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Three ways to improve patient satisfaction without driving your staff nuts

Clinicians relive the same “improve patient satisfaction” training scenario over and over.

  1. The clinicians get called into a meeting to discuss how to improve patient satisfaction. Sometimes, the meeting involves a manager giving pointers on how to provide good customer service. Other times, employers will pay big money to have experts, or those in the know from a service industry, come to the workplace to do a special workshop.
  2. There is an example given – it usually involves how customers are best treated when they walk into a clothing store or a restaurant. Customers should be greeted with a smile, the presenters explain. They assert that clinicians should behave like sales clerks or waitstaff, smiling and serving up whatever the patients ask for.
If the person giving this talk were to look out into the room of clinicians, they would probably see a bunch of bored looking people. Some may be on their phones; some may have brought charts into the talk. There may also be others who have found an excuse not to attend the meeting at all.

All too often, employers make the mistake of treating clinicians like maître d’s, waitstaff, or sales clerks in training. Healthcare gets viewed as a business where the customers are patients, and the clinicians are providing a service. Just like they are waiting tables, or assisting with the purchase of goods, healthcare providers are expected to efficiently move the patient through with a smile.

What employers often forget is that providing a service in healthcare is different than providing a service in the hospitality industry.
  • How often do you go to your neighborhood restaurant when you have the flu?
  • Do you try to hobble in to your favorite clothing store when you throw out your back?
  • When you are under the weather, or injured are you typically in a good mood? Are you nervous, or worried?

Patients seek out healthcare advice and a fix for whatever situation they are in. Most people look forward to going to restaurants or stores.

The type anticipation that people have for going to favorite stores or restaurants does not hold true for visiting their local healthcare provider.

Patient perception and satisfaction is important. Often times, people have a choice of which hospitals and healthcare providers they utilize, and they will go to the place where they think that they will get the best care. So how do you get clinicians to buy into the idea of providing good service, or making patients happy?

1. Building relationships is key

Allow clinicians to build good relationships with patients.

Managers can enable clinicians to build good relationships by giving them a little extra time in their day to make connections with patients. Even just 2-5 minutes per patient can make a huge difference.

If the clinician better understands his or her patients, their backgrounds, their concerns and their beliefs, then the clinician can guide those patient to make better decisions regarding their care.

Some studies suggest that a positive patient-clinician relationship can influence patient adherence to treatment as well as healthcare outcomes.1,3 Communication between patients and clinicians may also have an influence on outcomes. Good communication between these groups may lead to patient understanding, trust and clinician- patient understanding.6

As a clinician, I have experienced first hand how spending a few extra minutes to explain a diagnosis, or treatment to a patient whether in person, or on the phone can improve my overall interaction with the patient throughout the course of the care.

Often, this type of interaction with the patient is difficult, or not lucrative to bill for; however, it can make the rest of the clinicians’ interactions with the patient more positive and efficient.

Building a good relationship with patients is helpful in getting the patient to trust their clinician and to be compliant with treatment. Patient noncompliance is a huge problem in healthcare.5 A strong patient- clinician relationship can improve patient outcomes.

So why are managers putting clinicians through customer service training where they are told to answer the phone with a smile, or personally escort patients to the restroom? Make clinicians aware of how their relationship with patients can affect their outcomes.

2. Show the evidence

Doctors, nurses, optometrists, therapists and other types of clinical personnel are analytical. They like to take data, whether it is a patient’s vitals, range of motion, strength tests, or lab tests and make an assessment.

Having clinicians attend classes on customer service may get them to realize that people like to be greeted, smiled at and made to feel comfortable, but it won’t change their behavior.

Reviewing studies, and exploring how creating a good relationship with patients can improve outcomes is more likely to get healthcare clinicians to buy in. Instead of holding a meeting where you tell your clinical staff to provide service with a smile, why don’t you point out some of these studies to them…or better yet, have them read the studies.

A systematic review of therapist-patient relations in treatment outcomes in physical therapy found that several different diagnosis groups responded positively to therapeutic alliance. Compliance to treatment in patients with brain injuries and patients with multiple pathologies increased with positive therapeutic alliances (the relationship between a healthcare professional and a patient).

Geriatric patients and patients with chronic low back pain also showed positive correlations in treatment satisfaction and therapeutic alliance.3 In a randomized control study examining outcomes in 182 patients with chronic low back pain, therapeutic alliance was a predictor of improvements in all outcomes including global perceived effect of treatment, function, pain and disability.2

3. Give good advice to employees

When you’re working with clinicians to improve patient satisfaction, remember to provide solid examples of how to show interest in patients’ lives.

  • Make eye contact with patients
  • Find a way to relate to patients (“Oh, I know the traffic is horrible”)
  • Remember details about patients’ personal lives, then asking them about them on follow-up appointments (“How was your daughter’s birthday party last weekend?”)
While building such a relationship with a patient can take time, it can pay huge dividends in patient satisfaction and adherence. A patient that adheres to their plan of care is less costly to treat. A patient that is satisfied with their care will return to the clinic, hospital, or healthcare provider for their future healthcare needs.

Spending a few extra minutes with a patient can make a huge difference in their perception of a clinician. Being able to relate to patients will also help to build a good patient-clinician relationship. While more research needs to be done to better understand this patient-clinician alliance, there is evidence that bolstering this relationship can improve outcomes.

The key is looking at these interactions as more than shallow chatter and thousand-watt smiles. Patients need to feel heard, and they need to feel like their clinicians genuinely care for them. This boils down to taking time to create true relationships between patients and clinicians.

Making clinicians aware of these findings is a step in the right direction of getting them to buy in to patient satisfaction. As a result, the patient is more likely to adhere to their treatment, report less pain, and be satisfied with the care they receive. Satisfied patients will return to future care. Compliant patients will cost less to treat.

Wasn’t this something that you were trying to achieve in the first place?



1 Garrity, T.F. (1981). Medical compliance and the clinician-patient relationship: A review. Social Science &Medicine. Part E. Medical Psychology, 15(3), 215-222.

2 Ferreira, P.H., Ferreira, M.L., Maher, C.G., Refshauge, K.M., Matimer, J; et al. (2013). The Therapeutic Allaince Between Clinicians and Patients Predicts Outcomes in Chronic Low Back Pain. Physical Therapy; Washington, 93.4, 470-8.

3 Hall, A.M., Ferreira, P.H., Maher, C.G., Latimer, J., Ferreira, M.L. (2010). The Influence of the Therapist- Patient Relationship on Treatment Outcomes in Physical Rehabilitation: A Systematic Review. Physical Therapy; Washington, 90.8, 1099-110.

4 Hush, J.M., Camern, K., Mackey, M. (2011). Patient Satisfaction With Musculoskeletal Physical Therapy Care: A systematic Review. Physical Therapy; Washington, 91.1, 25-36.

5 Iuga, A.O., McGuire, M. (2014). Adherence and health care costs. Risk Management Healthcare Policy, 7, 35-44.

6 Street Jr, R.L., Makoul, G., Arora, N.K., Epstein, R.M. (2009). How does
communication heal? Pathways linking clinician-patient communication to health outcomes. Patient Education and Counseling, 74(3), 295-301.


Julie McGee

Julie is a San Francisco based PT. Running competitively in high school and college sparked her interest in human movement, and led her to major in Exercise Science at the University of Massachusetts. After taking a job in a lab, she realized that she needed to work with people and become a PT. Since graduating from PT school, she has worked in acute rehab, workers comp, outpatient orthopedics and home health. In her spare time she enjoys running, biking, swimming, reading and yoga.

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