Customer Satisfaction:
For That Competitive Edge, Give Your POL A Checkup
by Dr. Sheila Dunn
Reprinted with Permission from Washington G-2 Reports,
Physician Office Testing, June 1997
Remember the last time the
daily news didn't tout the latest merger, consolidation or downsizing in
the business world? Neither can I. Virtually every business in America
is changing to boost operating efficiency and cut costs. Healthcare is
no exception. Just look at the activity among your local hospitals, clinics
and physician practices.
All we can count on for sure is this: healthcare will
keep changing, but those who take advantage of the changes better than
their competitors will not only survive, but also prosper. One crucial
area to exploit: show those in the driver's seat (healthcare payers) how
your physician office laboratory (POL) contributes quality to the services
they reimburse.
If you see quality only in terms of test result accuracy
and reproducibility, look again. To your customers, quality usually has
nothing to do with clinical quality--they expect it and take it for granted.
Patients, for example, may see quality as fast turnaround time, getting
back to work or home quickly, being treated kindly, starting medications
sooner or avoiding an extra trip to a pharmacy or other laboratory.
To payers, including managed care plans and Medicare/Medicaid,
quality is a simple proposition: patients get better faster (improved outcomes);
patients are pleased with the services furnished (increased satisfaction);
and costs to achieve these aims are reasonably low.
A Tall Order?
A test is a test is a test, right? Not necessarily, though most managed
care payers tend to regard lab testing as a commodity that can be performed
by any licensed lab. For this reason, they often shop for the lowest contract
price and deny payment for more expensive testing performed in POLs. You
need to persuade your payers, both current and prospective, that your POL
services cost less in the long run because they contribute to a better
quality of care.
As an integral part of a doctor's practice, the POL is
both a commodity and a service business. More than 10% of patients changed
doctors last year and another 30% reportedly are willing to switch. Sounds
like ambulatory care is a service business where customers vote with their
feet.
One argument you can make to payers: your customers demand
your services! But first, specify who they are: patients? the patient's
family and employer? your physicians? referring physicians? managed care
companies? All of the above?
If the answer is all of the above, you're right on target.
To demonstrate the tangible benefits of your services, transform your POL
into a customer-centered operation in which you exceed customer needs and
expectations.
Take Your POL's Pulse
So, how do you measure up in terms of customer satisfaction? To find out,
survey your customers. You may think you know what they want, but you'll
be surprised at the responses you get, because each POL is different. Nonetheless,
the bottom-line is this: customer satisfaction is what your customers tell
you it is.
Some methods to gauge customer satisfaction:
- Suggestion boxes
- Patient surveys in writing or by phone
- Focus groups (used to test concepts or gather qualitative
data; most apt for assessing the overall physician practice)
I suggest you begin to measure customer
satisfaction with written surveys targeting your two largest customers:
ordering physicians and patients. Sample questions for surveying your ordering
physicians and your patients are presented in Figures 1
and 2.
Preface your survey with a short statement about its purpose
in order to get a good response rate: "We know you depend on our lab
for much of your routine testing, so we'd like your honest opinion about
how we're doing. Please answer the following questions by selecting the
response that best applies. Write any additional comments on the reverse,
if you wish (be sure to cite the number of the question you're commenting
on). Thanks for your input!"
In devising your own surveys and deciding which questions
to ask, put yourself in the shoes of those you are targeting; chart each
step in their encounter with your POL. Then, develop one or two questions
to rate their satisfaction with each step. Don't forget to include aspects
of the practice that are not lab-related (such as their experience in contacting
your office by phone).
In surveying patients, you also want to ascertain what
exactly makes them appreciate your POL's performance and how you can improve
your services. To get at the former, you may need to elicit negative responses
about your competition--such as patient dislike of traveling to a draw
station, waiting 2-3 days for test results, then playing telephone tag
to learn the results.
Customer Service Pays Off
When your POL becomes a customer-focused operation, share your survey results
with those who use your services. By doing so, you can:
- Increase the number of new patients (the best advertisement
is a satisfied customer!)
- Retain current patients (they'd rather fight than switch!)
- Gain a competitive advantage (increase your leverage
with payers)
- Improve patient outcomes (cut costs in the long run)
- Achieve organizational efficiency (reduce operational
steps to save money)
- Improve staff morale and reduce turnover (it's gratifying
to know you're doing a great job; besides, hiring and training new employees
is costly and time-consuming)
Toot Your Own Horn
Not only will surveys help to improve your service to customers, but also
wise use of the results shows your willingness to work with payers as a
responsive business partner. This can only produce a "win-win"
situation for you, your patients and payers. Share the results of your
patient and physician surveys with payers, especially any managed care
plan that has limited or denied payment for POL testing. If you can show
managed care executives that your customers--and theirs--prefer lab testing
on-site during the office visit, you'll enhance your chances of being paid
for these tests.
Figure 1: Sample POL Survey Of Ordering
Physicians
1. How would you rate the quality of the test results
you receive from our laboratory vs. _______________________________________________?
Would you say the test results from our lab are...?
____ Better than
____ Equal to
____ Not as good
2. How timely are the test results we provide? Would you
say we're...?
____ Excellent
____ Good
____ Fair
____ Poor
3. Does having lab results from our in-office lab enable
you to manage patients more effectively?
____ Yes
____ No (Please skip to Question #4)
3a. Is it helpful in making a diagnosis?
____ Very helpful
____ Helpful
____ Somewhat helpful
____ Not helpful
3b. What about in selecting treatment or medication options?
Would you say it's...?
____ Very helpful
____ Helpful
____ Somewhat helpful
____ Not helpful
3c. What about for monitoring chronic or acute conditions?
____ Very helpful
____ Helpful
____ Somewhat helpful
____ Not helpful
4. Does our lab provide the range of testing services
you need for your patients?
____ Always
____ Usually
____ Sometimes
____ Seldom
____ Never
5. In your opinion, does our ability to offer in-office
testing improve the effectiveness of patient care?
____ Always
____ Usually
____ Sometimes
____ Seldom
____ Never
6. Does our ability to offer in-office testing improve
the efficiency of patientcare?
____ Always
____ Usually
____ Sometimes
____ Seldom
____ Never
7. Do you think our having a lab in our office increases
or decreases patient satisfaction with their care?
____ Increases patient satisfaction
____ Decreases it
____ No effect
8. What, if anything, do you like about having this lab
in our office?
9. Is there anything you dislike about it? (Please specify.)
10. What changes or improvements, if any, should be made
to our lab and its services?
Figure 2: Sample POL Survey Of Patients
1. If you've ever had blood work done at this office,
please answer the following questions (otherwise, skip to Question #2).
When you had your blood drawn here, was the laboratory
staff...?
a. skillful in drawing your blood? ____ Yes ____ No
b. courteous? ____ Yes ____ No
c. prompt? ____ Yes ____ No
2. How satisfied are you with having to travel to ABC
lab to have your blood drawn?
____ Very satisfied
____ Satisfied
____ Somewhat satisfied
____ Not at all satisfied
____ Does not apply to me
3a. Would you prefer having your blood drawn and tested
in our office at the time of your appointment?
____ Yes
____ No
3b. Why is that? ______________________________________________
4. What is your opinion of the quality of test results
received from our laboratory compared to __________________________________________________?
____ Get better results here
____ Get better results there
____ Results appear to be the same
5. Would you be willing to pay a little more to have your
lab tests performed at this office during your visit?
____ Yes
____ No
6a. In your opinion, does our ability to draw and analyze
your blood here improve the care you receive from your physician?
____ Yes
____ No
6b. Why is that? ____________________________________________
7. What do you think you'd like best about having your
blood tested here?
8. What, if anything, don't you like about having your
blood tested during your appointment?
9. What, if anything, would you suggest we do to improve
our in-office lab services?