7 quotes from Geisinger's Greg Burke on engaging patients and improving clinical hospitality

At Danville, Pa.-based Geisinger Health System, Greg Burke, MD, an internal medicine physician and chief patient experience officer, aims to ensure the system's patients are treated with the same type of respect and attention comparable to that delivered to guests at upscale hotels.

In November 2015, Geisenger made national headlines when the system's CEO David Feinberg, MD, announced patients dissatisfied with their care experience could request refunds for out-of-pocket costs. To date, the system has issued $400,000 in refunds to patients.

Recently, Dr. Burke spoke with U.S. News & World Report on issues surrounding the patient experience, as well as Geisenger's patient refund program.

Here are seven quotes from Dr. Burke's interview in U.S. News & World Report.

1. On what patients want: "They want to be greeted by name, they want their healthcare professionals [to] be identifiable and professionally dressed. They don't want to wait long for an appointment. They want to hear results quickly, and they want rapid access to their clinicians. At a fundamental level, they want to be treated with kindness and compassion and feel they're not a number, they're a human being."

2. On the definition of patient engagement: "The best measure of patient engagement is how comfortable a patient is within our system. How likely are they to follow through with good medical advice and screening procedures? How likely are they to keep appointments, follow through on suggestions to change their lifestyles and take their medication? I know if we have better patient experience, assuming that competency and that medical care is superb, then we're going to have a more engaged patient."

3. On measuring patient engagement: "You can be technical about it, and look at how they interact with the system — do they use the internet or phone, do they have frequent visits, do they Skype with [health care staff]? That's one way people look at engagement. I tend to look at it at a higher level: How motivated are they to take an active role in their own well-being? That's the ultimate goal of health care — to have the most engaged patient you possibly can, to get the best possible outcome. In other words, the best way to have an engaged patient is to give them a great patient experience."

4. On refunding bad experiences: "My father was a corner grocery-store owner. Every now and then someone would come in with sour milk. He would say, 'I think they bought that down the street' or, 'They bought it last week, saw the expiration date, waited four days, and then returned it.' He would always give them their money back anyway. Returning the money always seemed like good business practice. There's an ethical dimension, too. If we've given poor service, we want to make up the failure and regain the customer's trust. I can't deny there's a business aspect to this, but it's appropriate."

5. On the difficulties of fielding patient complaints: "We've created an environment where more grievances, more complaints are routed to us. Dr. Feinberg has told me that he published his email address and phone number so that employees and patients can reach out to him directly. This has meant more work for him ...We got so busy that we had to take on a patient advocate who was assigned to his office to deal with those complaints. Last month, there were 130. She dealt with every one personally ... Last week I spent two hours with a widow of a patient who died from cancer. She was disappointed and hurt because she had bad interactions with our staff. I spent two hours listening to the story and promising to follow up with everyone involved to make sure that it doesn't happen again. Our goal in the next two or three years is to see the number of complaints go down, because we've fixed a lot of the problems."

6. On patient honesty: "The vast majority of the cases have been reasonable. A big concern of critics is that people will take advantage of us. I always say: We ask you to trust us with your lives; we have to put our trust in you to be honest about this."

7. On burnout and provider perception of patient satisfaction: "There are some studies showing that from 30 percent to 50 percent of physicians experience burnout, compassion fatigue, irritability and lack of engagement in themselves and their career. That's a big challenge. One of the things we've done, and I've been particularly strong on this, is to reassure our physicians that nothing we do related to patient experience or hospitality will compromise our commitment to quality medical care. We're never going to ask doctors to something that they don't feel is appropriate just to please the patient. We've got to have their back. There's a lot of cynicism on the part of physicians about patient satisfaction. Many think "satisfaction" has nothing to do with the science of medicine and that it's an emotional reaction ... We do work with some of our physicians who are having problems with patient relations. We mentor them, we coach them ... It doesn't make a lot of sense to talk continually about taking care of our patients in such an excellent way, and, in the meantime, forget our physicians, clinicians, nurses and our other workers when they're struggling."

More articles on patient engagement: 
Medical practices focus on patient experience, survey finds 
New York-Presbyterian partners with telehealth provider Avizia 
Through the eyes of the patient: Looking beyond HCAHPS to improve patient experience

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