• AHAP Inc.

How do you ensure your primary care patients stay in your system

Hospital and healthcare executives have a lot to focus on: patient volume, revenue and costs, physicians, specialists and staff, facilities, third-party billings, regulations, and medical technology— a list that keeps on growing. It’s a lot to also pay attention to patient satisfaction. Still, hospitals survey millions of patients each year in hopes of finding a better way to serve them, from assessing communication and pain management to food, cleanliness, and noise levels. But those surveys typically measure inpatient satisfaction—not the happiness of health system[1]based primary care patients. There is data out there, and unfortunately, it’s not pretty. Only 58 percent of patients in traditional primary care practices are satisfied with their doctor-patient relationship.1 Patients are increasingly willing to leave their primary care physician to seek care at alternative sites like urgent care centers and minute clinics.


The Patient as Consumer


What your patients actually want out of the healthcare experience

As much as we try not to, it’s easy to think of patients as charts, procedures, copays, and billable visits. That’s part of practicing volume medicine. But patients have different expectations about how care should be delivered. When those expectations aren’t met, just like any other service segment, they will go somewhere else for care.


Consumer-driven Healthcare


Forty years ago, patients were concerned about a physician’s competence and personal qualities, like bedside manner5 Those dynamics haven’t changed patients still prefer doctors with whom they have good relationships, according to a study of patient reviews.6 But they’re also looking for conveniences and time with their physician. With today’s complex health system and regulatory framework, it’s hard to develop good relationships in the brief time many primary care physicians spend with their patients. And an hour-long wait for a 10-minute appointment doesn’t put patients in the best of moods.


Primary Care Visits Decline


While visits to primary care doctors plummeted during the coronavirus pandemic, they were declining rapidly before. In fact, nearly half of insured adults had no primary care visits, according to a study published in February 2020 in the Annals of Internal Medicine. 8 The study’s authors suggest one of the reasons is that adults are finding more convenient service from urgent care centers, among other primary care deterrents. If you’re counting on your primary care patients to deliver down-channel revenue through other procedures, a poor primary care experience in your clinics may send them to an urgent care clinic—which may send them elsewhere for more advanced care.


An Issue of Loyalty


The younger patients are, the less likely they are to be loyal to a primary care doctor. That’s partly because younger patients have fully adopted a consumer mentality. Gen-Xers, Millennials and Gen-Zers are more apt to use urgent care to supplement primary care. But even Boomers, who generally prefer to receive their primary care at a hospital or medical clinic they’re already familiar with, aren’t particularly loyal, especially if the healthcare experience is poor. They’re not willing to wait days for an appointment, for example.9 Increasingly, they are willing to go elsewhere for care.


Almost half of Baby Boomers are dissatisfied by the primary care experience, according to an MDVIP/IPSOS survey.10 They cite waiting times (often longer than the appointment duration), time with their physician and their ability to get an appointment for their dissatisfaction, conditions exacerbated by today’s volume primary care practices.

What do Boomers, the number one consumers of healthcare, want from a primary care doctor? They want visits that don’t feel hurried, a kind and compassionate bedside manner and a partner who focuses on prevention and wellness, not just sick care. Bottom line: Patients want this model and are willing to pay for it.


Patients leave primary care practices for a variety of reasons. Sometimes they leave because they’ve moved, or the office has moved. Sometimes they leave because the physician no longer accepts their insurance. But the top two reasons patients leave— for better treatment and better service. They’re more than twice as likely to leave a practice to get better service than if the physician stopped taking their medical insurance.13 Better service covers a lot of territory: wait times, staff interactions, convenience, communication, and the ability to make an appointment with ease. In one recent study, 35 percent of all patients had left a practice in the last two years—and 20 percent of Baby Boomers, the biggest spenders on healthcare, planned to if things didn’t improve; 44 percent of Xers and Millennials say they would change.14 These numbers aren’t a surprise—only 42 percent of Boomers and 32 percent of Xers were completely satisfied with their PCP in the same survey.


By MDVIP a membership-based healthcare based in Boca Raton, FL (As published online with BECKER’S Hospital Review)


SOURCES:

1 https://openpublichealthjournal.com/contents/volumes/V8/TOPHJ-8-1/ TOPHJ-8-1.pdf

5 https://www.sciencedirect.com/science/article/abs/pii/S0271712380800320

6 https://www.beckershospitalreview.com/quality/survey-patient-satisfaction-may-depend-on-bedside-manner-more-than-medical-skill.html

8 https://www.acpjournals.org/doi/10.7326/m19-1834

9 https://www.advisory.com/en/topics/consumerism/2020/04/different-generations-primary-care

10 https://www.mdvip.com/about-mdvip/press-room/survey-baby-boomers-say-fear-primary-health-motivator 13 https://altarum.org/sites/default/files/uploaded-related-files/CCCHCResults03_LikelihoodSwitch_0.pdf

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