ORLANDO Optimize patient interaction, staff training, professional relationships, and office setup to increase office efficiency and personal satisfaction, Roger I. Ceilley, M.D., said in a presentation at the annual meeting of the Florida Society of Dermatologic Surgeons.
"Patient satisfaction plus personal satisfaction equals fun. And I'm having more fun in my practice now than I ever had," said Dr. Ceilley of the department of dermatology at the University of Iowa, Iowa City.
Ask patients about their personal lives on the basis of a few words written in the record, look directly at patients when you speak"some older patients have a component of lip reading"and sit down with patients whenever possible, Dr. Ceilley suggested. Have a warm handshake and touch patients reassuringly, he added. "Laying on of hands lets the patients know that you care."
Always review the chart before entering the room. It is okay to enter a room quickly, but always leave slowly, Dr. Ceilley said. "Look at the patient before you leave. Ask: 'Is there anything else you need?'"
Other factors that increase patient satisfaction include:
▸ Patient registration forms available on the practice's Web site, so patients can fill them out ahead of time if they desire.
▸ Dedicated check-in and check-out areas.
▸ Wet gauze placed over patients' eyes before dermatologic surgery. "Tell them it will help prevent a headache from the bright lights," Dr. Ceilley said. "That's true, but it also helps ease the patients because they don't see all the needles and instruments."
▸ Absorbable sutures when indicated. "Patients who travel a great distance really appreciate not having to return for suture removal," he said.
▸ Good handouts and oral and written postoperative instructions. Advice on acceptable postoperative activities is critical. Emphasize the use of ice packs at home after surgery, Dr. Ceilley said. He suggested that patients use bags of frozen vegetables from their freezer.
▸ Free medication samples, and a prescription with enough refills to last until the next office visit.
▸ A sense of humor. "Humor is very important," Dr. Ceilley said.
In addition, patients appreciate receiving letters ahead of time outlining, for example, Mohs surgery or a cosmetic procedure. Physicians must give patients realistic expectations.
"We provide warnings about swelling, hematoma, drainage, and infection, particularly when working on the forehead or scalp," he said.
Always make a follow-up call to ascertain how patients are faring after surgery, he added.
When it comes to office assistants, it is critically important to train your own staff, Dr. Ceilley said. "When I used to have someone else train them, I realized after a few years that I was doing things the way my staff wanted, not the way I wanted." He added that there are only two criteria for good office employeesintelligence and a positive attitude.
Another tip is to develop a close relationship with other physicians in the community. A dermatologic surgeon should have an ongoing relationship with a dermatopathologist, surgical consultant, and oncologist, Dr. Ceilley said. "That way, you don't call them only when you are in trouble."
He offered a wide range of practical tips for improving office setup. For example, a communication center separate from a patient reception area does not take front desk people away from the patients to answer the telephone. It is also a good way to meet the privacy requirements of the Health Insurance Portability and Accountability Act.
The communication center staff can make appointments and referrals, and recall cancer patients. Dr. Ceilley has a dedicated pharmacy line in his communication center and encourages refills via fax. "The biggest waste of office time is medication refills and the time it takes to call in refills," he said.
Another time-consuming task for staff is to assist patients who show up without a referral. Have a telephone in the waiting room for patients to call the referring physician themselves, he suggested.
A sheet of preprinted labels in a patient chart can save time as well, Dr. Ceilley explained. Use a label maker to print out current patient information, including critical data, contact numbers, and insurance information, he suggested. "Just stick them on [documents] when needed, such as pathology requests."
When a patient is diagnosed with skin cancer, document all skin malignancies using anatomic diagrams, Dr. Ceilley advised. Track patients carefully; in his office, an oversized orange sheet is placed in the patient file. The sheet can be removed only by the physician after the cancer is treated. "That way, no one falls through the cracks."