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    Susan Childs
    Susan Childs, FACMPE

    The increasing importance of the patient experience necessitates benchmarking and reporting for patient satisfaction goals. Insurance companies, compliance efforts and other initiatives have made customer service and satisfaction a central consideration of patient retention. How we administer the increased demand for patient advocacy is reflected with every patient interaction.

    Accountable care organization (ACO) success is measured in part by patient engagement, which includes physician communication, access to specialists, health promotion and education and shared decision-making. Quality measurements and performance standards can have substantial impact on your revenue.

    No matter the specialty or size, the patient and physician should be central to every decision and process.

    First impressions are made in 12 seconds

    If someone were to appear at your practice’s doorway, what would you tell them about your approach to patient care? No matter the medium, patients should know why they should see your physicians over all others and what makes your practice unique.

    How easy is it to request an appointment, learn more about the physicians and can patients establish a payment plan via your portal?
    While online presence is essential, personal references are the most reliable resource. They remain one of the most trusted referrals as patients choose their physician.


    How do we cultivate patients who are happy to remit their financial portion of the visit? Patients walk in with expectations, most often based on their last experience with your office or another practice.

    Help patients feel welcome, secure and prepared by confirming details: appointment time, financial obligation and pre-visit instructions. Addressing anything that can make them more comfortable upfront is the goal.

    For example, picture how your staff looks as patients approach the front desk. Is there privacy or is it a fishbowl? Does it feel unorganized? The front desk’s appearance influences how patients envision their care experience.

    Remember that this is where we spend at least eight hours every day and it becomes like our living room — you may not notice gradual changes that patients often notice at first glance.

    The new threshold and re-positioning of patient experience standards

    Setting customer service standards offers a stellar example of how to enhance the patient experience at your practice:

    • Clearly define what great customer service means
    • Set goals based upon your unique vision and customer service principles
    • Support and advocate for your employees1

    Staff member engagement leads to better patient engagement and more favorable satisfaction scores. One way to manage staff behavior and recognize improved performance is to have a continually running patient satisfaction survey. A neurosurgical practice I work with selects a different physician each week. Patients are given a card to fill out and place in a locked box upon checkout. It is a great way to catch all ranges of behavior, especially for new employees. Someone doing a great job can be given affirmation right away.

    Surveys also should always offer an open text area to provide patients with a voice for any issues practices have not been able to address.

    Patient surveys can also have skewed results. A patient’s happiness may not directly coincide with best practices of care. For example, patients who are prescribed more antibiotics tend to be happier with their physicians than patients who are not prescribed antibiotics. Having a physician or staff member communicate why an antibiotic may not be right for them helps set proper expectations.

    Demonstrate value to patients

    It is up to practice leaders to set the best possible example of how to treat patients by actively modeling desired behavior.

    Communicate to your physicians to emphasize how each patient is directly connected to them. Patients need to know that their providers are involved with every decision regarding their care plan. The key is to associate the provider’s name with every step of care. For example, the lab tech or nurse could say, “Dr. Fink is very happy that you are able to come in for your labs today and that you are feeling so much better,” to help the patient feel a direct connection to the physician. The provider also can cross reference the lab tech by asking the patient, “How did you like Susan, our new lab technician?” This shows patients a collaboration of care, which can grow patient trust.

    Patient experiences, angst and priorities

    Fine-tuning and tweaking your clinic in small ways can have a positive effect on patients.

    Consider a scale placed in an open area. Some patients may prefer privacy while being weighed. Making that patient feel comfortable in an uneasy situation can lead to more patient information being offered. Move the scale to a private area and include a positive message on the wall to reassure the patient. For example, it could say, “The scale only gives a numerical reflection of your relationship with gravity. It does not measure character, love, purpose, talent, strength, beauty or possibility.” A patient who otherwise would be anxious may instead relax and then share more information with his or her doctor.

    Similar steps for putting a patient at ease while in the practice should be reflected in patient communications, which should be outlined in your documented policies and processes.

    Everyone likes to know where they stand. When the care visit is complete, train your staff to help bring conclusiveness with a closing statement. Statements such as, “You’re all set,” “We do not need to see you for another six months” or “No need to come back unless you show symptoms again,” will send the patient away with more confidence. Patients receiving post-care instructions should also be advised of all the ways they can communicate with the practice to get back in touch before they leave.

    Policies and actions to promote patient self-care

    We all have our own processes of receiving and relaying information. We tend to hear what we want, then define and rationalize as needed. All information is processed through the emotional part of our brain before common sense comes into the picture. This is where knowing your patient base will contribute immensely as you reestablish your foundation of communication with patients and staff.

    One priority for reaching patients based on their preferences is through electronic platforms, including patient portals. Easy-to-use portals can help convince patients that their provider is involved with decision-making, mitigating the task of asking patients for information. Building the patient-provider relationship digitally can help establish a long-term relationship and boost patient retention. A portal tips the scale toward a partnership in which the patient has more trust in the decision-making.

    However, educating patients on using a portal often is the first hurdle you must clear in building that trust. Patient-facing staff should be trained on using a portal so they can easily explain the process to patients. Role-playing as patients during staff meetings also can prepare your staff for challenging conversations, build confidence and establish consistency in scripting or messaging.

    As you build out new methods for patients to communicate with the practice, don’t forget your phone system, which is a prime example of a tool that can help or hinder communication. Don’t lose sight of these phone strategies:

    • Voice attendants should have no more than five options — the fewer the better.
    • Staff members should answer the phone personally, with the voice attendant picking up after three rings.
    • Staff members’ voice messages should match information listed on the website and not cause confusion. Suggest voice message scripts for your staff.
    • Ensure your phone system has an option to reach a live person at the end of each step.
    • After 30 seconds of keeping someone on hold, consider a “thank you for waiting” message. Some phone systems offer patients a callback option when a staff member becomes available.
    • Update your phone system with current information that patients need to know. Patients on hold are a captive audience for receiving practice updates.
    • Avoid having incoming calls answered at the reception area. Beyond privacy issues, your front desk staff should have their eyes facing toward the rest of the room and patients as they arrive.

    When I think about improving patient-physician relationships and communications, there’s no better example than Douglas Drossman, MD, a gastroenterologist with whom I’ve had the honor to work.

    According to Dr. Drossman:

    Without the human interaction to gather the patient’s life, personal perceptions, attitudes and behavior surrounding the medical data history, we lose the capability to understand the full picture of the patient’s illness, make proper clinical judgments or develop [a] gratifying therapeutic relationship. One of the key benefits of having good communication skills is increasing patient satisfaction, and clinicians are now being evaluated for this. … good communication skills relate to many other important clinical benefits: The disclosure of more meaningful information, greater patient adherence to treatment and emotional distress, and overall better clinical outcomes.2

    He also adds that there are four questions you can routinely ask to understand the patient’s complete agenda:

    1. What brought you here today?
    2. What do you think is the issue?
    3. What worries or concerns do you have?
    4. What are your thoughts of what I can do to help?3

    Conversation and action with physicians and staff is intertwined throughout the practice and reflects upon every employee. When working together with the team approach, respecting coworkers in each other’s role, we can all improve to meet patient needs and better our office culture as well!

    Patients expect some basic things: A level of expertise, cutting-edge technology, provider access, short wait times and to administer their insurance plan as best we can.

    They also expect the magic pill. I know I do. I want a pill that tastes like chocolate (no calories), heals instantly and is free! Some have also observed that the level of patient expectations coincides with the increase in premiums.

    Perception is reality. We can indeed deliver that magic pill — in strong doses with each improved process, constructive conversation and quality patient interaction.

    It all comes back to common sense. Would you send your mother to your practice? It’s something that all of us should be able to answer with a resounding, “Yes!”

    Susan Childs

    Written By

    Susan Childs, FACMPE

    Susan Childs, FACMPE, can be reached at

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