“Patients say what they want is immediate acknowledgement,” adds Bradford. “When they walk in the door, someone should engage them in eye contact, even if they are on the phone. A simple smile can say, ‘I see you, I’m glad you’re here, and I’ll get to you in a moment.’ That all can be communicated nonverbally. It’s one of the most important interactions you will have with that patient that day.”

3. Patient greeting and exam. Another vital patient-service experience occurs when the patient is called into the back office. “Often a patient has been waiting a long time and is growing anxious,” says Bradford. “When his name is called, he becomes very nervous. It’s a time when the nurse or assistant receiving the patient can best help counteract those feelings and make the patient feel more at ease.”

Most often, when patients are taken into a practice’s back office, they make several stops before they are shown into an exam room: one place to get weighed, another to have their temperature and blood pressure taken, and perhaps a third to talk to a nurse about their presenting illness and health history. Sanderson-Austin says that although traditional physical plant issues support this game of “room tag,” research has shown that taking a patient into a single exam room complete with all of the equipment necessary to take and record the patient’s vital signs boosts both office efficiency and patient satisfaction. “It’s the new model that practices are striving to develop,” she says.

McAllister says his one-stop exam room model has been very well received by his patients and their parents. “As I do their vital signs and take their histories, the kids and their patients get a chance to warm up to me,” he explains. “They don’t feel like they’re telling their story seven or eight times to different people and never really getting anywhere, so I think my model simplifies things greatly.”

McAllister even administers vaccines and draws blood himself if needed. Everything is done in the same room. He has the capability to do some simple lab work, such as rapid strep tests and urine strips in the office; for more complex work, he contracts with a lab.

McAllister says that doing all of these procedures himself allows him to spend more time with individual patients. Since he currently sees eight to 12 patients a day, he says he doesn’t feel rushed through appointments. Indeed, the most positive feedback he’s received has been on the amount and quality of the time he spends with patients and parents. “They’re able to ask a lot of questions, and I’m able to make sure that they really understand what I’m saying. … It helps because in the long run it saves me time on the other end because there are fewer questions that come up later that night.”

4. Patient check-out procedures. McAllister’s “one-stop-shopping” model also includes check-out procedures that are performed in the exam room. If any prescriptions are warranted, he sends them electronically to the local pharmacy. He schedules any follow-up appointments, and his EMR reminds him if the child is due in the near future for vaccinations or well-baby visits that he also schedules on the spot. Finally, for baby visits, McAllister prints out a growth chart for the parent.

To ease check-out procedures at her large practice, Miller says that her check-in and check-out staff are part of, and report to, the billing team. “Once or twice a year we do a major billing and access team meeting in which we talk about all billing aspects because it’s all tied together,” she explains. Having this know-how allows front-desk staff to knowledgeably explain charges to patients who come to them with questions.

Another convenience Family Practice Associates of Lexington offers its patients is the opportunity to fill some of their prescriptions at check-out. The group stocks a small formulary of acute episodic drugs. Patients really appreciate the convenience of not having to go to a pharmacy after their visit. And so does the staff. “It’s not something that involves scheduling or coordinating appointments or collecting money,” explains Miller. “They kind of get involved in the patients’ care.”

Keep in mind that the person who checks out your patients is the last face they will see before leaving the office. “If they are treated well, they’ll feel like they are leaving a group of friends, people who will welcome them when they return,” says Bradford. But she also cautions managers to tell their check-out staff to choose their words wisely when talking to departing patients. “Be careful when asking questions like, ‘Did everything go all right today?’” she says. “For some patients, it may not have.”

5. Follow-up. For most patients, their care continues long after their appointment with you. They need prescriptions, lab work, X-rays, scans, tests, and referrals. Keeping track of patients once they leave the office is “probably the hardest thing we do,” says Miller. Her group is in the process of transitioning from a document management system to an EMR, and Miller hopes that will ease their follow-up procedures. Her office currently tracks all referrals by recording the date and time a patient is scheduled to see a specialist and then follows up to ensure the appointment was kept. If not, her staff contacts the patient to determine why not, and does its best to “close the circle of service” by ensuring the patient receives referred care.

I can’t get no …

Patient satisfaction is easy to take for granted. But you don’t want to wait until your phone stops ringing before you think about patient attraction and retention.

“Physicians really need to look at how patients want to be treated in the nonclinical part of their experience in a medical practice,” says Bradford. “They’ve got to understand the uniqueness of their customer population and their setting. So details are key.”

Amidst the hustle and bustle of everyday practice, it may be easy for you to miss a floating dead fish in the tank in your reception area. But your patients won’t.