Older women doing physical therapy

Patient Satisfaction as a Risk Management Tool

Malpractice cases take a heavy toll on doctors. This is something attorney Thomas Jensen has seen firsthand when defending chiropractors and medical doctors in dozens of malpractice cases.

Many doctors describe a malpractice allegation as “one of the worst experiences of my life,” “disruptive,” “humiliating” and “upsetting.” Sometimes it can even trigger a lack of trust in patients, long-term anxiety and depression.

Studies have shown the professional negligence claim process can result in doctors expressing a feeling of helplessness about the claim, along with self-doubt, worry about incompetence, and angst about being judged, while some noted feelings of loneliness and isolation that had disruptive effects on marriage and family, and the doctor’s practice. 1

Two decades of surveys, research investigations and studies of anecdotal evidence have culminated in recognition that high levels of patient satisfaction with the doctor/patient relationship has many benefits, including a reduction in professional negligence claim presentations. Avoidance of such claims shields the clinician from the professional practice and personal upheaval such claims can trigger. It follows that efforts made to achieve favorable patient clinical experiences are an important risk management technique all practitioners should strive for.

Compared to medical physicians who may expect to face at least one malpractice claim over the course of their careers, the risk of a malpractice allegation resulting from SMT is likely to be significantly lower. Nevertheless, high patient satisfaction with the doctor may temper adverse responses to transient chiropractic events and serious complications, and thereby reduce claim frequency. A study undertaken in 2010 found that physicians who were rated as “very good” had a significantly lower risk of lawsuits, whereas those rated as “very poor” had up to a 20 percent risk of litigation. 2

The Centers for Medicare and Medicaid Services developed the Consumer Assessment of Healthcare Providers & Systems (“CAHPS”) survey to evaluate patient satisfaction scales. Data derived from these surveys provide quantifiable evidence that help to inform providers of ways to improve patient experience and thereby lessen risk of care readmission, improve post-care guideline adherence, and reduce utilization of unnecessary services.3 It would seem certain that reduction in professional negligence claim presentations would also fall within that list of benefits.

Most clinicians in private practice do not compile patient satisfaction data. But increasingly doctors in integrated care facilities are finding the institutions have initiated patient satisfaction score measures for myriad beneficial reasons. Chiropractors should evaluate means by which patient satisfaction data can be gathered. Healthcare recordkeeping or patient communication e-mail survey software programs may provide means by which care evaluations can be reported. We may also be seeing third-party entities, including insurance networks, harvesting patient satisfaction data for panel membership evaluation.

This also provides an impetus for clinicians to be mindful of the importance of high levels of patient satisfaction in managing one’s practice. Even old-fashioned postage-paid postcards made available to patients in the clinic may assist in data gathering. Being alerted to patient-reported encounter deficiencies enable the clinician to offer remedial responses that mitigate dissatisfaction. Knowing that patient satisfaction may be evaluated by itself can implicitly motivate clinicians to foster favorable clinical experiences thereby enhancing risk management outcomes.

Managing, marketing, performing, billing and recording a healthcare clinic and the patient encounter can be burdensome, so adding steps to daily office activity can be unwelcome. But in this information-driven healthcare economy, the use of patient experience metrics increasingly will be a component of clinical life. Wholly aside from altruistic, reimbursement, panel membership continuance, and other reasons, is the fact that happy patients reduce malpractice claim risks. Doctors of Chiropractic should focus on the importance of the simple measure of scoring the patient experience to reduce the hassle presented by professional negligence claim involvement.

1 See Patricia Salber, What Happens When Doctors Get Sued, The Doctor Weighs In (2015) (https://thedoctorweighsin.com/what-happens-when-doctors-get-sued) (last reviewed September 28, 2019).

2 See Darlene Falco, et al., Patient Satisfaction with Anesthesia Care: What Do We Know?, 85 Am. Ass’n Nurse Anesthetists J. 286, 287 n. 4 (Aug. 2017).

3 Becker’s Hospital Review, Patient Experience and Quality Impacts on Reimbursement: 5 Things to Know (Feb. 18, 2015) (https://www.beckershospitalreview.com/hospital-physician-relationships/patient-experience-and-quality-impacts-on-reimbursement-5-things-to-know.html)

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