Use Shadow Coaching to Improve Medical Practice Performance

February 15, 2013

An effective shadow coaching program can boost patient satisfaction scores. Here’s how to do it right.

Implementing a shadow coaching program for providers at your practice, including nurse practitioners, physician assistants, and physicians, is a great way to boost patient satisfaction scores. 

“When people are getting low patient satisfaction scores, they don’t know why,” Meryl Luallin, a partner at California-based medical practice consulting firm SullivanLuallin Group and a medical practice shadow coach herself, recently told Physicians Practice. “Shadow coaching is to help the [provider] to realize by way of an actual observation, mannerisms that he or she might have that they are not aware of.”

Here’s how to create an effective shadow coaching program at your practice:

Survey first. For shadow coaching to be effective, it should be done after a patient satisfaction survey. That way, once the provider has shadowed and begins focusing on identified problem areas, you can put forth another survey to gauge progress, said Luallin.

Identify a shadow coach. An outside consultant is the best option, said Luallin. For one thing, the consultant will know what to look for and how to go about observing the provider. For another, he will have an unbiased observation because he has no professional or personal connection to the provider.

If a practice hopes to use one of its own employees to serve as the shadow coach, it works best in a larger group practice, said Luallin. “ ... The shadow coach would be someone from a different site or a different department that doesn’t have a whole lot of interaction with the doctor other than to come in and observe for that day,” she said. 

Determine what to observe. The identified shadow coach should adopt a patient’s perspective while observing the provider in action. “Put yourself in the patient’s place and if you were a patient, what would you expect from the doctor?” said Luallin. Here are a few things the coach should note while observing:

• Whether the provider knocks before he enters the exam room;
• Whether the provider calls the patient by name;
• Whether the provider makes eye contact with the patient, sits down, and listens without interrupting;
• Whether the provider comes across as caring about the patient, does not rush through the visit, and explains things clearly;
• Whether the provider writes directions down for the patient, connects the patient with necessary resources, and reviews directions at the end of the visit;
• Whether the provider gives the patient the opportunity to ask questions. 

“Those are some of the basics and believe me, from our experience as shadow coaches, lots of doctors don’t do many of those things,” said Luallin.

Make the intent clear. It’s critical that the shadow coach approaches the observation with the right intent. That’s the only way the provider will be receptive to his input and advice. “The shadow coach has to empathize with the doctor, wants to be helpful to the doctor, and wants to see his or her role as being supportive and helpful rather than going in and just telling the doctor where he’s wrong and what he needs to do to change,” said Luallin. “It takes a special person to be a shadow coach. Not everybody can do it.”

Luallin spoke with Physicians Practice about the benefits of shadow coaching at MGMA12. Click here for the video.