Two weeks ago, I worked with the staff at a large, local primary care practice teaching them some basic customer service-type skills to help them better manage their patients and, truthfully, improve their own job satisfaction, too. Nurses, receptionists, the referral group, billing and cashiers – clinical and non-clinical staff attended. From making lists of the things their patients complain about most (you guessed it – prolonged time in the waiting room), to determining what the benefits to managing things differently might be (fewer headaches for everyone), we arrived at some simple and no-cost approaches they could use.
Their assignment, then, was to begin implementing some of those ideas, to assess what did, or did not work, and to begin thinking themselves of ways they could improve that constant patient interface that can become so problematic for everyone.
Then, after ten days of practice, we came back together to debrief.
Now, I’ll admit… I was a little nervous. I had no idea what to expect. Had it worked? Did they actually implement some of our ideas? And if they did, what was their assessment of success?
They loved it! Many of the ideas worked very well. They were pleased, patients were pleased… I’m going to share a couple of examples with you, because they will help you with your work with patients, caregivers, providers and others you interface with, too.
The Waiting Room:
My question to the group during the first workshop was, “You walk into a crowded restaurant, look around you, see that there are many people waiting, and what’s the first thing you ask the host?” The answer, of course, is “How long is the wait?”
But patients rarely do that. They walk into a crowded waiting room, check in, and sit down. They don’t ask how long the wait is – then they get upset if it’s “too long” – which each of them defines differently. That’s a major source of friction (which no doubt raises blood pressures, too) – and it’s mostly unnecessary.
A two-pronged approach can satisfy most (not all) of those frustrations. The first is my mantra “manage their expectations.” You don’t have to tell them exactly how long the wait will be, but you can be relative. “Dr. Smith is running behind – it may delay him a half-hour or more.” If it takes Dr. Smith a half-hour – then the patient will understand because she was told it would take that long. But if the patient only has to wait 25 minutes – then she’s thrilled because she got called “early.” Granted, the delay may be very difficult to assess, but some indication is better than no indication at all. The key is to let them know “what’s next.”
Now – as advocates, that part isn’t particularly helpful to us. I share it only to give you the provider side of this two-pronged approach. Because the patient (or advocate) should use the flip side. If the receptionist (or nurse or whomever greets you in the doctor’s office) doesn’t give you some indication of the wait – then ask! You ask in a restaurant, right? So why not ask at the doctor’s office? Manage your own expectations for a more satisfying experience. Manage your patient-client’s expectations and he or she will be more satisfied with your interaction, too. Ask “what’s next?”
And that’s what the buttons were for. See that “what’s next? Ask Me!” button at the top of this post. Each of the people who attended the workshops wore those buttons. And yes, patients did ask. I’m told those patients learned something, too.
The Referral Desk:
In this large practice, they have a group of people who do nothing but make referrals for patients. Their major frustration was that patients call them before the referrals are complete, upset that it’s taking so long to get the referral. Of course, fielding all those phone calls takes time – time they can’t spend working on completing the referrals.
Now – I know this to be true, because I am a patient at this practice, and I always have to call them to see where my referral is…. it takes weeks or even a month sometimes. Turns out the reason it takes so long is because my insurer takes so long. I had no idea!
In fact, their policy is to make the first attempts at the referrals through the payer within 24 hours of receiving the referral from the doctor. After that, they mostly have to wait, and follow up, and follow up, and take calls from irate patients. Then, once they finally get the payer’s paperwork, they can call the referral doctor to make an appointment. As I said – it can take weeks and weeks for someone with insurance like mine.
So what did I suggest to them? Tell patients the process! Tell their patients what to expect. Manage their expectations. Tell them “what’s next“.
It begins with the doctor. “Mrs. Smith, I’m going to refer you to an orthopedist. Just so you know what to expect – depending on your insurance, this referral may take two weeks, or it may take a month. We’ll contact you as soon as we get the approval.”
What drives the referral team nuts is taking the irate calls from patients. But if patients understand that it can take many weeks, and that it’s their own insurance that holds up the process, then the referral team won’t get so many of those calls. Patients are more understanding, and staff is happier. Win Win. And all because they answered the question, “what’s next?”
It’s a different way of thinking for many people. Letting everyone know what to expect, even if they don’t like it, at least affords them a platform of understanding in a different way. Plus it’s a sign of respect.
But remember, there’s no reason why, if no one else is managing your expectations for you, that you can’t manage them yourself. Whether it’s for yourself, or on behalf of a client, continue to ask “what’s next?” to make the interface go smoothly.
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