Physician Productivity
vs. Patient Satisfaction:
Not Quite a Conundrum
Dylan J. Chadwick
Physicians Office Resource
Staff Writer
O
verall, the “Triple Aim” approach to
the improvement of healthcare is
sound. In accordance with the
concept, physicians are to provide the
highest level of care, patients are to
have the best possible healthcare
experience and the service itself is to be provided at the
lowest cost. While the last corner in the Triple Aim
triangle is a continuing challenge for physicians (and
politicians), this article will focus on the first two, that
of physician productivity and of patient satisfaction.
In a Permanente Journal article entitled Patient
Experience and Physician Productivity: Debunking the
Mythical Divide contributors describe a
preconception which many physicians hold when it
comes to “Triple Aim” healthcare as a zero-sum game.
That is to say that, for many physicians, the concepts
of “patient satisfaction” and “physician productivity”
operate like disproportionately weighted participants
on a see-saw. Any improvement in one area leads to
an overall dis-improvement in another area and vice
versa. Essentially, improvement in one area can only
come at the expense of another.
A 2012 study conducted by HealthPartners Inc. (St
Paul, MN) took this popular physician apprehension to
heart as they constructed a study which charted groups
of physicians in four specialty departments (podiatry/
foot and ankle surgery, gastroenterology, general surgery
and vascular surgery) and sought to find correlative
behaviors between physicians with “strong” levels of
productivity and those with “strong” levels of patient
satisfaction. All of the studied physicians worked in a
similar environment and under similar conditions, for
example, all studied physicians in the field of
gastroenterology saw the same kinds of patients, had
similar workloads and had the same type of facility and
support staff. Though admittedly small in scope relative
to the entire healthcare landscape in the country, the
study did find some key correlations between physician
behavior and patient satisfaction, and found that the two
end goals aren’t necessarily mutually exclusive.
Productivity Hold-Ups
In her TalkChart article 5 Biggest Barriers to
Physician Productivity (Surprise: They’re Not All
Electronic Medical Charting) Andrea Jacques outlines
some of the most frustrating physician “bottlenecks”
which put an efficient practice in a daily stranglehold.
These obstacles range from so called “schedule busters”
in which a steady stream of attention-needing walk-in
patients throw off a tightly planned schedule to that of
time-intensive patient encounters. For example, seeing
elderly patients may take a physician much longer to
visit with than a young adult, and if there’s a steady
stream of elderly patients, it can have a tremendous
effect on a physician’s level of productivity.
Other factors, like the patient panel size, general
workflow obstacles which can come up (such as a
new electronic medical records system) and the
general disruption of time-consuming, yet
important, established routines, can all chew into a
physician’s overall productivity, and require much
time and effort to handle.
When it comes to a quick fix or an easy cure-all for
productivity woes, Jacques simply says “there isn’t one.”
The fact is, there will always be changes and variables
in the day to day workings of a practice, and there’s no
sure-fire way to prevent anything from going awry.
Streamlined efficiency and productivity is often
achieved only after time and a careful evaluation of end
goals and some on-the-job practice. However, this isn't
to say that the end goal of upping both patient
satisfaction and physician productivity is hopeless.
Scatterplot
This isn't to say that the end goal of upping two
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