Things you may not think would affect how patients feel about their health care, but do

Doctors know that patient satisfaction and perception of care are not the same thing, though the phrases are often used interchangeably. This can be frustrating, since doctors also know that a happy or satisfied patient doesn’t always equal a healthy patient.

To put it in stark terms, “The most satisfied patients were significantly more likely to die in the next four years,” according to an article in The Atlantic examining the efficacy of patient-satisfaction surveys such as HCAHPS.

What patients want is not always what they need. Instead of chasing higher patient satisfaction scores, why not shift your focus to these five factors proven to impact patients’ perception of care? You have more control over them than you may think.

1. Your waiting room

A 2002 study published in the Journal of Environmental Psychology found that the design of doctors’ waiting rooms influenced patients’ perceptions of the quality of care delivered by those doctors. Researchers learned that “perceived quality of care [was] greater for waiting rooms that were nicely furnished, well-lighted, contained artwork, and were warm [welcoming] in appearance versus waiting rooms that had outdated furnishings, were dark, contained no artwork or poor quality reproductions, and were cold in appearance.”

In 2017, in the age of HGTV, Pinterest, and social media, the waiting room environment has only increased in importance. For more on this topic, read Three Ways to Improve Your Waiting Room for Patients and Five Ways to Revamp Your Waiting Room This Year.

2. Your staff

You probably know that hiring a pleasant receptionist is important for making a positive first impression on patients. But studies show that it’s actually clinical support staff that has the most significant impact on both patient satisfaction and perception of care.

“Because nurses are at the forefront as the most patient-facing representative, they are in a position to heavily influence the patient experience,” wrote Karlene Kerfoot, chief nursing officer at API Healthcare, on Advance Healthcare Network. “The connection between nurse satisfaction and quality of care cannot be ignored. Research shows that for every 10 percent of dissatisfaction among nurses, patient referrals to a hospital decrease by 2 percent.”

In fact, making nurses happy appears to make everyone happy. A Health Affairs study comparing patient-satisfaction scores with HCAHPS surveys of almost 100,000 nurses showed that a better nurse work environment was associated with higher scores on every patient-satisfaction survey question.

For tips on how to keep your practice staff engaged and motivated, check out this post: Use Staff Incentives to Help Your Bottom Line.

3. Your patients’ age

Studies have shown patient perceptions of health care interactions vary by age. One such study found that older patients were generally more satisfied with their care: compared to patients age 65 or over, patients ages 18–64 were less likely to report that their provider “always” listened to them, “always” showed respect for what they had to say, and “always” spent enough time with them. Another study found that patients’ perceptions of overall quality of care were most clearly linked to adequate numbers of staff, and that older patients were more satisfied with staff number than younger patients.

You may not be able to do anything about your patients’ age, or how many employees you have, but you can educate yourself about generational differences between patients and how to relate to them better. For more on this topic, see Health Care Decisions by Generation: How Do Patients Differ?

4. Your attire

In a survey published in JAMA Internal Medicine, 52 percent of respondents “strongly favored” doctors who wore “traditional attire with a white coat” when shown photos of doctors in different attire. “Physicians in traditional dress were seen as most knowledgeable and most honest,” the researchers wrote. The next highest preference was for doctors wearing scrubs (24 percent), followed by a business suit (13 percent). The results indicate that patients and their family members prefer attire that identifies a doctor as a health professional.

Other studies have confirmed that professional status and quality care is linked to style and color of uniforms or scrubs in hospital settings, reported American Laundry News. Color-coding scrubs by role—e.g., different colors for doctors, nurses, and laboratory staff—is helpful to patients in identifying staff, stated the article.

To find out more about giving patients what they want, read Five Steps to Running a Patient-Focused Practice.

5. Your patient education

Making sure patients understand the health information doctors provide to them is important. But comprehension is not the only measure of patient education’s success. Researchers at Rendia conducted a randomized study to evaluate whether the type of educational materials—text-based versus narrated animation—impacts patients’ perceptions, attitudes, and intended health behaviors.

The study revealed that when given animations, patients were 2.7 times more likely to feel that their provider cared for them, 2.7 times more likely to continue to seek care from that provider, and more than two times more likely to recommend that provider to others.

For more results from the survey, download the full Impact of Narrated Animations Study today.


Sometimes, it’s the little things that matter most. For tips on keeping your patients happy (and healthy), subscribe to our monthly email newsletter:


Click here to subscribe >>