Under more scrutiny from patients and insurers, some doctors are working to improve their patient-interaction skills.
Dr. Melissa Neisen takes a seat next to her radiology patient, Susan Jesso, and leans close. With expressive hands, Neisen calmly describes the diagnostic procedure she just completed to check Jesso's kidney dialysis capability.
"We'll get you feeling better," Neisen assures the Blaine resident. "Do you have any questions? Is there anything you want to ask me?
The doctor-patient exchange seems textbook in nature. But it's something that Neisen studiously works to perfect.
"I want to be close, but not too close, to bond with the patient," she explains later. "I want to build a rapport in short order and use layman's terms. I want to leave room for questions."
Neisen's mentor on her beside manner is Susanne Egli, a professional actress by training and an executive coach by vocation at Talon Performance Group. The two met periodically two years ago to work on patient communication and, in turn, patient satisfaction. They did role-playing. Egli videotaped Neisen as she worked through hypothetical patient experiences. They studied voice tone and modulation, how to communicate bad news as well as good news.
Egli's work in the medical field comes at a time when patient satisfaction is in the spotlight of health care providers and plans. In a medical world where pay-for-performance is an increasing trend, it doesn't hurt to have an edge.
Egli worked with about a dozen doctors last year to improve patient skills as well as leadership skills in packages ranging from three months of periodic interaction to a year at a cost of up to $5,900.
"Doctors are in practice to serve," said Egli. "They want to help a patient solve a problem. Trust and credibility is very important to them. I encourage them to touch the patient and pick up on the patient's personality. The patient will leave feeling they've been heard, that they've been taken care of."
"I wanted to be able to project my message more effectively," Neisen said. "I was a fast talker, and she told me to take my time and not rush. It was a game-changer for me. I'm proud that I did it."
The daughter of a retired doctor, Egli said that a decade ago doctors had more time to spend with their patients and naturally had a closer rapport with them. In her father's day, she said, it was not uncommon for the doctor to treat an adult whom the doctor had delivered as a baby.
"These are not skills that you would necessarily learn in medical school," said Egli.
Egli, 53, grew up in Mississippi and Iowa, studied theater at the University of California at Irvine and joined the National Shakespeare Company in New York at 22.
In 1982 she moved to the Twin Cities for its theatrical offerings. Egli filled her time doing training films and a home improvement show on PBS. She also studied organizational development on her way to becoming an executive coach.
Egli, who also counsels non-medical executives on communications and leadership skills, said her doctor clients come to her on referrals from other doctors.
MN Community Measurement, an independent nonprofit that gathers health care data, measures it for quality and posts it on the Internet for public consumption, recently started to track physician quality in terms of patient satisfaction.
Jim Chase, president of the organization, said doctors -- who are reported by practice group and not individually -- tend to score fairly high, around 89 percent, in terms of patient satisfaction.
Patient satisfaction can also be an issue in pay-for-performance calculations where reimbursement is tied to outcomes.
"We publish this because we know the public is interested. It helps identify issues around the relationship that patients should look for," Chase said. "Medical groups use it to improve their relationships with patients, and payers [insurers] are looking at the patient experience as well as quality of care and cost of care."
Bloomington-based HealthPartners, which is both a health insurer and a care provider, has been measuring patient satisfaction for the past two years, and includes it as a factor in physician compensation.
"The patient experience is of critical importance because experience is the care," said Dr. Brian Rank, medical director of the HealthPartners medical group. "We want to know how we can improve. We get lots of information. We ask about lab interaction, receptionist interaction, radiology interaction, but the apex of the visit is with the clinician."
Rank said the insurer also pairs a "shadow coach" with doctors to watch them in action with patients and later offer recommendations for improving their bedside manner.
"It's the care that's the important thing," Rank said.
"This is not a charm school and this is not a 'you're-in-trouble' school," Egli said of her coaching sessions. "These are people that are already good. They want to pick up their learning and get better."
David Phelps • 612-673-7269