In many ways, office efficiency and patient satisfaction go hand in hand. Effective communication is one key to achieving both, according to Dr. Roger I. Ceilley.
During a talk at the Hawaii Dermatology Seminar sponsored by Global Academy for Medical Education/Skin Disease Education Foundation, Dr. Ceilley of the University of Iowa, Iowa City, offered several tips for improving patient interactions through such communication.
A good first step is to be prepared.
"Always review the patient record before entering the room," he said, noting that this will provide a quick recall of the patient’s history and will provide the patient with the knowledge that he or she will be receiving informed care. Look for notes from assistants, who may have noted why the patient is being seen and if the patient is upset or has special concerns.
Also, it is fine for a provider to enter the room quickly, but be sure to always leave slowly. Offer a warm handshake, and remember the value and healing power of "laying on hands," he said.
During the visit, make a note of something personal about the patient, and put it in the chart to reference at the next visit. For example, "Patient will celebrate 50th anniversary on June 20."
During the encounter, sit down for a brief time whenever possible, look directly at the patient when speaking, and convey that you care and that you enjoy what you are doing, Dr. Ceilley advised.
Interject humor whenever possible, he added. When used appropriately, humor will further put the patient at ease in what may be an uncomfortable circumstance. Keep in mind that some patients have hearing loss and lip read to some degree and want to see your expressions.
On average, physicians give patients less than 30 seconds to express concerns, and physicians tend to focus on the first problem that a patient mentions. The first one they mention may not be the one of most concern, so take time to hear their other concerns as well, he said.
Be sure to take an inventory of patient expectations and discuss realistic expectations of treatment options available, carefully review the treatment plan and costs, and obtain informed consent prior to any procedure (including disclosure of expectations, side effects, and costs,) he added.
At the close of the visit, supply handouts and provide enough refills until the next visit or for 60-90 days depending on insurance requirements, and ask the patient if there is anything else he or she needs. You may not be able to take care of these needs, but they should be addressed. Then schedule a follow-up appointment, refer the patient, or have the clinical staff assist them, Dr. Ceilley said.
"And remember, patients won’t remember everything exactly as you said or everything that you did, but they will remember how you made them feel," he said.
A few other things that can contribute to patient satisfaction and/or office efficiency are samples and supplies (provided with instructions and quality handouts), a dedicated check-in and check-out process, a communication center (for making appointments, handling referrals, managing faxes and other communications, and triaging patients), and a website to serve as a patient resource.
Dr. Ceilley also offered tips for hiring and training practices that can improve office efficiency and physician, staff, and patient satisfaction. When hiring staff, take your time and don’t settle for less than you need, he advised.
A tiered interviewing process by which prospective employees are interviewed first by management, then by lead staff, and finally by the physician is optimal. The inclusion of at least a few hours of shadowing with staff before a position is offered to a final candidate can help improve the likelihood that the best hiring decision will be made.
Among the factors to consider in a candidate are attitude, intelligence, experience, loyalty, stability, enthusiasm, judgment, and technical ability. Staff efficiency is best achieved with high-quality staff, and that efficiency will more than make up for the extra pay likely required to hire the best, he said.
"One excellent staff [member] at 20% over market rate pay will equal or exceed in work output 1.5 average staff at the market rate – at less cost," Dr. Ceilley said.
To further ensure the highest level of efficiency, consider personally training your assistants, he said, noting that the physician’s role in creating an efficient office environment involves earning the trust of employees – this is where communication also can benefit this aspect of practice. Employees need to know that they won’t be taken unfair advantage of, and this is communicated by demonstrating consistency (which provides a sense that things will be handled in an even and predictable manner every day) and conveying confidence, (which provides a sense that things are under control).