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Simple steps to good customer service in medicine

A column about keeping your practice in good health

By Victoria Stagg Elliott is a longtime staff member. She covered practice management issues and wrote the "Practice Management" column from 2009 to 2013. She also covered public health and science from 2000 to 2009. Posted Nov. 5, 2012.

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When patients talk about what they see as a good experience at a doctor’s office, the physician’s diagnosis of their problem may be less of a factor than whether the waiting room chairs are comfortable.

So physicians are advised that when it comes to keeping patients satisfied, they look at the whole patient experience — from the call to make an appointment, to entering the main office door, and everything that happens before they walk out — to ensure that a visit is as pleasant as possible. Otherwise, a practice could fail to keep or attract patients and get dinged on patient satisfaction scores, which can determine how much it gets paid.

“Customer service is important because, even in health care, everybody has choices,” said Jacob DeLaRosa, MD, chief of cardiac and endovascular surgery at Portneuf Medical Center and Idaho State University in Pocatello. “And if the practice has bad customer service, it’s a reflection on me.”

For example, a PwC survey of 6,000 people released July 26 found that 34% were willing to switch physicians if offered an ideal experience elsewhere. That is similar to the 35% who would change retailers if offered an ideal experience by another company.

Practices that want to improve their customer service must pay attention to patients’ experiences. Improvements may be fairly minor but can combine to create a much better impression of the practice and the physician.

“The good news is that a lot of the time, the problems are not that challenging to fix,” said Laurie Morgan, a senior consultant with California-based Capko & Co. who advises medical practices on customer service. “There can be very small things that will make patients feel better about the services they are getting.”

The first step is to consider the experience of making an appointment. How many times does the phone ring before it is picked up? How long do patients spend on hold? Consultants say reducing these numbers does not necessarily mean hiring more staff. Staggering schedules so the phone is nearly always answered by a staffer, especially during the lunch hour, can reduce patient frustration in trying to get through. Staff can then spend less time returning messages.

“A lot of patients can only call during lunchtime, and this change can be pretty easy to implement,” Morgan said.

The next step is to consider the waiting area. Even if the goal is to reduce the waiting time, practices need to ensure that the waiting room experience is pleasant. Depending on the nature of the practice, some may consider offering refreshments when a patient arrives. Patients should be kept apprised of any delays and given estimates as to when they will be seen. Magazines of recent vintage should be available.

“This is all part of building a nice relationship with a patient,” said Darleen Hutchins, CEO of the Hutch Group, a physician consulting company in Miami Beach, Fla. “Our patients are our guests. We want them to return. We want [them] to tell others that the practice is nice.”

Practice management consultants say the next step is to pay attention to the exam room experience. Does the patient know when the physician or a staffer will come see them? If there is a delay, have they been informed? Are there magazines in there as well? This can be particularly critical if the practice asks patients to turn off their phones.

“There should be something there for them to do,” Morgan said.

When they arrive for their visits, physicians can do two things that impress upon patients that they care: Know their history, and listen and talk to them with respect. A Harris Interactive Poll of 2,311 people issued Sept. 10 found that 94% considered a physician having access to relevant medical histories as important or very important in creating a positive customer experience. Ninety-five percent said the same about the time spent with a doctor. To improve this part of the visit from a customer service perspective, consultants suggest that physicians review a patient’s chart before entering the exam room. When in the exam room, the physician should sit in front of the patient and make eye contact.

“Patients want to know that a physician knows them,” said M. Bridget Duffy, MD, CEO of ExperiaHealth in San Francisco, a subsidiary of Vocera Communications that works on patient experience issues.

When services are complete, practice management consultants say how a patient exits a practice can be just as important as how they enter. Patients should be told by the physician or another staffer when the visit is over and what they should do next. Well-placed signage can help point them to checkout.

“Patients walk out into this rabbit warren,” Morgan said. “It can be very difficult for them to know where to go.”

Although many of the changes in this area may be fairly minor, experts say they shouldn’t necessarily be made all at once. Improving customer service is a process rather than a project, and it is never fully completed. Staff should be asked for feedback and suggestions on customer service. In addition, physicians may find that they have a significant role in setting the customer service tone.

“A practice’s culture really comes from the doctors, and it trickles down,” said Joseph Michaels, MD, an aesthetic and reconstructive plastic surgeon in North Bethesda, Md. “And it’s the little things that make a difference. Patients will remember.”

Victoria Stagg Elliott is a longtime staff member. She covered practice management issues and wrote the "Practice Management" column from 2009 to 2013. She also covered public health and science from 2000 to 2009.

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