Ratings reveal Minnesota clinics with best communication, access

Doctors might not be able to turn on the charm overnight, but new Minnesota patient survey data show it is entirely possible for them to become better at seeing and talking with patients.

The second release of patient satisfaction data by MN Community Measurement on Wednesday shows little change overall — 79 percent of patients gave top marks to their doctors in 2014, compared to 78 percent in 2012. But some clinics made substantial progress.

"It doesn't have to be that somebody really competent should also be rude to you," said Jim Chase, executive director of the nonprofit rating organization. "The [patient] experience still matters."

Only 38 percent of patients gave positive grades for accessibility to the Scenic Rivers clinic in Cook, Minn., in 2012. Leaders there added three clinicians and an online portal, so patients could update clinical and personal information before office visits. Now 66 percent of patients view the clinic as accessible — a measure of available appointment times and waiting-room delays.

Only 68 percent of patients at the Albany Area Hospital and Medical Center gave top marks to doctors in 2012. A concerted effort to provide these scores to doctors helped drive changes. By 2014, they had boosted their positive rating to 86 percent.

"They took it to heart and worked on improving their dialogue and communications with their patients," said Renee Thelen, a spokeswoman for the central Minnesota center.

Research linking positive feedback to better patient outcomes is in its infancy, but evidence so far suggests that a happier patient is likely to be a healthier and more compliant patient.

Even with four of five patients already giving top marks to doctors, similar progress is expected over time with patient satisfaction, Chase said.

The most recent survey, of 200,500 patients treated at 765 primary care and specialty clinics in fall 2014, was the largest of its kind in the nation.

As in the first survey, the results varied by specialty. Patients held generally favorable views of their oncology clinics and plastic surgeons, but were less satisfied with urgent care and pain clinics.

The differences are understandable given that patients don't know the urgent care staff and often arrive at odd hours with stressful problems. Doctors at pain clinics must be rigid in the amount of medication they give for chronic pain, even if it alienates their patients.

But it is fair to hold physicians from different specialties to the same patient satisfaction standards, because the survey assesses them on basic things such as their communication skills and the courtesy of their front-office staff, said Stefan Gildemeister, health economist for the Minnesota Department of Health, which released the rating data jointly with MN Community Measurement.

"What we don't understand so well is how patients present themselves to different providers," he added. "Do they come with a sort of preconceived notion to an oncologist vs. a pain specialist?"

Hennepin County Medical Center's Positive Care Center in Minneapolis received a top rating — 97 percent of patients gave high marks to its doctors — while serving a chronically ill HIV-positive population.

"A smile goes a long way," said Dr. Nick Vogenthaler, the clinic's medical director. Familiarity with the clinic staff and their willingness to connect patients with organizations providing stable housing and transportation also help boost the ratings.

Associates in Women's Health in Minneapolis received the highest scores for its reception and office staff.

While doctors strive for high-quality care at low cost, they need to pay attention to these satisfaction scores that can resonate with patients and distinguish clinics in competitive specialties such as orthopedics, said Adam Berry, chief executive for Summit Orthopedics. "Customer service … is something that everybody can latch onto and understand."

Summit clinics received predominantly average patient satisfaction ratings, which was typical for orthopedic clinics, but the satisfaction score at its Hastings clinic rose 14 percentage points from 2012 to 2014.

Insurers now are using patient satisfaction data to set payment rates or bonuses in contract negotiations with clinics. Chase said he believes the data will only become more influential over time in motivating better care.

"That," he said, "is what we hope to foster."