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  • Input desired (patient satisfaction scores)

    I am a pulmonologist. In the last year my patient satisfaction scores have dropped from the 90s to the 70s. The negative feedback from patients is predominantly related to my somewhat aggressive but always respectful recommendation to get vaccinated for COVID-19.

    My question is how much should I care? How much should I care about my satisfaction scores, vs how much should I care about pushing the vaccine? Do I have a duty to advise my patients to get vaccinated, and attempt to correct the rampant misinformation in my patient population and continue to engage my patients? OR Should I just say, "you should get the vaccine if you haven't already" and then move on?

    I know this isn't really about investing, but this is the best and most efficient way for me to get the advice from other physicians. Thank you in advance.

    Ryan


  • #2
    i wouldn't care about this even a little bit.

    i find these arguments that the unvaxed need to be treated w/ kid gloves and not made to feel upset totally idiotic. it begs the question that if a doctor was just nice and respectful they would roll up the sleeve. in reality everyone that i know who is unvaxed at this point is just waiting for someone to ask them about it and are spoiling for a fight.

    it's such a toxic dichotomy we are living with right now
    otoh i am a tough, free thinking, self made citizen who is part of the real old fashioned backbone of this country
    otoh please don't say anything that i disagree with or me fee-fees will be hurt

    give me a break.

    you're doing your job, just like when you tell them to quite smoking.

    Comment


    • #3
      Do what you think is right. My policy regarding vaccines, for the most part, is the same as that involving patient care in general: I can only care as much as you care. In pediatrics, you might need to care more, esp when it comes to neglect, etc. Seems more clear cut in adults. 'I believe this will increase your chance of surviving COVID, you're free to make your own decisions.'

      Of course what MPMD said can be turned around onto progressives as well, on topics such as the free-floating militant agnosticism of all values and norms. There's a reason there's so many adolescent girls who believe they are boys, and there's a reason that the only 'treatment' that is accepted is so-called 'affirmative care' - please go right ahead and start menopause, flirt with infertility, and we'll help you disfigure yourself permanently, setting you up for a lifetime of continued misery, because you misplaced the source of your mental distress, and we're too chicken, intellectually and morally, to take a stand.

      Comment


      • #4
        Originally posted by MPMD View Post
        i wouldn't care about this even a little bit.

        i find these arguments that the unvaxed need to be treated w/ kid gloves and not made to feel upset totally idiotic. it begs the question that if a doctor was just nice and respectful they would roll up the sleeve. in reality everyone that i know who is unvaxed at this point is just waiting for someone to ask them about it and are spoiling for a fight.

        it's such a toxic dichotomy we are living with right now
        otoh i am a tough, free thinking, self made citizen who is part of the real old fashioned backbone of this country
        otoh please don't say anything that i disagree with or me fee-fees will be hurt

        give me a break.

        you're doing your job, just like when you tell them to quite smoking.
        I don’t disagree with anything you said, but I do also feel like, right or wrong, after I’ve engaged in a discussion with an antivaxxer, I’ve lost them. Maybe not as a patient. But I’ve lost them as a teammate in their care. I forfeit the ability to help them with the actual reason they came to see me.

        Comment


        • #5
          Is your clinical income tied to patient satisfaction score?

          Comment


          • #6
            Originally posted by FunkDoc83 View Post
            Is your clinical income tied to patient satisfaction score?
            Minimally. A certain percentage of an end of year bonus is related to patient satisfaction scores. I’ve not done the math but I can’t imagine we are talking about more than two or three thousand dollars / year.

            But that’s not really why it bothers me. As I described above it bothers me because after one of these discussions I feel the doctor-patient relationship is forever fractured.

            Comment


            • #7
              Originally posted by RJB View Post

              I don’t disagree with anything you said, but I do also feel like, right or wrong, after I’ve engaged in a discussion with an antivaxxer, I’ve lost them. Maybe not as a patient. But I’ve lost them as a teammate in their care. I forfeit the ability to help them with the actual reason they came to see me.
              I've had a lot of conversations regarding vaccines, and other aspects of the medical system, and the distrust that some people have of the system. I also have some degree of distrust, and I echo this in talking to parents, but I also acknowledge that we might be at odds. I think in acknowledging that, it's easier to keep trust. But again, I don't consider myself a 'teammate in their care' - someone might unload their life story on me and I'll listen and empathize as a human being, because that's what we're in together -- our humanity. Everything else, including healthcare - you're on your own, I'm just here to help. 'Help me help you' - or don't.

              "I think you're wrong about this - I wouldn't push you on it if I didn't believe it would benefit you." Ultimately, it's a question of whether they can believe/trust you as a human being. If they can't, so be it - this will not be the only wedge in your relationship if so.

              Comment


              • #8
                Satisfaction scores are dumb. If you have a score approaching 100% I will suspect you to be either a pill mill or someone who give abx to everyone who is sick and Adderall to everyone who is tired and fat.

                You can be compassionate and still provide good care. It is hard sometimes. But we have to have the thicker skin to do what is right!

                RJB are you a parent? Think of it like your kids. Sometimes you have to do things that they do not like for their own good. Choose your battles but you are ultimately the boss.

                Comment


                • #9
                  Patient "satisfaction" caused the opioid epidemic.

                  My approach now to Covid vaccines. I ask all high risk patients if they have had it (if I can't see in the EMR they already have). Typically pretty clear which unvaccinated patients have reasonable misgivings and want to talk about it in an intelligent manner vs the nut jobs. I will have a discussion with the ones about it that are reasonable. The ones that start saying the crazy stuff I cut off and end it with saying I still recommend it as prevents hospitalizations and deaths. Most of those don't return to me, but I feel that is a win for my personal clinic.

                  Comment


                  • #10
                    I always looked at patient satisfaction as if it is a free world, that if patients are not satisfied, they can go else where.

                    Comment


                    • #11
                      Originally posted by Lordosis View Post
                      Satisfaction scores are dumb. If you have a score approaching 100% I will suspect you to be either a pill mill or someone who give abx to everyone who is sick and Adderall to everyone who is tired and fat.

                      You can be compassionate and still provide good care. It is hard sometimes. But we have to have the thicker skin to do what is right!

                      RJB are you a parent? Think of it like your kids. Sometimes you have to do things that they do not like for their own good. Choose your battles but you are ultimately the boss.
                      I am always as respectful and caring as possible, but I have no issues talking to my patients about obesity and smoking. Some of them don't like it, but it rarely leads to negative reviews and comments. I think there is something deeper with the vaccine. I just wonder if it is the "hill I want to die on" so-to-speak. I could spend 85% of a visit taking a great detailed history and formulating a big differential and diagnostic / treatment plan and really have the potential to make an impact on a patient's care, but if I lose them with a spirited debate about the vaccine, have I really been the best doctor I could have been?

                      Comment


                      • #12
                        Originally posted by Random1 View Post
                        I always looked at patient satisfaction as if it is a free world, that if patients are not satisfied, they can go else where.
                        I am always as respectful and caring as possible, but I have no issues talking to my patients about obesity and smoking. Some of them don't like it, but it rarely leads to negative reviews and comments. I think there is something deeper with the vaccine. I just wonder if it is the "hill I want to die on" so-to-speak. I could spend 85% of a visit taking a great detailed history and formulating a big differential and diagnostic / treatment plan and really have the potential to make an impact on a patient's care, but if I lose them with a spirited debate about the vaccine, have I really been the best doctor I could have been?

                        Comment


                        • #13
                          Originally posted by Sampter View Post
                          Patient "satisfaction" caused the opioid epidemic.

                          My approach now to Covid vaccines. I ask all high risk patients if they have had it (if I can't see in the EMR they already have). Typically pretty clear which unvaccinated patients have reasonable misgivings and want to talk about it in an intelligent manner vs the nut jobs. I will have a discussion with the ones about it that are reasonable. The ones that start saying the crazy stuff I cut off and end it with saying I still recommend it as prevents hospitalizations and deaths. Most of those don't return to me, but I feel that is a win for my personal clinic.
                          I am always as respectful and caring as possible, but I have no issues talking to my patients about obesity and smoking. Some of them don't like it, but it rarely leads to negative reviews and comments. I think there is something deeper with the vaccine. I just wonder if it is the "hill I want to die on" so-to-speak. I could spend 85% of a visit taking a great detailed history and formulating a big differential and diagnostic / treatment plan and really have the potential to make an impact on a patient's care, but if I lose them with a spirited debate about the vaccine, have I really been the best doctor I could have been?

                          Comment


                          • #14
                            I'm still holding out hope that the pandemic would permanently kill patient satisfaction scores. I haven't heard the term 'Press Ganey' in the ED in almost two years. I suspect they'll rise back up from the grave but I can't think of anything outside of the Joint Commission that is more useless than patient satisfaction scores.

                            Comment


                            • #15
                              Originally posted by RJB View Post

                              I don’t disagree with anything you said, but I do also feel like, right or wrong, after I’ve engaged in a discussion with an antivaxxer, I’ve lost them. Maybe not as a patient. But I’ve lost them as a teammate in their care. I forfeit the ability to help them with the actual reason they came to see me.
                              Do you have a trusted teammate, clerk, nurse, who can play the role of an antovaxxer, while you do your spiel, and then give you feedback? Maybe you're coming across too... stridently. Just like we don't berate our patients who smoke, or are obese, or don't exercise, there's probably a way to engage civilly about this issue, meeting your obligations as a physician but not being a jerk.

                              It's commendable that you've even thought to ask about this, rather than just immediately brushing it off as BS.

                              Comment

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