Thursday, August 29, 2013

Doctors tweet about IWantGreatCare

My post about the IWantGreatCare patient evaluation program prompted some interesting conversation among UK doctors on Twitter.  I'm not suggesting this is a statistically valid sample of physician responses to the program--after all, these are doctors who feel comfortable talking about such matters on Twitter--but it is an indication that IWGC is adding some value to the doctor-patient relationship. The doctors also note a desire to get more participation from patients and steps they are taking along those lines. I conclude that this is a work in progress, and it will be good to get more updates over the coming months.

First, Clare Rees @doccmr (a pediatric surgeon) noted she was impressed with Oliver Warren @DrOliverWarren (surgeon) on his engagement with the patient in the example I posted.  He responded:

Thank you! Bit nerve wracking sometimes but right thing to do.

Then Dermot O'Riordan @dermotor (surgeon and medical director in Suffolk) led us to his blog post on the issue:

I must confess it was an anxious leap of faith to start asking patients to take cards home and rate me anonymously. I have read lots of stories about the pitfalls of unmediated review sites, e.g. TripAdvisor.

I have been giving them to every patient I have seen in clinic for three months. To start with nothing happened. A couple of weeks later I received my first review & it wasn't that flattering: I wondered if I was doing the right thing.

However I persevered and further reviews started to come in. Fortunately some were much more positive and it is always nice to hear good things. Most patients after all do trust, respect and value their doctor, in contrast to many other professions. In addition I have received constructive comments that I have tried to learn from.

Without this sort of feedback I might never know how I am perceived by patients. The response rate is still not high but I feel that it is an incredibly powerful rebalancing of the doctor-patient relationship for the patient to know that I have invited them to feedback. It does involve trusting the patient but it is important to remember that the patient is trusting me to operate on them!

I am convinced a system such as this can play a major role in changing the culture of medicine towards transparency and putting the patient in charge. It also plays a major role in providing patient feedback for doctors to support their revalidation. A number of clinicians whom I spoke to were highly positive.

Clare noted reactions and then asked:

Every single parent has been surprised to be asked - need to change #culture.  What's your response rate? I give them to everyone but very few give feedback.

Oliver answered:

Three packs of cards used 30 responses. Estimate about 1 in 20.

Dermot said:

Mine's bit lower but don't only do it for the response but cos change dynamic of consultation/trust.


OK not just me then!


But those that do respond do seem to like you.

Clare joked:

Guess I should look at the half full part of the glass more often!

I'd like to hand out iPad with link to improve response rate, but then it wouldn't be anonymous.

In a separate thread, Dermot has a conversation with Richard Bogle @RichardBogle (cardiologist), who notes:

The only thing we have to fear is fear itself.

Dermot replies:

Totally agree. The patient survey produced by @gmcuk was unhelpful. Using @iwgc changes consultation but accept is a big step.

Richard comments, too, on the previous system:

The 360 degree patient feedback is totally useless. It represents about 0.1% patients seen and is self selected.

Then they discuss how to get more responses from patients:

Dermot: Clinic nurse gives it to every patient I see.

Richard: I have the link to iwgc on my website and also a friends and family test on the site. I put the web address on all correspondence. The website gets lots if hits but no responses on iwgc. I think I will start using the cards.

Dermot: I too put my @iwgc URL in footer of all letters. Not sure if produces that many responses.

1 comment:

Doug said...

Here's 2 options on how to improve your response rates:
1) (absolutely necessary): Publicly post, on both your web site and in your waiting area, the constructive feedback you have received and what you're doing / have done to address it. You may need to edit the feedback (slightly) to keep it general.
2) (the bold step): summarize all your survey results, good and bad, and relate them to some target, and post that in public

When consumers of any kind know their feedback will be acted upon, they will be more likely to respond.