Prioritizing patient satisfaction

By Emily Margosian, Assistant Editor, March 1, 2024

DermWorld talks to Vinod Nambudiri, MD, MBA, EdM, FAAD, associate professor of dermatology at Harvard Medical School, about strategies for improving patient satisfaction.

Dr. Nambudiri: I’m an academic dermatologist based out of Brigham and Women’s Hospital and Dana-Farber Cancer Institute in Boston. My practice is a mix of general dermatology, complex medical dermatology, and cutaneous oncology patients across two different clinical practices. There’s a fair amount of variety in the patient population, ranging from relatively healthy individuals presenting for routine dermatologic visits, to patients with active malignancies on systemic chemotherapies and immunotherapies with an array of cutaneous complications from their disease or treatments. The staffing in the clinics is variable over time as well, including a mix of trainees (such as a students, residents, and fellows) and clinical support staff (such as scribes, medical assistants, and nurses) across different settings.

DermWorld: Why is patient satisfaction important in a dermatology practice?

Dr. Nambudiri: Patient satisfaction is critically important to a successful dermatology practice. We are in a privileged position to be taking care of individuals’ health; patients place an enormous amount of trust in our hands. When we think about factors that influence trust, an individual’s competence and character are both key components of establishing a trusting relationship. As such, dermatologists who can demonstrate their outstanding competence — through exemplary medical knowledge and patient care, as well as their outstanding character through high standards of professionalism and communication — will be poised to achieve high levels of patient satisfaction. Ensuring high levels of patient satisfaction cultivates long-term trust between patients and their dermatologists, and is ultimately beneficial for patients, physicians, and our specialty as a whole.

DermWorld: What factors impact patient satisfaction? What can dermatologists do to make patients happy beyond just providing good care?

Dr. Nambudiri: Time and again, one of the most important factors that is strongly associated with patient satisfaction is effective communication — and in particular being an attentive listener to patients. We spend a great deal of time in medical training thinking through how to arrive at a correct diagnosis or identify the appropriate treatment. Critically important to achieving either of those successfully is to listen to patients regarding their perspectives and insights, ensuring they feel empowered as a participant in the process of medical care.

A second skill dermatologists can work on to enhance patient satisfaction is to manage patient expectations effectively. There are typically very few interventions that “work overnight” to clear a patient’s skin disease. Having a reasonable, balanced, honest discussion about a treatment and the time it will take to show its efficacy is critically important in ensuring patients are satisfied with their care. Similarly, anticipating side effects that may arise from a new treatment and taking the time to talk through them is critically important to help patients navigate through the interventions we recommend for them.

Finally, remembering the humanity of each patient that comes through the door is key. In a busy day, a dermatologist may see dozens of patients, but whether they are your first patient, last patient, or somewhere in between, they deserve your full energy and expertise as a human being. Being friendly, kind, courteous, compassionate, and caring — even in the face of clinical stressors or other responsibilities that may be occupying your mind — will go a long way in making sure each patient feels satisfied with the care that you are providing to them. I sometimes take a moment just to take a deep breath for a few seconds before entering a patient’s room to reset myself in the middle of a long day, remembering to try and smile and greet each patient as enthusiastically as I began the day.

DermWorld: What are some practice management solutions to help improve patient satisfaction?

Dr. Nambudiri: Dermatologists are typically seeing a high volume of patients in a short amount of time, which — while beneficial for overall patient access — can come with challenges such as running delayed to unforeseen procedures, or individual visits running longer than anticipated. One location in which I practice uses an electronic screen in the patient waiting room to let them know if a physician is running on time or behind schedule (e.g., on time, 0-15 minutes wait, 15-30 minutes wait, etc.) that is updated periodically throughout the day to help patients understand what to expect when in the waiting room.

Another strategy for dermatologists to help manage their patient satisfaction is to always be aware of when your next available appointments are for your new and returning patients. If you conclude a visit and tell your patient you would like to see them back in a specified time but your schedule is completely booked, your patient may end up dissatisfied with their overall experience. Knowing when you have upcoming availability is key, and working to hold slots for return patients or having a fixed follow-up interval for particular patients with specific diagnoses can be helpful as well.

Finally, think about your practice’s professional image/brand. What is it that you want to be known for? The way in which your practice positions itself or markets itself should be aligned with the care that you are providing, as this will help ensure that patients are getting from you exactly what they’ve been seeking out.

DermWorld: How can staff contribute to improving patient satisfaction?

Dr. Nambudiri: Your office staff are often the first face that a patient comes into contact with when they arrive, and the last face that they see when they are about to leave. Friendly, courteous, and professional office staff contribute to an outstanding patient satisfaction experience. Cultivating a practice culture that celebrates patient satisfaction — rewarding comments from patients, recognizing excellent service that goes above-and-beyond — will pay dividends in terms of staff retention, morale, and ultimately patient experience in the office.

Engaging staff in designing strategies to boost patient satisfaction is also a key principle in driving a winning culture in the practice that will make it a wonderful experience for everyone who comes through the door. Finally, the same principles of interacting with your patients — listening, managing expectations, and embracing humanity — all apply to interacting with staff around you as well!

DermWorld: What are some ways technology can be leveraged to help improve patient satisfaction?

Dr. Nambudiri: Many innovative software platforms exist to help with patient outreach, scheduling, patient education, medication management, and even clinical care delivery. Think about what you and your patients are comfortable with and how this could help enhance satisfaction. For example, if you and your patients are able to use telemedicine visits for followup of particular skin conditions, this could be a way to enhance patient satisfaction by saving them a trip to your office and still allow them a chance to connect with you to receive care in an efficient manner.

Another technologic innovation is using something like a digital assistant or virtual scribe. Doing so can take your attention off of the EHR during a patient visit and back to directly interacting for a greater portion of the visit with patients themselves. This face-to-face time — rather than face-to-screen time — during an in-person visit will likely help patients feel more connected to their dermatologists during visits and enhance their satisfaction with the care they’re receiving. And, even without a technology-based solution, the presence of a medical scribe to focus on documentation during a visit is something we’ve had extensive experience with in our practices and has really helped dermatologists connect more directly with their patients during their visits; patients have appreciated the greater level of attention consistently.

DermWorld: How important is patient feedback?

Dr. Nambudiri: Pay attention to feedback — it really matters! If you get comments back from patients about an aspect of the patient experience that can be improved, take them seriously and dedicate some time — maybe once a week, once a month, maybe once a quarter — to really think about how the patient experience in your practice can be improved. By doing so, you’ll help to ensure that patients coming through the door will really get the most out of their visits with you.

Vinod Nambudiri, MD, MBA, EdM, FAAD, is associate professor of dermatology at Harvard Medical School.

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