The User Experience, according to ISO Standards is defined as “a person’s perceptions and responses that result from the use or anticipated use of a product, system or service.” I recently had a User Experience at a new hair salon. I left my previous hair salon because I did not have a good experience there.
My new hair salon appears to be actively competing for my business (I show up for appointments, pay my bill and tip the stylists – what’s not to like?) and seems to have designed my salon experience to keep me coming back.
My Customer Experience at the New Salon:
In our consulting practice we are seeing physicians fleeing hospital employment just when many people are predicting the death of the private medical practice. We affectionately call these physicians our “Single Shingles” and they are approaching private practice much differently. These physicians often bring their spouses into the practice as their business partners, and we teach them how to manage the practice.
Here are some practice models that solo physicians are considering for their Single Shingles.
The Retainer-Based Practice
Although the retainer-based practice has many other names, calling it retainer medicine seems to be the most generic way to describe direct care, or care that patients pay for directly without the intervention of a third-party payer source. There are as many variations of retainer-based practices as there are name variations, but the three main types are listed below.
“Physicians are reaching the tipping point on their business models, particularly in primary care,” Tom Blue, executive director of the American Academy of Private Physicians, recently told the San Antonio News-Express in an article about concierge and direct-pay practices. “They just can’t make ends meet. They’re being forced to make decisions about changing their revenue models.”
And while no one knows exactly how fast the retainer trend is growing, a 2005 report from the U.S. Government Accountability Office found there are 146 retainer physicians nationwide, noted USA Today. The article also cited a 2009 report commissioned by the Medicare Payment Advisory Commission that compiled a list of 756 retainer physicians. And according to a 2010 survey of members of the American Academy of Family Physicians, 3 percent of respondents said they ran some form of retainer practice, up from 1.2 percent in 2009. Finally, the San Antonio News reported that the American Academy of Private Physicians estimates 1,100 primary care physicians don’t accept insurance, double the number of five years ago.
Image credit: Getty Images via @daylife
If you can’t find the right part-time or full-time employees, maybe you’re not looking in the right places. One of the great things about business today is that a portion of your workforce an be anywhere. Your best employees may not live in your town, your state or your time zone.
Who Is Press Ganey and why are they measuring patient satisfaction?
In 1979, Irwin Press, PhD focused his interest on the modern patient experience, the study of which would lead him to become known as a patient satisfaction expert. In 1984, Dr. Press introduced the importance of survey methodology when establishing a patient satisfaction program and by early 1985, he had developed a survey that would measure patient satisfaction as a means to improve performance. To address the need for statistical analysis and survey methodology, he collaborated with Rod Ganey, PhD and together, the two formed Press Ganey Associates in 1985.
According to their website, today Press Ganey “partners with more than 10,000 health care organizations worldwide to create and sustain high performing organizations, and, ultimately, improve the overall health care experience. Press Ganey works with clients from across the continuum of care hospitals, medical practices, home care agencies and other providers including 50% of all U.S. hospitals.”
The Press Ganey Pulse Report is an annual report which collates research and analysis of public and proprietary data and the perspectives of patients, employees and physicians to uncover trends in healthcare. The 2011 report reveals:
“The top priority item for medical practices is sensitivity to patient needs, indicating a need for medical practices to personalize their interactions with every patient.”
The remaining top-priority items for medical practices all reference patient satisfaction with the care provider, and include:
- Physicians and medical practices need to serve the whole patient.
- Physicians and medical practices need to understand a patients culture, the relationship with a patients family or caregivers, and the unique communication needs of individual patients.
- Physicians and medical practices need to validate patient concerns and confirm comprehension, which are critical to ensuring compliance with treatment protocols, and also increases the likelihood for better outcomes and greater patient satisfaction.
The report also has some pretty fascinating information on the Overall Satisfaction in Top 25 Medical Practice Specialties (!) and Medical Practice Satisfaction by Waiting Times. Press Ganey outpatient questions are answered by over 3 million people annually over the course of 12 months. You can download the 2011 Press Ganey Pulse Report here.
Press Ganey also has other free resources available on their site:
For Medical Practices and Outpatient Facilities – case studies, recorded webinars, ROI resources and White Papers here
For Hospitals – case studies, Pulse Reports, Emergency Department resources, recorded webinars, ROI resources and White Papers here
For Home Care -case studies, recorded webinars, ROI resources and White Papers here
Government Initiatives for Public Reporting – includingthe Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CGCAHPS) survey, the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, the Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) survey, and Meaningful Use and Value-based Purchasing here
Like other medical conditions, behavioral health issues span the spectrum from mild to significant mental illness (SMI). There are many national studies, such as the Impact Model, showing the benefits of identification and treatment of depression in the primary care setting. Many practices have added a mental health clinician or social worker to their staff to expand on-site care for those needing lower level behavioral health services and to reduce the stigma for patients accessing mental health services. It is care for those with more significant mental illness that becomes challenging to the primary care practice.
What is the relationship of SMI to physical health?
The National Council for Community Behavioral Healthcare reports that 3 out of 5 individuals with a SMI die from a preventable health condition. In general, the life expectancy of a person with SMI is 25 years less than the average population. They have a higher incidence of chronic medical conditions for individuals exacerbated by smoking, obesity, homelessness, and sometimes by the very drugs used to treat their psychiatric condition. There are many reasons for the lack of medical care for these individuals including social isolation, cost, transportation, and inability to fit in to a primary care practice culture of focused discussions. Many use the emergency department for routine care rather than establishing and maintaining a relationship with a primary care practice.
Barriers to behavioral health services and to primary care for behavioral health patients
For the organized and busy professional on the go, the smartphone has quickly become a necessity on par with a persons house keys, wallet, or purse. The past five years have vaulted the smartphone from status symbol to must-have business tool by bringing data and communication capabilities from your office to the palm of your hand. With decision making and communication tools always at the ready, you can be productive from anywhere you are, and you are freed up to bring information to clients, meetings, and conferences without the hindrance of a laptop.
Physicians, practitioners and forward thinking healthcare organizations are leading the charge to embrace mobile health, often called mHealth, or the practice of patient care supported by mobile devices. A survey conducted at the physician online and mobile community QuantiaMD in May of 2011 found 83% of physicians reported using at least one mobile device and 25% used both a phone and a tablet. Of the 17% surveyed who did not use a mobile device, 44% planned on purchasing a mobile device sometime in 2011. Physicians surveyed reported their top uses for mobile devices as :
A Continuing Care Retirement Community (CCRC) offers a span of care in a single setting beginning with independent living and as needed, assistance-in-living and skilled nursing care.
The goal of these communities is to allow residents to age in place.
Support for independent living and quality of life for every stage of life is evident in the flexibility and choices residents in these communities have. Residents do not have to move elsewhere to obtain the care they need regardless of how long they live in the community.
CCRCs require a sizeable entry fee plus monthly maintenance fees in exchange for a home or apartment, food and care. This model requires a long-term, upfront financial commitment that, in turn, guarantees housing, services and nursing care all in one location through the end of life.
A special type of CCRC is a LifeCare community.
LifeCare communities must provide:
- Health care coverage for life in a skilled nursing center at little to no increase in the housing monthly service fee.
- A guarantee that if the residents resources are exhausted they do not lose their residence or their benefits.
- The retirement community has to have a skilled nursing facility within the community itself.
I had the opportunity to visit a LifeCare CCRC this week.
I was visiting my dad and stepmom, who live at Abbey Delray South (ADS) in Delray Beach, Florida owned by not-for-profit Lifespace Communities, Inc. headquartered in Des Moines, Iowa. Every time I visit I am more impressed with the community and the life my parents are leading.
My parents have a garden home at the LifeCare CCRC where they’ve lived for 8 years. They know almost everyone in the 400-resident, 222-staff, 35-acre ADS community. They take advantage of most of the community amenities including:
- Heated pool and jacuzzi, horseshoes, driving net and putting course, croquet, shuffleboard
- Weekly group exercise classes as well as personalized exercise groups for specific needs
- Dakim BrainFitness computer exercises designed to improve functional independence
- On-campus worship and transportation to local churches and synagogues
- Poker, billiards, Wii bowling, chorus, bridge, computer classes, lectures, movies
- Discussion groups, book clubs, entertainment nights, wine and cheese events and monthly parties
- Transportation to stores and medical appointments, on-site rehab and physical therapy services
At this community, one meal a day is included.
Residents sit on an advisory committee to give the dining room managers and chef feedback on their likes and dislikes. Dinner in the dining room requires a jacket (my dad has quite a selection), but not a tie for the men. After the meal, residents pick up soup, cookies and fruit to have in their own kitchens for their other meals. A cleaner comes once a week, laundry service is available for sheets and towels, and household repairs and maintenance are included in the monthly fee.
The week we visited ADS was in the midst of their annual promotion of the FITSIXTM wellness program. Each resident receives a lanyard (see top picture) with a pie chart showing the six dimensions of wellness physical, social, intellectual, emotional, spiritual and vocational – and spends the week earning “jewels” for participation in many special events and programs. At the end of the week, the residents meet to hear how they’ve done and prizes are awarded.
Here’s a fascinating video on how the Internet is transforming healthcare. Susannah Fox from the Pew Internet and American Life Project spoke in September 2010 at Mayo Transform 2010 : Thinking Differently About Health Care. The transcript of her talk is here. If you have an interest in where healthcare is going and where your medical group needs to be, take 15 minutes and listen to Susannah Fox.
Adrian told me “I am on my fifth career” and that “the arch of my life makes sense.” What a wonderful thing – to have one’s life make sense.
He has been an academic, a physicist, an IT consultant, a conference developer, and now, a consultant to others searching for ways to make conferences work. His book “Conferences That Work” was published last year and is now gaining the recognition it deserves. Among others, he has been consulting with MGMA on the new “EDGE” program they are unveiling for 800 people in March 2011.
Adrian and I covered a range of topics and we discussed my dwindling interest in attending conferences for the past several years. He, too, had been disappointed in conferences – even those he organized – and was determined to find why traditional conference aren’t making the grade any more.
His book outlines four assumptions that traditional conference planners make:
Assumption #1. Conference session topics must be chosen and
scheduled in advance.
Assumption #2. Conference sessions are primarily for
transmitting pre-planned content.
Assumption #3. Supporting meaningful connections with other
attendees is not the conference organizers job; its something
that happens in the breaks between sessions.
Assumption #4. Conferences are best ended with some event that will hopefully convince attendees to stay to the end.
Adrian’s starting point was the current conference model of passive learning – letting others choose the topics and speakers and offering attendees limited opportunities for anything besides pre-determined content. He moved from the model of passive learning to peer learning – leveraging the power and knowledge of the attendees to harness the hot topics of THAT MOMENT, not the moment that the conference committee met to determine the educational content 12 months or even 6 months ago. He noted that the best conference committees are able to guess less than 50% of what attendees really want from a conference.
Adrian uses the example of social media to illustrate the difference between broadcasting information (old) and partnering to share information (new), and notes that the goal of Conferences That Work is to “bring the resources of all attendees to each attendee.” I’ve been to a one-day meeting that accomplished that goal and I left the “camp” feeling energized, overrun with ideas and already connected through Twitter with almost everyone at the well-attended program. It was amazing.
If you are developing meetings or conferences for your church, your charity, your local or state managers group or for any other type of group, or if you want to see the future of conferences, you owe it to yourself to read “Conferences That Work” by Adrian Segar. He’s on a mission and he’s going to design and rock a conference that you, if you’re lucky, will attend some day soon.
Excerpts from his book are available here.
Free downloads to assist in making conferences that work are here.
His blog is excellent and can be found here.