Understanding Patient [Client] Satisfaction

The Fine Art of Exceeding Expectations

By Dr. David E. Marcinko MBA, CMP™

By Dr. Gary L. Bode CPA


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Patient [client] satisfaction occurs when patient perceptions exceed their expectations. They get an intangible “something extra” from the visit, above what they paid for.  We’ll concentrate on managing patient perceptions of their physicians in this ME-P.  It is applicable to financial advisors [FAs], as well.

Note that when patient expectations match their perceptions, mutual obligations are fulfilled, making both practitioner and patient “even”.

Clinical Results

The clinical result, within a relevant range, is only part of the patient’s perceptions.  Numerous unconscious impressions comprise the remainder.  We’ve all had patients love us despite a less than optimal result.  We’ve all had patients angrily leave the practice over some non-clinical matter like a trivial billing dispute. A patient’s perception of any health care service is colored by a vast array of prior experiences that set up current expectations.  The patient is pleased to the extent that his current perceptions exceed his pre existing expectations.  This encompasses far more than the clinical result (within a relevant range), and includes such non-treatment issues as the demeanor of the staff, condition of the physical premises, psychological comfort during the visit, etc.

Patients Talk

Remember, all patients talk about you anyway. In the past, a happy patient told four others about what a nice doctor you are. Today, patients post website comments or blogs immediately after their visits. They are more likely to complete treatment and follow instructions, thus obtaining a better medical outcome, and, generating additional fees for the practice. They pay quicker, cause less bad-debt and help create a pleasant environment for us to work in.

Un-Happy Patients [Clients]

An unhappy patient vehemently tells nine others, onground or online, what a nasty greedy rip-off artist you are. Sad, but true!  They are not as likely to complete treatment, thus incurring a less than optimal result, and generate fewer fees.  They pay slower, if at all, create a stressed environment and detrimentally affect the attitude of other patients in the office.

Try to eliminate problems that might cause negative perceptions (i.e., a filthy restroom) and implement controls that help assure positive perceptions.

A Soft Science

Patient satisfaction is a soft managerial science.  It is a numbers game.  Most patients don’t pre- define what would be “acceptable” from this encounter, but have vaguely defined ranges of prior expectations anyway, gleaned from a lifetime of health care related experience.  Any variance between these this “acceptable” range of expectations and each trivial encounter invokes some degree positive or negative feeling in the patient.

Total Perceptions

The total perception of the office experience is an aggregate of multiple trivial, often subliminal, observations. Patient satisfaction is an intangible and amorphous process complicated by:

  • Inter patient variables:  Significant differences between patients in their “expectations”. 
  • Intra patient variables: A single patient can perceive the same thing or situation differently at different times, depending on uncontrollable variables like mood, or, context of occurrence which may (sometimes and/or partially) be controllable by the practice.
  • Luck of the draw” in physical variables: Does Sally or Mary escort the patient to the exam room?  Was it the blue or green exam room?  Did the last patient to use the rest room, five minutes ago, leave a disgusting mess?
  • Heterogeneous staff variables: Even with appropriate training, people are not machines and have their own quirks.

A Multi-Faceted Amorphous Subject

By proactively anticipating the entire visit, from the patient’s perspective, the practitioner can structure and arrange things such that most patients have, mostly positive perceptions, most of the time.  This can be done despite all the potential heterogenicity of the above factors. Patient satisfaction can be improved in any office, and can be done by anyone.

Because patient satisfaction is a multi-faceted amorphous subject, there are multiple correct approaches to the subject and no “cook book” recipe on how to proceed.  Try and get the big picture.  Identify the worst areas and fix them.  Identify the best areas and reinforce them.  Proceed slowly.  It can be done one facet at a time.  Adapt things to your own managerial style and personality.  Be completely open to suggestion and change.  Be aware that patient relationship and satisfaction implementation strategies frequently overlap.


The tone of this post is equally applicable to financial advisors and medical management consultants.


And so, your thoughts and comments on this ME-P are appreciated. How do you define patient [medical professionals] or client [FAs] satisfaction? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com and http://www.springerpub.com/Search/marcinko

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