Physicians Practice - July/August 2008 - (Page 46)

PATIENT RELATIONS At his ofﬁce, Welters asks all patients who are on controlled substances for more than two months to sign a contract saying they won’t solicit medication elsewhere and if they do, they must agree to let his ofﬁce know. THE ANGRY PATIENT USING PATIENT COMPLAINTS TO YOUR ADVANTAGE You’re short-staffed, the waiting room is packed, and your EMR is threatening to implode, when a disgruntled patient decides to alert you that he doesn’t much appreciate the curt response he’s received from your front desk clerk. He’s ready to walk unless someone can resolve his billing dispute — pronto. Certainly, this does nothing to calm your frazzled nerves, but he’s not necessarily wrong either. “Your immediate knee-jerk reaction is to think, ‘Oh, they’re a crazy patient,’ but for every complaint you hear there are a lot you probably don’t hear about,” says James Welters, a family practitioner and chief medical ofﬁcer with Minneapolis-based Northwest Family Physicians. And one patient’s displeasure can spread faster than lice in a kindergarten class. “If one person is unhappy, they’re going to tell their friends and coworkers,” Welter points out. “That can be devastating to a practice.” When someone complains, recast it into opportunity. How? Actively seek out patient perspective, mining for feedback that can help sharpen your competitive edge. Encourage patients to voice their concerns, air grievances, or offer suggestions by: You can use an outside vendor to administer the survey. The National Committee for Quality Assurance maintains an online database of certiﬁed vendors who provide such surveys through its Healthcare Effectiveness Data and Information Set tool. (Visit www.ncqa.org, then click the “HEDIS” menu tab on the left. Click “Survey Vendor Certiﬁcation Program” under “HEDIS Programs,” and then “Current Vendor List” on the right side of the page.) Another alternative is the National Research Corp. in Lincoln, Neb., a healthcare survey research ﬁrm that conducts telephone, mail, and kiosk-based patient satisfaction surveys on behalf of practices to measure the patient experience and provide analysis for clinical quality improvement. “A lot of times we ﬁnd that what the doctors think is important and what the patients think is important are very different,” says Jason Rowe, NRC’s vice president of business development. Prices for such services can vary dramatically, depending on the sample size and methodology. Telephone surveys are more expensive than both do-it-yourself kiosks and mail-based campaigns. Rowe says the cost for a typical mailed questionnaire can range between $250 and $500 per physician. LET THEM BE HEARD Whether you receive a complaint in person or via a survey, it’s critical that someone on your staff respond quickly and courteously. You can’t implement change based on every frivolous grumble you receive, but you can establish goodwill by giving the patient a chance to be heard by a live person from your staff. “Most of the time, we can address their concerns and, if nothing else, say, ‘We hear you and thank you for bringing it to our attention,’” says Welters. “At least they feel that someone listened to them.” Some examples of positive outcomes stemming from a complaint: A friendlier protocol for putting patients on hold (“Sorry, can I please put you on hold?” replaced “Hold please.”) and a more streamlined process for writing referrals to specialists. • Placing comment cards at the front • Creating a separate e-mail address on your Web site solely for patient feedback. desk and instructing the receptionists to encourage patients to ﬁll them out. • Conducting “exit interviews,” that is, If you’ve been in practice for any amount of time, you’ve no doubt experienced the angry patient who walks in with a chip on her shoulder and untenable expectations on her mind. She ﬁnds fault with the medical profession in general and, often, with you, personally. “It’s important to keep your cool under any circumstance, but these are the ones who really test that,” says Wolf. “They say things like, ‘You’re late. What kind of care is this? I don’t know why I’m here; you can’t ﬁx me anyway.’” What works? Let the person vent — brieﬂy. Then follow up with a comment, such as, “I can see you’re very angry.” This sort of reﬂective response counts with these patients because it legitimizes their feelings. Often, adds Wolf, these are patients who feel impotent either in life or in the doctor-patient relationship. You can help to re-empower them. “Tell them [that] what you really want to do is work together to address their health concern,” says Wolf. “Let them know that they’re the one who ultimately makes the call on whether or not they choose to get that MRI or take the medication you prescribe. If you allow them to choose it on their own, they’ll choose it.” ALL IN THE FAMILY reaching out to patients who have left your practice. Though most leave because they’ve changed insurance providers, you might just learn that one physician is alienating patients with a dismissive bedside manner, or a parking shortage is literally driving patients away. But your best tool, by far? A patient satisfaction survey. Usually conducted by phone or mail, such surveys ask direct questions that address everything from access issues to quality of care. The answers patients provide help identify areas of weakness that require change. 46 It’s not always the patient who causes problems, of course; sometimes it’s the spouse or adult children. “When you have a patient who is terminally ill, in particular, it’s usually the family who has the more unrealistic expectation of what can be done,” says Centor. “That’s a very difﬁcult situation, partly because of the angst you feel when they demand unnecessary tests for a patient that you know will only cause suffering and not do any good. It eats at your heart. You don’t want to get WWW.PHYSICIANSPRACTICE.COM | PHYSICIANS PRACTICE | JULY/AUGUST 2008 http://www.ncqa.org http://WWW.PHYSICIANSPRACTICE.COM

Table of Contents Feed for the Digital Edition of Physicians Practice - July/August 2008

Physicians Practice - July/August 2008 Contents The Bigger Picture: Battle Royale in the EMR Market Letters Physicians Practice Pearls: Hire Right Noteworthy Cover Story: Healthcare Reform: Voting for Change Patient Relations: Dealing with Problem Patients The tech Doctor: Is Self-Service Medicine Inevitable? Technology: Do EMRs Make You a Better Doctor? The Guide Idealab: Cash-Only Care Still Works The Administrators Desk: Who’s in Charge? Ask The Experts What Went Wrong: ‘Why Our Great Idea Didn’t Work’ Coding Start It Up: How to Launch a Practice: Operations Partnership: Don't Let Partner Conflict Destroy Your Practice Appraisals: What’s Your Practice Worth? Getting Advice: How to Hire a Consultant Classifieds Advertiser Index

Physicians Practice - July/August 2008

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