What Makes Our Clinic Patients Unhappy? A Statewide Survey of GI Outpatient Visit Satisfaction

Introduction: A patient-centered approach to medical care is vital to achieving patient satisfaction and optimal clinical outcomes. Patients of outpatient gastroenterology (GI) practices may be dissatisfied for different reasons, not limited to adverse physical or emotional experiences. Unhappy patients are less likely to follow through with treatment plans and may delay or truncate their care. Online Google reviews is a known public recourse used by patients to document their displeasure for any care received. We assessed the main reasons behind individual 1-star (lowest out of maximum 5) Google ratings given for a representative sample of outpatient GI practices across the state of Georgia, USA. Methods: Using the Google maps online search engine, we selected a sample of 30 non-academic outpatient GI practices with patient ratings in 23 cities/towns across the state of Georgia. All had more than one GI provider and at least five individual 1-star ratings to meet inclusion criteria. Data was extracted on June 1, 2023. Average Google ratings for the 30 practices ranged from 1.6 to 4.9 stars. 1-star ratings with a compatible reason were used regardless of date of entry, and broadly categorized by the primary reason given. Either five or ten consecutive 1-star ratings were used from each practice, randomly determined based on the total number of ratings available on Google. A total of 200 ratings with reviews were included in the study. Results: The 13 reason categories for 1-star ratings with corresponding percentages (Figure 1) were; Billing issues 47 (23.5%), Office wait time 35 (17.5%), Rude office staff 33 (16.5%), Appointment scheduling 25 (12.5%), No retuned calls 19 (9.5%), Results communication 14 (7%), Uncaring provider 10 (5%), Incompetent staff 7 (3.5%), Outdated office 4 (2%), Rushed visit 3 (1.5%), Procedure complication 1 (0.5%), Misdiagnosis 1 (0.5%) and Miscommunication 1 (0.5%). Conclusion: The three major reasons for patient lack of satisfaction are billing, office wait time and rude office staff. Reasons related to direct provider interactions like a procedure complication or misdiagnosis were reported less. Areas for intervention may include improved education for correct bill coding, appropriate level of staffing and enhanced customer service training for staff. In the era of increasing online presence and social media, increased awareness of patient experience and quality of care will help guide gastroenterology providers and practice managers in their quality improvement efforts.Figure 1.: Patient-documented reason categories for the lowest (1-Star) Google ratings for outpatient GI practices across Georgia.