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2017 ; 6
(2
): e22
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"A Phenomenal Person and Doctor": Thank You Letters to Medical Care Providers
#MMPMID29097353
Miron-Shatz T
; Becker S
; Zaromb F
; Mertens A
; Tsafrir A
Interact J Med Res
2017[Nov]; 6
(2
): e22
PMID29097353
show ga
BACKGROUND: Thank you letters to physicians and medical facilities are an
untapped resource, providing an invaluable glimpse into what patients notice and
appreciate in their care. OBJECTIVE: The aim of this study was to analyze such
thank you letters as posted on the Web by medical institutions to find what
patients and families consider to be good care. In an age of patient-centered
care, it is pivotal to see what metrics patients and families apply when
assessing their care and whether they grasp specific versus general qualities in
their care. METHODS: Our exploratory inquiry covered 100 thank you letters posted
on the Web by 26 medical facilities in the United States and the United Kingdom.
We systematically coded and descriptively presented the aspects of care that
patients and their families thanked doctors and medical facilities for. We relied
on previous work outlining patient priorities and satisfaction (Anderson et al,
2007), to which we added a distinction between global and specific evaluations
for each of the already existing categories with two additional categories:
general praise and other, and several subcategories, such as treatment outcome,
to the category of medical care. RESULTS: In 73% of the letters (73/100),
physicians were primarily thanked for their medical treatment. In 71% (71/100) of
the letters, they were thanked for their personality and demeanor. In 52% cases
(52/100), these two aspects were mentioned together, suggesting that from the
perspective of patient as well as the family member, both are deemed necessary in
positive evaluation of medical care. Only 8% (8/100) of the letters lacked
reference to medical care, personality or demeanor, or communication. No
statistically significant differences were observed in the number of letters that
expressed gratitude for the personality or demeanor of medical care providers
versus the quality of medical care (?21, N=200=0.1, not statistically
significant). Letters tended to express more specific praise for personality or
demeanor, such as being supportive, understanding, humane and caring (48/71, 68%)
but more general praise for medical care (?21, N=424=63.9, P<.01). The most often
mentioned specific quality of medical care were treatment outcomes (30/73, 41%),
followed by technical competence (15/73, 21%) and treatment approach (14/73,
19%). A limitation of this inquiry is that we analyzed the letters that medical
centers chose to post on the Web. These are not necessarily a representative
sample of all thank you letters as are sent to health care institutions but are
still indicative of what centers choose to showcase on the Web. CONCLUSIONS:
Physician demeanor and quality of interaction with patients are pivotal in how
laymen perceive good care, no less so than medical care per se. This inquiry can
inform care providers and medical curricula, leading to an improvement in the
perceived quality of care.