Dr Neil Bacon, founder of www.iwantgreatcare.org, discusses how to maximise the potential of patient feedback.
A friend of mine, a surgical SpR, was breaking bad news to an 80-year-old patient and his elderly wife. A few months earlier the patient had undergone a Whipple’s procedure, with all its associated pain, distress and decrease in quality of life.
Despite this, the operation had sadly failed to remove the pancreatic cancer. My friend had to tell the patient and his wife that he had only a few months to live. Breaking such awful news made for an emotional and difficult consultation for all involved, and one that is all too common whichever area of medicine we practise in.
"Breaking such awful news made for an emotional and difficult consultation for all involved, and one that is all too common"
But what happened next was anything but usual. The patient’s wife leant over and, putting her hand on the surgeon’s arm, said: “Thank you for telling us this awful news in such a kind and considerate way, but we knew you’d be excellent as we’d looked you up on the internet and saw what your patients said about you. We knew we were in the very best hands.”
It is now common practice for patients to Google their doctor, whether they are registering with a new GP, being referred to secondary care, or seeing who will be caring for their relatives. At the same time more and more patients and their families are writing internet reviews of their care experience and online assessments of their doctor. It is clear that this is not a passing fad, but rather is here to stay, with healthcare – and all those who work in it – being rated and reviewed as is the norm in other service sectors.
"We knew you’d be excellent as we’d looked you up on the internet and saw what your patients said about you. We knew we were in the very best hands"
Far from being a bad thing, many doctors have already realised that online reviews of their care provide a range of powerful benefits for both their patients and themselves: as part of personal development, to meet the needs of revalidation and appraisal, to manage and enhance their professional reputation, and – as the example above shows – to build trust and confidence amongst those they care for.
But how can you ensure that you realise these benefits? How can you make it easy for your patients to provide the quantitative and qualitative feedback that you need? How can you prevent abuse or fraudulent reviews, and how can you know what is being said about your professional reputation on the internet?
Actively manage your online reputation
This is not complicated – many sites will already have a personal profile page for you – all you need to do is activate it and personalise it.
- Upload your picture, add a brief biography and a professional description.
- Ensure the site is secure, robust and has proven systems to prevent abuse or inappropriate comments.
- Encourage all your patients to leave feedback about your care – the most effective way is to give them a small card with the address of your personal profile page. Patients typically like being asked for their opinion and are usually grateful for this simple, easy way to say thank you for the care they have received.
Ensure you know what is being said about you
Once you have asked your patients to provide feedback, it is important that you know what is being said. Again this is not complicated – and doesn’t require you to monitor numerous websites every week!
If you have chosen a professional organisation to collect the feedback on the care you personally deliver (as opposed to websites that collect general stories about your hospital or GP practice), then there should be the facility to receive an email alert when someone adds a review about you.
"Many doctors have already realised that online reviews of their care provide a range of powerful benefits for both their patients and themselves"
This ensures that you are the first to be informed when a new review is added, allows you to respond if necessary, and – with the vast majority of reviews being positive – provides good news in at least one of your daily torrent of emails!
Respond to comments by patients
You’ll find that your patients will often leave detailed comments with a number of points in a few paragraphs. In the same way that you wouldn’t ignore a letter from a patient, it is important that you can easily respond when you want or need to.
"In the same way that you wouldn’t ignore a letter from a patient, it is important that you can easily respond when you want or need to"
This needs to be simple for you to do, and your response must not breach confidentiality; it should also be fully compliant with GMC guidance – in particular, the GMC’s specific guidance on social media use, which will be published in its revised Good Medical Practice, due by the end of 2012. A carefully thought-out response can be a powerful and rapid way to ease a patient’s concern, and prevent issues escalating into more formal procedures – saving you and your patient a lot of time and worry.
Make online patient reviews work for you
One of the most useful things about real-time, online patient feedback is that it helps you meet a whole range of professional needs.
"There is only one person who can tell you the experience you give to your patients and help you ensure it is as good as it can possibly be – and that is the patient themselves"
Professional development, appraisals, job interviews and revalidation are a few of the instances where rigorous feedback from patients is required. For those doing private practice, online reviews are already proving to be a highly effective way to inform patients making choices about their care, whilst many other doctors just see this as a sensible, modern way to better understand the needs of those they care for, and they like getting regular feedback on their performance as judged by those they treat.
The vast majority of online feedback from patients is highly positive about their doctor. Typically, patients will provide detailed descriptions of just how and why their doctor made such a difference to them or their families. Of course, there is only one person who can tell you the experience you give to your patients and help you ensure it is as good as it can possibly be – and that is the patient themselves. Online reviews from your patients make it as easy for you to benefit from the wisdom of your patients, as it is for them to benefit from the wisdom of their physician.
- Dr Stephanie Bown, Casebook editor-in-chief, will feature in new educational videos from NHS Choices later this year.
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