helping medical practices. (See sourcekit, p. 37, for contact information.)

Once you narrow your choice, you should ask consulting firms about their processes and review a sample report. If a firm is unwilling to provide a sample, that should be a warning, she says.

The cost of a good survey will differ from community to community and practice to practice, consultants say. "It depends on who is doing it," says Joseph. He says a price of $5,000 to $10,000 is realistic. That would include the survey, the analysis, and some travel expenses. Anwar puts the price for a typical two physician practice at around $3,500.

A giant step forward

Convincing your physicians to spend the money may seem daunting task, but Anwar says it’s easy once they understand the importance of patient satisfaction to a growing practice. "If you turn patients off, you have to know because it affects the bottom line. If you are doing well, you want to know that, too, because it can be a real morale booster."

There is something wrong with a practice that can’t take the results of the survey and implement changes that will either save you the cost of the survey or give you a way to earn the cost of the survey through additional fees, Joseph says. "There are a lot of practices out there that earn $20 million per year. How many other businesses of that size don’t have directors of sales and marketing that are always concerned with customer satisfaction?"

Joseph says practices that opt to do a comprehensive patient satisfaction survey are "taking a psychic leap. They are going from telling patients what they need to asking what the customer wants. It might be hard to convince doctors that patients can also be customers. They are used to being in the position of sage.’ But now patients can click a mouse and find out more about myocardial infarction than a doctor can tell them in a 10 minute appointment. Patients are more educated and insistent on getting good service."

Practices, he says, must change or fail.

Most of all, says Anwar, you should see your choice — and the results — as an opportunity. "This is not destructive criticism, but a constructive critique. Remember that."  

National Association of Healthcare Consultants, Washington, DC. Telephone: (800) 313-6242.

Cathy Casali, Director, Rhode Island Primary Care, Warwick, RI. Telephone: (401) 781-7810.

Randy Hutchison, Administrative Director, Penn State Geisinger Health System, Danville, PA. Telephone: (717) 271-6358.

Preston Ribnick, MS, President, Professional Resources, South Wellfleet, MA. Telephone: (800) 836-1805.

Vance Chunn, MHA, FACHE, Executive Director, Cardiology Associates, Mobile, AL. Telephone: (334) 607-9797.

Stan Joseph, Cowan & Joseph, Atlanta. Telephone: (770) 395-9255.

Rebecca Anwar, PhD, President and Chief Executive Officer, The Sage Group, Philadelphia. Telephone: (215) 247-9334.