That’s not a problem for Terrence McAllister, a pediatrician in Plymouth, Mass. McAllister often answers his own office phone, something that surprises his new patients and downright startles pharmacists, nurses, and other physicians. Such easy access is the aspect of his practice that draws the most kudos from his patient base. “They love that I answer the phone or that I call them right back,” says McAllister.

How does he do it? For one thing, he has to. Performance Pediatrics’ only other staffer is Leann DiDomenico, the practice’s administrative director.

Technology is essential for McAllister to provide such personalized service. With his fully implemented EMR, his year-old practice is automated and paperless. The practice’s Web site is very comprehensive, incorporating insurance information; downloadable registration, health history, and adolescent health forms; FAQs about the practice; links to helpful sites for parents and children; a monthly e-newsletter that patients can opt to receive; and more.

McAllister encourages new patients to go to his Web site before their office visits to familiarize themselves with his practice and to download and complete the necessary forms in advance. He says that about half of his patients have their completed forms in hand when they arrive. “Patients really do like it,” says McAllister. “If they have a toddler they have to keep an eye on while filling out paperwork in the office, it’s difficult. If they can do that at home, when the child is asleep, it makes it a whole lot easier. And I get more thorough information that way as well. They have time to think about things like family history, talk to their spouses about it, and give me more information.”



After an appointment is scheduled, DiDomenico verifies the patient’s insurance online and collects any copay upfront. McAllister greets his patients himself and escorts them to one of his three age-appropriate exam rooms. (He has separate rooms for infants, children aged 2-12, and teenagers.) His office’s wireless network makes it easy for him to tote around his tablet PC, which he says is no more intrusive than a pen and clipboard.

Miller’s much larger Family Practice Associates of Lexington (FPA) averages about 300 patient visits daily. But the practice’s Web site, where patients can download all necessary forms and even complete and submit them online if they choose, enables FPA to offer optimal service right from the start. Patients can also request appointments and prescription renewals online, get self-care information, and learn general background about the practice, its physicians, and its policies. “We find that if we can drive patients to our Web site right at the beginning of their experience, then they’ll know what’s there and feel more comfortable with us,” says Miller. “We get uniformly positive feedback from our patients regarding our online services.”



But regardless of how many features your Web site may have, it’s only effective to the extent that your patients know about it and use it. When surveyed patients gave Miller’s practice low scores on their wait time, she knew the group could move through office visits much faster if more patients took advantage of their Web site’s capabilities.

“Frankly, we hadn’t done a good job educating our staff about what our site offered,” says Miller. So she held educational sessions in which she guided staff members through the site and its offerings. “Some of our staff had never been to our Web site and really had no idea what was there.” Once employees were more comfortable talking to patients about the site and its capabilities, surveyed patients began indicating positive experiences with their wait time.

Finally, always keep in mind that when a new patient calls, the person who answers is her very first contact with your practice, and it’s essential that that person is courteous, helpful, well-informed, and respectful. This may seem self-evident but it’s surprising how often practices make this staff person their lowest priority — hiring teenagers with no professional experience and poor social skills, and then giving them little or no training.

Paula Comm, practice administrator for PRA Behavioral LLC, a psychiatry practice in Schaumburg, Ill., says that when she is training new staff, she uses a “mystery shopper” service that calls new employees and poses as a patient. Later, the “shopper” reports back to Comm on her new hire’s performance. “When someone is making that first call for a psych appointment, you need to understand just how difficult it is for them,” explains Comm. “Regardless of how unclear they may be, you have to have 10 times more patience when taking that call because it was so difficult for the patient to make it.”

2. Front-desk intake procedures. “Check-in is no longer a warm, fuzzy experience,” says Miller. “Today, it’s ‘I need to get all of this information about you, it needs to be accurate, we need to know what your insurance is and get all of those details now so we can get you in to see the physician as quickly as possible.’”

If not well-monitored, Miller says the typical check-in process becomes a push-and-pull between the front and back desks. “They want the patient’s information in the back as quickly as possible because they want to get the patient roomed and stay on time, and then I’m putting all kinds of pressure on the front desk to get accurate billing information so we can make sure we get paid for the visit,” Miller explains.

Of course, patients entering an office may be ill, irritated at having to take time off from work, anxious about impending test results, or worried about their loved ones. So they’re usually not at their best when they approach the registration desk. “We talk a lot about how not to take things personally,” Miller says.