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Fam Pract Manag. 1998 Jun;5(6):12.

Patient satisfaction surveys


A managed care plan that contracts with our practice sent patient satisfaction surveys to many of our patients asking about the care our practice provides. Should we be conducting these types of surveys, too?

Patient satisfaction surveys can be used to assess office efficiency and friendliness, and can assist in documenting staff problems that may be difficult to address without specific evidence. Some managed care organizations (MCOs) use patient satisfaction data to determine capitation bonuses for primary care physicians and, sometimes, to decide which referral specialists to reselect for (and deselect from) their panels.

If you are considering a practice survey, keep these points in mind:

  • If you plan to create your own survey instrument or tabulate the results in-house, first do your homework. “Patient Satisfaction Surveys,” a monograph in the AAFP's Vital Signs series (available as item #754 from the AAFP order department, 800-944- 0000), is an excellent primer. It provides a quick start for any practice considering a patient survey and includes a ready-made survey.

  • Patients are often more willing to register their dissatisfaction than to tell you how wonderful you are. But don't bias your sample by surveying only friendly patients. You may want to ask patients with complaints to express their feelings via the survey. It will give them a constructive way to convey their complaints without tying up front-desk time and creating a negative practice environment.

  • Be sure you have an adequate number of randomly distributed surveys before assuming valid results. The number of surveys depends on the size of your practice, but the ideal would be to get at least 200 surveys per physician (assuming a response rate of 25 percent, that would mean sending out 800 surveys). If the ideal is out of reach, collect as many surveys as your resources will allow. Again, consult the Vital Signs monograph for guidance.

  • Consider offering an incentive for patients to complete their surveys — at a minimum, a stamped, self-addressed envelope to make returns easy. Beyond that, a small gift that is easily mailed is a nice touch. Letter openers, calendar cards and magnets are inexpensive items that can be imprinted with your practice's name and phone number to provide a reminder of their source.

Support staff ratios


Our practice has seven family physicians and two physician assistants. We have two full-time-equivalent (FTE) support staff per provider, which isn't enough. How many support staff should we have? What data support your answer?

Two FTE support staff per family physician is an extremely low ratio. In its Medical and Dental Income and Averages: 1997 Statistical Report Based on 1996 Data, the Society of Medical-Dental Management Consultants (SM-D) reports an average ratio of 4.24 FTE support staff per physician for family practice. In its Cost Survey: 1997 Report Based on 1996 Data, the Medical Group Management Association (MGMA) reports 4.77 as the median FTE support staff ratio for family practice groups. FTE support staff include all nonmedical employees (such as nurses, receptionists, secretaries and billing clerks).

The SM-D and MGMA ratios include statistics from efficient and inefficient practices. An efficiently run practice may experience a lower or higher ratio than the median. The variables that most affect the ratio are patient volume and patient characteristics. For example, a practice that has a large patient volume will generally need more support staff to be efficient, resulting in a higher ratio. Other factors to consider are the practice's level of automation and the extent of its services.

Remember that each practice is different and that national statistics should be used as guidelines, not absolutes.

*Denotes charter members of the Academy's Network of Consultants.


Copyright © 1998 by the American Academy of Family Physicians.
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