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Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Patient Satisfaction and Pearls of
Practise
Docto...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Behave Professionally
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Practise management skills
Every doctor is an ent...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Patients satisfaction
Satisfied patient 3 other p...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Medical Professionalism : Deprofessionalism
Cause...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Being a doctor today is not easy
!
too much work
...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Physician motivators
Intrinsic
Serving people
Wor...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Physician : lets take lead
● Leadership – genes, ...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Patient Autonomy
Autonomy = freedom to decide
!
D...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Educating patients
Most doctors do not spend much...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Benefits of patient education :
Happier patients
...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Communication skills
“ Patients don’t care how mu...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Communication skills in clinical practice :
“Its ...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Patient education – key component
of informed con...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Start your own website !
Patients are hungry for ...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Improving Doctor-patient
relationship
Based on TR...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Become a Professional – 

Trust Equation
T = C + ...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Become a Professional – 

Trust Equation
Credibil...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
What do patients want
- Patient dissatisfaction r...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Educate All Informations to Patient
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Benefits of doctor patient communication
- commun...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Answering skills
▪ weakest communication skills a...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Barriers to communication
● Work over load on doc...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Communication
● 7% - Spoken words
!
● 38% - Voice...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
How do we fix the problem ?
Two players:
Doctors
...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Today’s Health Care System
Patient
Health 

Insur...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Patient Experience is all about
bottom line
LEAST
PROFITABLE

QUARTILE
MOST
PROFITABLE
QUARTILE
PATIENTSATISFACTION
1 2 3 ...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Patient Experience is a lot more
than clinical outcomes
How well staff worked together to care for me
Overall Cheerfulness...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Patients expectations from their
doctors ?
Expert...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Types of Patients
If you can’t measure, you can’t
manage
2 3 4 5 6 7 81 90 10
Never Absolutely
Detractor Passive Promoter
Detractors are cus...
It’s all about word of mouth
!
!
0
100
200
300
-100
-200
AVERAGE
CUSTOMER BASE
AVERAGE
CUSTOMER BASE
RETENTION
MARGINS
ANN...
What’s bad about good service
quality
A satisfied person has no story to
tell. Everything went just as
expected. It is the...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
5 Things that Matter Most to Patients
1. Doctors ...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Patients’ Expectations
• Experience + Needs + Com...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Patient Satisfaction: 

GREET Tool
GREET
– 10/5 R...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
○ Mayo Clinic conducted a research involving
192 ...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Factors Influencing Patient Satisfaction
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Balance

Patient experience = service quality + c...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Be a Committed Professional
• Staying Work-
Focus...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Good Doctor Skills
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Be you are remembered for
Principles and Integrity
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
What do doctors expect from their
patients ?
Pati...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Respect others and other
Respect you
• Respect Fo...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Having Positive Attitude -
Benefits
!
• Pleasing ...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Elements of success
Attitude
SkillKnowledge
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Be Confident
• Be confident. Others will
sense you...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Non-verbal communication
- SOFTEN
S- Smile
O - Op...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
How to talk to your doctor –

SAFEly !
Story: Sym...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
BATHE technique
B = Background. What’s going on ?...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Joy of practising medicine – how to
be a happy do...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Employees !
Can be your biggest asset – as well a...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
OPD SUBUNITS:
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Many other issues
Time management
Learning to kee...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Communicating prognosis, hope & risk
➢ Misunderst...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
● If too many anxious attendants, send them one o...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Do’s
● Patients should be attended promptly:
- Er...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Physicians should
Behave Professionally
Physician...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Don’ts
● Never argue with attendants. this
situat...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dealing with mistake
● Accept responsibility for ...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
!
Identify & avoid negative people
Positive
!
• P...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Be A Optimist
• No one likes a
constant pessimist...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Use common sense with knowledge
Knowledge Vs Wisd...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
“ The education of the doctor which
goes on after...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Upgrade the Knowledge or you
are Lost
Self-Upgrad...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
TRADITIONAL CME Vs CPD
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Practice building/Marketing
● Satisfied patients
...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Physicians: problematic spouse?
● Stage 1 -- Roma...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Marriages
● Spend time together
● Respect each ot...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!


Children
● A meal together everyday
● Fun toget...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Litigation
● Be a nice person
● Be honest
● Be op...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Make connections.
• Make connections. You
never k...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Retirement
● Don’t retire unless you have enough ...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Take home
● Let us enjoy being a doctor/physician...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Take Home
● Social capital is more important than...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Never forget Professionalism is an
important comp...
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
SUMMARY: Increase Patient Satisfaction
1.Give pat...
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Magical facts about patients satisfaction and pearls of medical practise::Doctor-Patient Relationship & Medical Professionalism dr.sandeep c agrawal agrasen hospital gondia india www.agrasenortho.com

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Magical Facts About Patients Satisfaction and Pearls of Medical Practise:Doctor-Patient Relationship & Medical Professionalism Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com
Patient Listening, Patient guide,Genuine Practise,Patient Satisfaction

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Magical facts about patients satisfaction and pearls of medical practise::Doctor-Patient Relationship & Medical Professionalism dr.sandeep c agrawal agrasen hospital gondia india www.agrasenortho.com

  1. 1. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Patient Satisfaction and Pearls of Practise Doctor-Patient Relationship & Medical Professionalism Magical Facts About Patients Satisfaction That you would die to know Dr.Sandeep Agrawal Consultant Orthopedic Surgeon MS,DNB Agrasen Hospital Gondia Maharashtra India drsandeep123@gmail.com ! www.agrasenortho.com ! 09960122234
  2. 2. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  3. 3. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  4. 4. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Behave Professionally
  5. 5. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Practise management skills Every doctor is an entrepreneur ! Needs to run a business ! These skills are never taught in medical college ! Some doctors never learn them and struggle to manage their practise
  6. 6. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Patients satisfaction Satisfied patient 3 other people ! ! Dissatisfied patient 20 others ! Satisfying unhappy patients 50 others
  7. 7. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Medical Professionalism : Deprofessionalism Causes ● Technology – Depersonarlise medicine & deprofessionalise a physician ! ● Corporatization of Medicine ! ● Specialization – Most patients identified by disease rather than human beings who happens to have disease ! ● Patients knowing limitation of modern medicine ! ● Greed
  8. 8. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Being a doctor today is not easy ! too much work too much hassle too much competition too much despair; and too little reimbursement ?
  9. 9. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Physician motivators Intrinsic Serving people Work interest Career growth Ability to support oneself & family Autonomy Empowerment Socio-cultural Respect Social rewards
  10. 10. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Physician : lets take lead ● Leadership – genes, charisma, education, wealth, luck, training, experience Ethics do right ! Reality Greatness vision Have no think big & new Illusion Courage act with sustained initiation
  11. 11. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Patient Autonomy Autonomy = freedom to decide ! Doctors need to : 1. present the options to the patients and 2. allow patients to choose for themselves ! Informed choice means patients need information
  12. 12. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Educating patients Most doctors do not spend much time educating their patients ! Primary role of a doctor should not be merely treating an illness, but helping people remain healthy Patients are the practise ! Everything else is just paper work !
  13. 13. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Benefits of patient education : Happier patients practice promoter Increase patient compliance Improve public health Overall :Helps to improve empathy Reduce risk of complications
  14. 14. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Communication skills “ Patients don’t care how much you know them, until they know how much you care”
  15. 15. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Communication skills in clinical practice : “Its an art to talk medicine in the language of a non medical men” ! ✓ separates successful doctors from unsuccessful ones ! ✓ include ability to engage with patients at emotional level, to listen, to convey information with clarity & sympathy
  16. 16. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Patient education – key component of informed consent Don’t tell the patient what to do Present the information and the treatment options – and allow them to make up their own mind ! Empower patients with information – they will respect you for this ! Information therapy - “ Prescribing the Right Information to the Right Person at the RightTime” is the best way of bridging the doctor-patient communication gap today !
  17. 17. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Start your own website ! Patients are hungry for reliable information Internet :Excellent source of information, but this can be wrong and dangerous ! Provide reliable information to your patients through your own website Very cost effective ! Think global – act local !
  18. 18. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Improving Doctor-patient relationship Based on TRUST Trust needs to be earned ! ! Patients feel exploited and believe medical profession has become crass and commercialized Doctors feel unappreciated, overworked, victimised and threatened. Foundation of the relationship
  19. 19. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Become a Professional – 
 Trust Equation T = C + R + I/ S, where T = Trustworthiness C= Credibility R= Reliability I = Intimacy S= Self-orientation
  20. 20. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Become a Professional – 
 Trust Equation Credibility =patient trust what you say ? Reliability = he trust your actions, confident that you will act honorably ? Intimacy = is he comfortable discussing his feelings and emotions with you ? Self-orientation = can he trust your motives, knowing that you care about him, and will act in his best interests ?
  21. 21. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! What do patients want - Patient dissatisfaction relate to problems of communication rather than clinical competence ! - They want ● - quality information about their problems ● - risks & benefits of treatment ● - relief of emotional distress ● - to be active participate in medical decision making
  22. 22. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Educate All Informations to Patient
  23. 23. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Benefits of doctor patient communication - communication with personal touch provides treatment beyond drugs ! - Patients more likely to comply ! - Overall quality of care & patient satisfaction improved
  24. 24. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Answering skills ▪ weakest communication skills among Indian Medical Professionals ! ▪ In Indian context patient satisfaction is largely decided by the quality of answers & explanation given by doctors ! ▪ Understand the question clearly, answer fully, & clearly but briefly ! ▪ Avoid major technical terms
  25. 25. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Barriers to communication ● Work over load on doctors ! ● Shortage of man power- less time for individual patient ! ● Lack of training in communication skills during medical education ! ● Individual attitude & personality traits ! ● Under utilization of paramedical staff
  26. 26. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Communication ● 7% - Spoken words ! ● 38% - Voice quality like Tone, Tempo, intonation ! ● 55% - Body language
  27. 27. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  28. 28. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! How do we fix the problem ? Two players: Doctors Patients ! It’s hard to change anyone else – you can only change yourself !
  29. 29. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Today’s Health Care System Patient Health 
 Insurance Government ! ! Information Overload Media Doctor
  30. 30. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  31. 31. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  32. 32. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  33. 33. Patient Experience is all about bottom line LEAST PROFITABLE
 QUARTILE MOST PROFITABLE QUARTILE PATIENTSATISFACTION 1 2 3 4 82.2 83.5 83.7 84.3 ! In research conducted by Press Ganey, hospitals were divided into four groups (quartile) based on their profitability. ! The least profitable hospitals had the lowest patient satisfaction scores (out of 100 points). The most profitable had the highest patient satisfaction ! ! Source: HFM Magazine, 2008 : Looking to improve financial results ? Start by listening to patients : By: Melvin F Hall PhD As patient satisfaction increased, the average hospital profitability increased Without a quantifiable link to profits, the push for patient satisfaction is based on nothing more than the moralistic view that “it’s nice to be nice”
  34. 34. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  35. 35. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  36. 36. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  37. 37. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  38. 38. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  39. 39. Patient Experience is a lot more than clinical outcomes How well staff worked together to care for me Overall Cheerfulness of the Hospital Response to concerns/complaints made during my stay Amount of attention paid to my personal and specific needs Staff sensitivity to the inconvenience of hospitalization How well nurses kept me informed Staff’s effort to include me in decisions about my treatment Nurses attitude towards my requests Skill of the nurses Friendliness of the nurses Press Ganey Satisfaction Report , August , 2003 0.79 0.74 0.68 0.65 0.65 0.64 0.64 0.64 0.63 0.62 When hospitals spend most of their efforts in clinical results & process improvement, their data are defined by outcomes and thus can be measurable objectively. ! ! Patient however, judge quality by his/ her perceptions, something that is subjective and cannot be verified in the same way as outcome. !
  40. 40. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Patients expectations from their doctors ? Expertise ( be well-informed and uptodate) ! Professionalism – look out for the patient’s best interests ! Accountability – be answerable; say Sorry ( if there is a mistake) ! Transparency – no unnecessary tests and referrals ! Respect their desires and their time ! Treat them as intelligent human beings
  41. 41. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Types of Patients
  42. 42. If you can’t measure, you can’t manage 2 3 4 5 6 7 81 90 10 Never Absolutely Detractor Passive Promoter Detractors are customers with the lowest rates of repurchase and referrals. Detractors spread negative word-of-mouth comments about the company Passively Satisfied customers stay with a company more due to inertia than true loyalty Promoters have the highest rates of repurchase and referral. THE NET PROMOTER SCORE
  43. 43. It’s all about word of mouth ! ! 0 100 200 300 -100 -200 AVERAGE CUSTOMER BASE AVERAGE CUSTOMER BASE RETENTION MARGINS ANNUAL SPEND COST TO SERVE Economic benefits NEGATIVE WORD OF MOUTH ! COST TO SERVE ANNUAL SPEND ! MARGINS !RETENTION Economic penalties Patients who spoke bad Patients who spoke good POSITIVE WORD OF MOUTH Each one point decrease in satisfaction is associated with a 6% increase in complaints Stelfox, et. al. (2005) AJM 118
  44. 44. What’s bad about good service quality A satisfied person has no story to tell. Everything went just as expected. It is the unexpected event that makes a stay memorable. ! For every loyal customer, there is usually a special story ! Fred Lee , Author of award winning book If Disney Ran Your Hospital Touch Point 1 Touch point 2 Touch point 3 Touch point 4 Touch Point 5 Touch Point 6 Touch Point 7 TOUCH POINTS What made them feel bad and at which touch point? What created tears of joy and at which touch point did that happen ?A good story to tell A bad story to tell Satisfied Person Hyper Satisfied Person Dissatisfied Person
  45. 45. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! 5 Things that Matter Most to Patients 1. Doctors treat patients with courtesy and respect. 2. Doctors explain the facts in a way that patients can understand. 3. Doctors, nurses, and other hospital staff do everything they can to help patients with their pain. 4. The hospital room and bathroom are kept clean. 5. Patients get information in writing about symptoms or health problems to look for after they leave the hospital.
  46. 46. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Patients’ Expectations • Experience + Needs + Communication = Expectation ! – If Perception exceeds expectations: Satisfaction ! – If Expectations are less than perception: Dissatisfaction
  47. 47. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Patient Satisfaction: 
 GREET Tool GREET – 10/5 Rule: At 10 feet acknowledge; at 5 feet greet/speak – Call patient by name (If known) – Make eye contact , Smile – Let the patient(s) know they are important RECOGNIZE – Welcome them to Hospital – State your name, department, & role in the patient’s care EXPECTATIONS/EXPLAIN – How long a procedure or test will take & why… – How long a patient should be expected to wait before getting results & why… EDUCATE – Explain the role of medical staff involved in providing care – Explain if the test or procedure will cause pain or discomfort, or if any post procedure instructions are necessary – Offer to answer any other questions, concerns, or resolve any complaints… you do have the time THANK YOU – Let your patient & family members know “Thank you for choosing me for you healthcare needs!” – Exercise courtesy by using words “Please” and “Thank You” in conversions
  48. 48. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! ○ Mayo Clinic conducted a research involving 192 patients and conclude that a model doctor should be:>> EXPECTATION OF PATIENT FROM DOCTORS ○ CONFIDENT ○ EMPATHETIC ○ HUMANE ○ PERSONAL ○ FORTRIGHT ○ RESPECTFUL ○ THOROUGH
  49. 49. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  50. 50. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  51. 51. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  52. 52. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Factors Influencing Patient Satisfaction
  53. 53. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Balance
 Patient experience = service quality + clinical quality Service Quality Clinical Quality Interpersonal skills/ Communication • Engagement • Empathize • Educate • Enlist Clinical Knowledge/ skills • Find It • Fix It Adapted from Institute for Healthcare Communication Process Skills • Technology • Process Improvement • Care Coordination Patient Experience

  54. 54. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  55. 55. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Be a Committed Professional • Staying Work- Focused. Not letting your private life needlessly have an impact on your job, and not spending time at work attending to personal matters.
  56. 56. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Good Doctor Skills
  57. 57. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Be you are remembered for Principles and Integrity
  58. 58. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  59. 59. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  60. 60. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! What do doctors expect from their patients ? Patients will: ! • Treat Doctor with respect • Will say “Thank You” when things go well • Will have realistic expectations of treatment • Will not unfairly blame doctor anytime there is a problem • Will pay their professional fees promptly and gracefully
  61. 61. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Respect others and other Respect you • Respect For Others. Treating all people as if they mattered is part of your approach.
  62. 62. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Having Positive Attitude - Benefits ! • Pleasing personality ! • Energizing ! • Inspiring ! • Problem Solving ! • Increase work output ! ! - 85% Attitude - 15 % Intelligence & knowledge of specific facts $ figures
  63. 63. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Elements of success Attitude SkillKnowledge
  64. 64. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Be Confident • Be confident. Others will sense your confidence when they see or meet you, and they will think better of you. Also, if you always wear a sly smile, like there is a joke you get but no one else does, people will think you are above them in your knowledge
  65. 65. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Non-verbal communication - SOFTEN S- Smile O - Open posture F- Forward lean T – Touch. This is a privilege – use it ! E – Eye contact N - Nod Polish your bedside manner How to perfect non verbal signal
  66. 66. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! How to talk to your doctor –
 SAFEly ! Story: Symptoms Assessment: Problem Fears: Overcome Patients fears by Discussion Expectations: What patient want from doctor ? Patients don’t care how much you know – until they know how much you care !
  67. 67. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! BATHE technique B = Background. What’s going on ? A = Affect. Feelings. What do you feel about it ? T = Troubles. What troubles you about this ? H = Handle. How are you handling this ? E = Empathy. It must be hard.
  68. 68. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Joy of practising medicine – how to be a happy doctor When it comes to getting positive feedback, no profession in the world comes close to medicine !
  69. 69. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Employees ! Can be your biggest asset – as well as your biggest problem ! Keep your employees happy, and they will keep your patients happy Don’t skimp on their salaries Train them well Key test – how well does your clinic run when you are not there ?
  70. 70. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  71. 71. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! OPD SUBUNITS:
  72. 72. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  73. 73. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Many other issues Time management Learning to keep upto date How to buy medical equipment How to keep medical records How to grow and expand Balancing family and career Retiring Ethics
  74. 74. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Communicating prognosis, hope & risk ➢ Misunderstandings in these areas can lead to patient dissatisfaction & litigation ! ➢ Prognostication is like weather forecasting uncertain but based on sound scientific principles Stage of illness at presentation of patient! Curability of disease! ! ➢ In face of uncertainty there is nothing wrong with providing hope ! ➢ Provide evidence based risks ! ➢ Never create guilt for negligence on part of patient
  75. 75. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! ● If too many anxious attendants, send them one or another job. eg. Bringing medicines, arranging blood- Energy utilization ! ● Never argue with attendants ! ● Argument will trigger them, at the same time your calmness and promptness will even calm down a triggered person. ! ● If patient is sick, attend patient periodically and talk to attendants. ! ● Check emergency tray for drugs. ! ● Try to solve/resolve crisis immediately Do’s
  76. 76. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Do’s ● Patients should be attended promptly: - Error in Decision making is Excusable but not attending patients timely is not. ! ● Identify a Prominent Person: - Important person/relative and explain initial assessment of patient immediately. - Explain them management has started. ! ● Ask if they have any questions ! ● Call senior consultant as per requirement, talk to them telephonically if possible delay in arrival.
  77. 77. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Physicians should Behave Professionally Physicians are capable of acting unprofessionally, but cannot act unethically, as ethical standards are part of their profession. Therefore, it behoves all patients to educate themselves on what constitutes  “professional”   and  “unprofessional”   behaviour for those involved in health care. -
  78. 78. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Don’ts ● Never argue with attendants. this situation teaches you how to remain calm in provocative circumstances. No book in the world can teach this. ! ● Never overlook a call, especially if call is by a attendant.
  79. 79. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Dealing with mistake ● Accept responsibility for the mistake ● Discuss with trusted friend, colleague or spouse ● Disclose & Apologize to the patients ● Error analysis ● Measures to reduce similar mistake in future
  80. 80. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! ! Identify & avoid negative people Positive ! • Part of the answer ! • Has Program ! • Let me do it for you ! • Difficult but possible ! • I must do something ! • See the gain ! • See possibilities. ! • Hard arguments, Soft words Negative ! • Part of the problem ! • Has excuse ! • Its not my job ! • Possible but to difficult ! • Something must be done • See the pain ! • See problem. ! • Soft arguments, Hard words
  81. 81. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Be A Optimist • No one likes a constant pessimist. Having an upbeat attitude and trying to be a problem- solver makes a big difference.
  82. 82. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Use common sense with knowledge Knowledge Vs Wisdom • Knowledge - Piling up facts Wisdom - Simplifying it ! •Knowledge - Potential power Wisdom - Real power ! • To attain knowledge - Add things everyday To attain Wisdom - delete things everyday ! ! !
  83. 83. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! “ The education of the doctor which goes on after he has his degree is the most important part of his education” John Shaw Billings Keeping updated : Managing knowledge
  84. 84. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Upgrade the Knowledge or you are Lost Self-Upgrading. Rather than letting your skills or knowledge become outdated, you seek out ways of staying current.
  85. 85. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! TRADITIONAL CME Vs CPD
  86. 86. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Practice building/Marketing ● Satisfied patients ● Volunteering at community medical service. ● Organizing an event – like conference ● Attracting Media attention ● Contributing article on health to magazine ● Public lecture ● News letter ● Website ● Marketing to referral base
  87. 87. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Physicians: problematic spouse? ● Stage 1 -- Romance – you are perfect ● Stage 2 -- Fault finding ● Stage 3 -- Blaming ● Stage 4 -- Acceptance ● Transformation – Growing together
  88. 88. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Marriages ● Spend time together ● Respect each other ● Have fun together ● Treat your spouse as your most important VIP patient -- A loved spouse is also loving spouse
  89. 89. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! 
 Children ● A meal together everyday ● Fun together once a week ● One holiday every year together ● Make sure children meet grand parents, relatives periodically ● Help children honour family traditions
  90. 90. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Litigation ● Be a nice person ● Be honest ● Be open ● Be accessible ● Keep up to date professionally ● Insurance How to reduce chances of litigation
  91. 91. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Make connections. • Make connections. You never know when you'll need to call in a favour from someone to get the job done help in your crisis moments, so it pays to know the right people.
  92. 92. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Retirement ● Don’t retire unless you have enough financial security ● Studies-Retirement has Predominantly positive impact on emotional state ● Explore you hobbies ● Explore your spirituality ● Serve other selflessly-do charity work/volunteer work ● Physical activity/light exercise
  93. 93. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Take home ● Let us enjoy being a doctor/physician, let us work for joy of working, nor for a home, car or vacation ! ● Don’t find faults in medicine, Identify happy doctor & follow their secrets ! ● Lets love what we do, and do what we love ! ● Watching dying patients should remind us about our own mortality enabling us to live each day well.
  94. 94. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Take Home ● Social capital is more important than financial capital at end of the day. ! ● Work & practice with Medical professionalism ! ● Use common sense. Identify local socio-cultural practices & integrate in your working style ! ● People prefer those doctors with average clinical skills but good communication skills rather than those with excellent clinical but poor communication skills
  95. 95. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  96. 96. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  97. 97. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  98. 98. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Never forget Professionalism is an important component of Medicine Professionalism is an important component of medicine's contract with society. Not only do we need to make good decisions for our patients based on the evidence in the literature, but we need to apply those decisions in a way that is professional and ultimately helps our patient
  99. 99. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  100. 100. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! SUMMARY: Increase Patient Satisfaction 1.Give patient your full attention 2. Build partnership with the patient 3. Maintain positive Attitude! 4. Respect patients privacy! 5. Handle complaints effectively 7. Practice good bedside manners 6. Listen to your patients
  101. 101. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! This presentation is for  doctors and students in general. . Graphics,Images and jpeg files are taken from Google and yahoo  Image  to heighten the specific points in this presentation.  • If there is any objection/or copyright violation, please inform drsandeep123@gmail.com for prompt deletion.  • It is intended for use only by the doctors of orthopaedic surgery. . Views expressed in this presentation are personal. • .For any confusion please contact the sole author for clarification.  • Every body is allowed to copy or download and use the material best suited to him.  There is no financial involvement.  • For any correction or suggestion please contact drsandeep123@gmail.com or www.agrasenortho.com

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