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    Chris Harrop
    Chris Harrop

    When it comes to managing patient satisfaction and retention, bigger is not always better for medical practices.

    That insight is part of what Lea Chatham, director, content marketing, Solutionreach, Lehi, Utah, outlined regarding the organization’s recent review of patient-provider relationships during an Oct. 24, 2017 webinar, “Bucking the Trend: 4 Ways to Use Technology to Improve Patient Retention."

    Chatham said most healthcare organizations face challenges with keeping up with both technology and the best ways to engage patients, and that small to medium practices sometimes have an easier time of addressing the issues.

    “This is a bigger challenge for bigger practices. The larger your organization, the bigger a problem retention can be,” Chatham said, noting that it usually costs about five times more to get a new patient rather than keeping a current patient.

    Chatham noted that as consolidation becomes a bigger trend, and the number of physician practices acquired by larger organizations grows, “we see that affects satisfaction.” That trend of mergers, acquisitions and even the addition of more providers influences patient satisfaction, as evidenced by the eye care industry.

    “There are now a lot of larger clinics [in eye care] … and satisfaction levels among patients who go to those larger clinics versus those who go to the smaller clinics are lower,” Chatham said. “Where we see big consolidation, purchases and mergers, we definitely are seeing lower satisfaction than what we see in smaller practices.”

    Beyond patient satisfaction, Chatham noted that her organization’s Patient-Provider Relationship Survey, which included more than 500 patients asked about their primary care provider, noted that only 39% of patients at larger practices would refer a friend, compared to 71% of small-practice patients.

    The survey data then was broken down along generational and gender groups to better understand how different patients felt dissatisfaction, their communication preferences and the behaviors that prompted some of them to switch to new practices.

    “Most of us think about switching [providers] as only something happens when people change insurance or move, but what we found was that one in eight patients left their primary care or similar practice in the last year,” Chatham said, “and quite a few more were considering leaving in the future.

    “They are feeling like they’re paying a lot of money for their care and their experience is not meeting their expectations, even if they like their provider,” she added.

    Chatham, citing the survey, said about 37% of patients who left in past year were dissatisfied not with the providers they see, but rather with practice logistics and customer service, especially how office staff treated them, difficulty scheduling appointments and poor office communication. Some of the lowest satisfaction rates with practice logistics were associated with wait times, reminders about tests and follow-up treatments, and ease of getting appointments.

    Chatham also noted the survey found that three different generations of patients — baby boomers, Generation Xers and millennials — share similarities in their expectations from providers.

    While boomers overall are more loyal to a provider, they have similar, shifting expectations about the care experience. And while only 20% of boomers were extremely, very or somewhat likely to switch in the coming years, that percentage was much higher for millennials (42%) and Generation X patients (44%).

    But just as telling, Chatham noted, was whether those patients were part of a large clinic or a smaller clinic: 53% of patients of large clinics said they would not return, whereas patients of smaller clinics had an 18% higher retention rate.

    Chatham outlined a few solutions for improving patient engagement and response rates, including:

    • Offering a full range of communication options, including text, email and phone.
    • Enhancing patient access to online scheduling, bill pay, social media interaction and follow-up health education, including e-newsletters.
    • Customizing the patient experience based on timing preferences of communications and the audience (including age- and diagnosis-specific communications).

    Practices that identify and implement these strategies to improve patient satisfaction can use that foundation as a growth strategy. Chatham noted that encouraging happy patients to leave reviews on social media and online rating sites is a no-cost method to attract patients who are considering leaving their provider or already have left.

    Decklan Miller-McGee, MGMA instructional developer, contributed to this report.

    Chris Harrop

    Written By

    Chris Harrop

    A veteran journalist, Chris Harrop serves as managing editor of MGMA Connection magazine, MGMA Insights newsletter, MGMA Stat and several other publications across MGMA. Email him.

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