The Primary Sources of Patient Complaints in ObGyn & Urology Practices

Posted by Clark Love on Oct 2, 2017 1:20:28 PM

Frustrated ObGyn and Urology PatientsIn today’s medical marketplace, physicians such as urologists and ObGyns are finding it more and more difficult to keep doors open in the face of deceased reimbursements and patients who lack medical insurance. Additionally, attracting new patients is harder than ever, thanks to the prevalence of websites which allow patients to rate their doctors, sometimes leaving bad reviews which do not adequately depict the situation from both sides.

Unfortunately, one bad word-of-mouth review can lead to decreased business. Listed here are the primary sources of patient complaints in ObGyn and urology practices, as well as tips for overcoming these issues.

Long Wait Times

Long wait times are a top patient complaint for both urologists and gynecologists. In some instances, long wait times can be attributed to emergency cases that doctors must attend to immediately, which is outside of the doctor’s control. If a urologist or gynecologist frequently deals with emergency cases that throw off the day’s schedule, it can be beneficial to work a couple 15 – 20 minute “open” appointment slots into the day in order to deal with these cases without throwing off the equilibrium of the entire practice.

In other instances, patients must deal with long wait times because of other patients. When patients are routinely late for appointments, this inconsideration puts a strain on the entire work flow and can make it difficult for a doctor to remain on time with his or her other appointments. If this problem is a continual concern, doctors can include time buffers between patients – or start charging repeat offenders a fee for tardiness.

Finally, many doctors must keep a strict schedule of patients to meet quotas for the day in order to be profitable, due to the current state of medical reimbursements. If being overbooked is the main reason for long wait times, doctors can audit their practice to look for ways of streamlining daily routines and improving efficiency as much as possible.

Two ways to effectively combat long wait times are: automated text messaging appointment reminder systems and calls to patients confirming appointment times.  Text messages have a 98% open rate in the U.S., so you are virtually assured that a message sent to a patient will be seen.  Text message reminders about appointments can drastically reduce no-show rates and help get patients to their appointments on time, which in turn lower waiting times because it streamlines the flow of patients throughout the day.  Furthermore, practices calling patients just prior to their appointments has a similar impact and allows for easily rescheduling if a conflict has arisen for the patient. 

Not Taking Pain Seriously

Recent studies have indicated that women’s pain is not taken as seriously as men’s pain, particularly when it is gynecological. Indeed, women are shown to be treated less aggressively until it is proven beyond doubt that their symptoms are just as severe as that of male patients. In general, women report more severe pain1 than men, and have more frequent incidences of pain for longer duration, but are time and again treated less aggressively – despite no biological difference between their pain mechanisms. In fact, the medical community has a term for this phenomenon: the Yentl Syndrome2, which is defined as the necessity of women to prove they are as sick as men to be taken as seriously.

While this complaint is common among women, men complain that their urologists might not take their pain as seriously as well. This phenomenon is likely due to the fact that urologists see patients with the same symptoms every day, and that pain is one of the most common complaints.

In both instances, it is important to remember to have empathy for patients, and to treat each one as an individual. Women and men should be treated equally, and each patient’s discomfort should be considered a cause for concern. 

Poor Bedside Manner

Another common complaint among patients is poor bedside manner, especially when it comes to the sensitive topics that urologists and ObGyns face daily. In a recent study of top complaints among dissatisfied patients, 43.1% listed poor bedside manner as their most relevant issue with their physician. What comprises poor bedside manner? In this instance, the perception of arrogance, lack of listening skills, and indifference were the top offenders. While doctors often feel as though their interpersonal skills should not be judged as a basis of their medical technique, the truth is that patients have little else to go by when choosing a physician.

Patients particularly found poor bedside manner with their ObGyn to be troublesome during labor. While it can be hard to calm first time parents, doctors should aim to lend an empathetic ear instead of rattling off a list of what makes them qualified for the job.  Similarly, urologists should remember that when a patient’s reproductive organs are not working properly, good bedside manner is necessary to keep a tense situation from escalating.

Poor Customer Service

Good customer service is important in any service industry, especially when it comes to medical practices. In fact, 35.3% of patients complain about poor customer service, which is wide ranging. For instance, inability to schedule timely follow up appointments was one concern that patients had, which is disconcerting for clients with a serious health problem.

Rude treatment by front staff was also a major concern. For many patients, seeing a specialist such as a urologist or ObGyn can be stressful, and rude or unaccommodating receptionists or nurses can be especially frustrating. While working in healthcare is not for the faint of heart, it is important that each patient is treated politely.

For other patients, the difficulty of talking to a person on the phone is especially aggravating. To clear up phone lines, physicians can set up online appointment scheduling, which streamlines the entire process. It is also useful to track patient phone calls and monitor when clients are most likely to call with emergencies or for appointment scheduling. During “down times,” staff can use this opportunity to confirm appointments and perform follow up phone calls without tying up the phone lines or placing too many patients on hold.

Not hearing back about test results in a timely manner

Along with poor customer service, patients complaint about physicians who do not alert clients to abnormal test results in a timely manner. This grievance is a serious one, and is complained about surprisingly often. When doctors operate on a “no news is good news” policy, it is important that physicians reach out to patients quickly when a problem is discovered. Not only is this method courteous, but it also allows patients to be treated as quickly as possible. To reach patients in a timely manner, many doctors have turned to mailing test results which came back normal directly to the patient, and only calling when results require follow up tests or treatment. Ultimately, a patient should never wait more than a week to find out something is seriously wrong, or get stuck playing phone tag with the receptionist.

Not calling in prescriptions

Similarly – and perhaps even more seriously – an all too common complaint is physicians that do not call in prescriptions in a timely manner. Oftentimes, patients with this concern have gone to the pharmacy to pick up their medication, only to be told by the pharmacist that the doctor has not yet called. This problem is often due to negligence of the doctor, and results in patients that are unable to take their medication consistently. This type of behavior can cause mistrust in doctors, and a lot of frustration for the patient.

However, patients often do not realize that doctors must comply with restrictive privacy rules and out-of-date technology that hinders efficiency in this regard. Doctors should audit their in-house processes, and work towards improving efficiency if these factors are affecting a patient’s care. While many complaints that a patient has about a doctor can be brushed aside, not filling prescriptions on time is a grievous offense that can cost a doctor many future patients.

Not consulting with referring physician

When patients are referred to specialists such as urologists, gynecologists, and urogynecologists, the reason is often because the patient is a special or advanced case. Therefore, it is not surprising that patients become frustrated when the specialist does not consult with the referring physician. Even worse, sometimes specialists fail to fully assess the patient and simply diagnose the symptoms based on the referring doctor’s notes. When this situation occurs, the patient can feel that his or her time or money was wasted.

While consulting is difficult between two doctors based on their busy schedules, it is important that the specialist respect that the referring doctor felt the case was more complicated than what he or she could handle. Urologists and gynecologists should use their best judgment when examining a patient, but be as thorough as possible when determining that the new client has the exact disease the original physician assumed.

False Diagnoses

Urology and gynecology are two fields where misdiagnoses can be especially troublesome to individuals. Indeed, 21.5% of patients complained of misdiagnoses from their doctors. In urology, the top offenders are urinary incontinence disorders, interstitial cystitis, chronic pelvic pain, and bladder cancer. Many of these disorders have similar symptoms, and specialists tend to diagnose common diseases before knowing the full scope of the problem – especially when the same disorders are observed every day with little variability among symptoms.

In the gynecology field, pelvic organ prolapse and miscarriage can be incorrectly diagnosed. Pelvic organ prolapse causes symptoms of urinary incontinence in women, which affects 1 in 3 adult females. However, a pelvic organ prolapse can affect one of five pelvic organs, and is a common complication of childbirth. Doctors should fully investigate whether a pelvic organ prolapse is to blame when a woman complains of stress or urge incontinence.

An alarming revelation that was made in the past decade is that ultrasound guidelines for the first trimester of pregnancy may result in a false diagnosis of nonviability of the fetus. In one study, researchers found that 1 in 23 pregnancies in the United States are misdiagnosed as nonviable, prior to women undergoing procedures to clean out the uterus. New guidelines for first trimester ultrasound have been released, which are aimed at reducing the number of these misdiagnoses.

Surgical Mistakes

While misdiagnoses are frustrating, 21.5% of patients also cited surgical mistakes as a source of frustration. Unfortunately, surgeons are not immune to human error. While thousands – if not millions – of surgeries around the globe are performed daily without error, the small percentage of incidences which do occur often speak loudest. In general, the three most common errors during surgery are wrong site surgery, wrong surgical procedure performed, and surgery performed on the wrong patient. While errors are likely to occur given the nature of surgery, these three errors are wholly preventable.

Indeed, in one study, preventable adverse events was the leading cause of death in the United States, and in New York alone 3.7% of hospital admissions were due to preventable adverse errors caused by medical professionals. Therefore, nearly 100,000 deaths per year in the United States can be prevented by surgical staff. While these complaints by patients are frustrating and indeed can harm a physician’s business, the fact of the matter is that surgical mistakes are a serious and life-threatening problem.

Not Listening to Patient Complaints

Another common complaint that patients have about their doctors – primarily in specialty fields – is physicians who do not adequately listen to the patient. While doctors seek the most accurate and relevant information possible, when only given a 15 – 20 minute time slot with each patient a doctor can feel rushed to make a quick judgment about the patient’s condition. Therefore, doctors might hear 4 out of 6 symptoms that a patient is experiencing, then cut him or her off to prescribe treatment. While this method is efficient for the doctor, it is frustrating for the patient. In many instances, such as when BPH or genuine stress incontinence is suspected, the doctor has seen countless similar cases in his or her lifetime and can make that judgment with high confidence, yet the patient is generally left feeling as though his or her feelings did not matter. Even worse, when the quick diagnosis is wrong, patients can feel especially cheated of both time and money. Even when a patient presents his or her symptoms and appears “textbook,” take the additional few minutes to hear out the patient completely.

Being Close-Minded to Non-Traditional Medicine

Non-traditional treatments are gaining traction, such as meditation, yoga, acupuncture, and herbal supplements. While there is evidence that some holistic techniques may be complementary to conventional medicine, such as acupuncture for women’s reproductive health3, other “remedies” might counteract traditional medicine. A good example is St. John’s Wort4, which diminishes the efficiency of the birth control pill, as well as certain antibiotics. However, the initial response many physicians have when their patients are discussing non-traditional medicine can cause patients not to disclose this information altogether. Not only is a teaching opportunity into the patient’s health lost, but doctors may be missing important contraindications, simply because the patient did not want to be sneered at for taking an herbal supplement. Open lines of communication are key when it comes to overcoming this complaint source.

“Private” Discussions

Urologists and gynecologists treat patients with sensitive problems every day. Infertility, erectile dysfunction, cancer, and incontinence are only a handful of the personal problems that bring people to see a urologist or ObGyn. Therefore, many patients wish for their conversations to be completely private and out of earshot of other clients. However, one common complaint among visitors of urology and gynecology practices is perceived lack of privacy, particularly when discussing the patient’s condition. Care should be taken to ensure the privacy of each patient, and for doctors not to discuss patient specifics with other physicians or nurses within earshot of other people.

Too-Early Hospital Release

As physicians and hospital staff are aware, patient turnover after in-patient procedures directly affects revenue. However, a significant problem arises when patients are released from the hospital too early. This trend is especially evident in women and newborns. In the past 40 years, the length of a hospital stay following delivery has drastically decreased. Indeed, there has been question recently whether early discharge of mothers and their newborns is safe. Additionally, there is evidence5 which suggests early discharge correlates with higher incidences of infant readmission to the hospital, increased attendance rates at hospital emergency departments related to infant health issues, more contacts with health professionals regarding infant health following discharge, maternal readmission to the hospital, more maternal health issues, increased incidences of maternal depression, anxiety, and fatigue following birth, and increased risk of breastfeeding problems.

In addition, urology patients that have serious urinary complaints – such as difficulty voiding – are sometimes released from the hospital too soon following surgery. While many patients dealt with these symptoms prior to surgery, post-operatively it is important to question whether the patient is fit to go home given the current problems. Ultimately, a release from the hospital too soon can result in serious complications that require additional medical appointments or hospitalization, which is why this complaint is common.

Conclusion

Ultimately, the primary sources of patient complaints in ObGyn and urology practices can be lumped into three categories: patient inconvenience (i.e. long wait times), patient – doctor interactions (i.e. poor bedside manner), and questions regarding physician competency (i.e. misdiagnoses).

While some of these complaints are unavoidable, such as long wait times due to emergencies, other issues can be overcome with enhanced attention to daily processes within the clinic. The most egregious complaints, such as surgical mistakes, can largely be overcome with implementation of better practices and closer attention to detail. Overall, doctors must recognize that just like any other service industry, customer service is important, and word of mouth complaints can be damaging to a business.

About BHN

BHN provides mobile diagnostics to over 300 urology and ObGyn practices across the country.  One of our primary services is urodynamics testing, where we provide the equipment, staff, and supplies to deliver turn-key urodynamics testing on site our our customers' locations.  If you would like more information on our urodynamics testing services, please kick on the button below.  

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References

  1. Hoffmann DE, Tarzian AJ. The girl who cried pain: a bias against women in the treatment of pain. J Law Med Ethics. 2001;29(1):13-27.
  2. Merz CN. The Yentl syndrome is alive and well. Eur Heart J. 2011;32(11):1313-5.
  3. Cochrane S, Smith CA, Possamai-Inesedy A, Bensoussan A. Acupuncture and women’s health: an overview of the role of acupuncture and its clinical management in women’s reproductive healthInternational Journal of Women’s Health. 2014;6:313-325. doi:10.2147/IJWH.S38969.
  4. Murphy PA, Kern SE, Stanczyk FZ, Westhoff CL. Interaction of St. John's Wort with oral contraceptives: effects on the pharmacokinetics of norethindrone and ethinyl estradiol, ovarian activity and breakthrough bleeding. Contraception. 2005;71(6):402-8.
  5. Jones E, Taylor B, MacArthur C, Pritchett R, Cummins C. The effect of early postnatal discharge from hospital for women and infants: a systematic review protocolSystematic Reviews. 2016;5:24. doi:10.1186/s13643-016-0193-9.

 

Topics: ObGyn Practices, Medical Practice Operations

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