Pleasing patients proves profitable for practices.

We often make the mistake of thinking that good clinical service equates to good customer service. In fact, it is the other way around. When a patient receives courteous, friendly and efficient service, that patient assumes that the clinical quality is excellent.

On the other hand, if poor service is rendered, there will always be a question as to the quality of the medical services received. How you treat patients from a non-clinical perspective will likely become the norm for patients who have an increasing choice of where to receive their health care.

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The patient is changing

Patient education levels continue to increase. This increase comes from not only a larger percentage of the population receiving a higher level of formal education, but also informal education. All demographic groups have greater access of information through Web sites, many of which have greatly improved their content in recent years.

Additionally, many pharmaceutical companies bombard patients with advertisements that encourage patients to request specific items to treat their own self-diagnosis. Irrespective of the value of these forms of heightened awareness, the physician practice and its staff must take these factors into consideration when interacting with their patients.

There is a real and significant trend toward greater choice and shifting the burden of medical costs directly to the patient. Under a system where co-insurance, copayments and deductibles are at a much higher level, patients begin to better understand the true cost of health care services.

The patient is accustomed to paying as little as a $10 co-payment for a wide range of services. It will not be unusual to see patients with $1,000 to $5,000 deductible plans in the near future.

It's easy to envision a situation where a patient refuses to pay or requests a reduction in fees if they feel that they did not receive appropriate value for the cost of services. Additionally, physician networks are becoming less restrictive and patients have the ability to shop around until they find the right combination of price and value.

Providing a pleasant experience, coupled with a true caring attitude by all members of the staff will add to the perceived value of the encounter and create a higher degree of patient loyalty.

The mystery of medicine is diminishing. Patients no longer feel intimidated by the physician office and are beginning to judge services much like any type of service industry. Customers place a high degree of value on convenience, efficiency, access to timely service and respect.

Your practice should expect patients to be more aggressive and demanding. Expect them to ask questions about complication rates, services you recommend that are not covered by insurance and why you made them wait so long. Be particularly prepared for questions related to billing statements (if they can read and understand them) and the cost of services.

Everyone in the practice should be responsible for providing excellent customer service. Every process within the practice has the capability of having an impact on the patient's perception of the visit.

Before the visit

The initial contact with a physician practice typically is by telephone, though we are beginning to see an increase in electronic interactions. You can prevail in this area by answering the telephone quickly and by minimizing time on hold.

Telephone interaction tends to be the most difficult process to manage within the practice. However, most practices attempt to resolve telephone issues by increasing staff, implementing auto attendants and adding more lines--with little success.

This is because the practice does not take the time to analyze what is driving telephone volume and finding ways to reduce the input of telephone calls. Take the time to find out why your patients are calling you and reduce that demand.

Most people who call for reasons other than appointments require additional information or they need prescription refills. Focus on these areas and overall telephone demand will decrease.

Other pre-visit issues involve pre-registration, appointment availability, directions and overall courtesy of the staff who handle the telephone call. Pay attention to these details and you will start the interaction off in a positive manner.

During the visit

The visit starts at check in. Make sure that your waiting room is neat, well-maintained and is appropriate for the types of patients being cared for by your practice. Pay attention to your patients by greeting them, do not ask them for information already provided and keep them informed of delays. It is your responsibility to keep track of the patient and ensure that their expectations are met.

During the encounter it is extremely important for all clinical support staff and the physician to transmit a confident, caring and positive impression to the patient. It is critical that the physician totally focuses on the needs of the current patient and not be interrupted or distracted.

The physician should demonstrate active listening skills by respecting the patient's point of view, separating the person from the problem, using positive body language and showing flexibility in proposing solutions.

Finally, the physician should make sure that the patient has complete understanding of the visit, which can be achieved by asking the patient to reiterate instructions.

At the conclusion of the visit, take a few seconds to thank the patient for having the confidence and trust to allow you to take care of his or her health care needs. Ending the visit on this note creates significant goodwill and patient loyalty.

After the visit

After the clinical exam, the patient should be escorted to the check out area or to the next step in the process. This may involve payment of a patient balance, making a future appointment or receiving a referral to another health care provider.

Take the time to make sure that the patient totally understands all instructions and next steps. Should the nature of the check-out process require confidentiality, make sure that you have a place to conduct business in a private location.

Customer-centric

Remember that the customer, and in this case the patient, is the most important person in your business. Patients do not depend on you. They have many choices about where to receive their health care services.

You depend on them for your livelihood. Patients are not an interruption of your work, they are the purpose of your work.

You are not doing them a favor by serving them, they are doing you a favor by giving you the opportunity to serve them. You should be thankful that they have expressed the confidence and trust in you and your practice to take care of the their health care needs.

A patient is someone who brings you their problems and concerns. It is your job to welcome them into your practice and handle their situations in a gracious manner.

RELATED ARTICLE: Problem Resolution

Is the customer always right? It does not matter who is right or who is wrong. One should always focus on resolving a problem and creating the most positive outcome possible based on the given circumstances. When dealing with a difficult situation, take a deep breath, put the situation in its proper perspective, do not take it personally and follow these ten steps:

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* Listen without interruption. Take the time to let the patient express their thoughts and concerns, and if necessary, do it in a private place.

* Do not get defensive. It is not your job to render judgment, make excuses or defend an action at this point in time.

* Apologize. It is okay to apologize and express concern for the situation.

* Express empathy. Show the patient that you have genuine concern for their situation and consider how you might feel if you were in the same position.

* Ask questions to clarify. It is important for you gain complete knowledge of the situation.

* Find out what the customer wants. Take the time to find out exactly what the patient wants or what course of action is expected. This does not mean that you need to solve the problem at this point, but you want to determine the patient's expectations.

* Explain what you can do. This does not mean that you can deflect blame or pass the buck to someone else. However, the patient should know your level of responsibility and that you will take the initiative to make sure that the problem is taken care of.

* Take notes and maintain a record. Record the entire context of the conversation and question the patient to make sure that you got it right. This is a good place for the use of a standard form that both you and the patient can sign.

* Take action. Whether you have the final authority to render a decision, you should become the point person until the issue is resolved. Get others involved and ask for help.

* Follow up. Make sure that all follow-up work is completed, expectations are met and that the patient does not have any outstanding issues.

By Rick Weymier, MBA 

Rick E. Weymier, MBA, FACMPE, is director of clinical consulting and physician services at VHA, Inc., a nationwide network of community-owned health care organizations and physicians. He is based in Irving, Texas, and can be reached at 972-830-0298 or at [e-mail].