The phones are a major operational issue in many medical practices. The reflexive solution is to add dedicated phone staff and/or move the function to a back room where the incessant ringing is isolated from the rest of the office. A real solution requires understanding the root of the problem.
Why are X telephone lines apparently not enough?
• The greeting is long and complex.
• The volume of calls is exaggerated because patients call again before getting a response to the first call.
• The average length of each call, when a person answers, is long.
• The person answering the phone tries to help but does not have the information readily available.
• Staff is not skilled in gathering the necessary information and ending the call.
Why is the office getting so many calls?
• It is the only way patients can make or change appointments.
• Patients call the office for refill authorization.
• Patients were distracted during their visits and are calling for clarification.
Seven Potential solutions to the root problems:
1. Simplify, shorten and reorder the greeting. Many greetings are unnecessarily complicated. Having nine options that take callers to another menu of nine options only sounds efficient. It wastes the caller's time and it ties up the phone line. The odds are good the caller will not end up in exactly the right voice mailbox anyway. Keep it simple.
Incoming calls fall into only a few categories:
• Physician or hospital calling.
• Pharmacy calling.
• Patient calling and needs to speak with the provider.
• Patient calling and is requesting something from the clinical or office staff.
The list above may not be comprehensive, but it is close.
Most greetings are ordered for the convenience of providers, hospitals, and pharmacies. It would be a better use of resources to order the options in terms of the associated volume of calls. For instance: patients, pharmacies, provider/hospital, other. Patients can select their option very quickly and go about the business of leaving a message. Regular callers can memorize the office's option appropriate to them. If a provider or hospital must wait to learn the appropriate number to press, the wait will not be long because the rest of the message is short.
Bonus: By leaving the most time-sensitive calls to the end, the office may be able to handle them differently without inviting a lot of special handling volume.
2. Reduce the number of rings before rolling to voice mail. Listening to the telephone ring is a waste of the patient's time, especially if he is going to voice mail anyway. For some practices, it may make sense for incoming calls to go directly to voice mail.
3. Tell patients when to expect action or a call back. Manage the patients' expectations. Some people will call every 30 minutes no matter what you do. Most people, given a “we will call you back no later than” time, will not call back before that time is past. Please note: Saying something like, “We will call you back by 7 p.m.” is much more effective than “We will call you back after the end of clinic.”
Include the standards for call backs in the telephone greeting and in information for new patients. Some offices may want to include a reminder from the provider at the end of the encounter.
4. Equip staff to handle calls effectively. Make the practice's expectations of phone staff clear:
• Be attentive, courteous, and friendly.
• Be businesslike and task-oriented; avoid social conversation.
• Assume responsibility for, and execute, tasks for which phone staff is authorized.
For call requests that require actions for which phone staff is not authorized:
• Capture the specific information other members of the practice will need to accommodate the requests.
• Remind callers not to expect action or a response before a certain date/time.
• If questioned, explain that an immediate response is not possible because the practice is taking care of the patients currently in the office.
5. Secure a portal for patient communication. Provide patients with a way to send electronic messages directly to the practice via a secure website. The topics are the same as a telephone conversation or voice mail.
6. Provide patients with educational materials they can reference at their leisure. These materials can be given to the patient at the end of the encounter, or they can reside on the practice’s website. The objective is to allow patients to serve themselves when they have routine questions.
7. Provide patients with a summary of the visit. A meaningful use requirement is the ability to give patients a summary of the visit. The summary is a good opportunity for the provider to anticipate patients' questions as they reconstruct the information received at the visit. This will also minimize the number of calls the practice receives from patients requesting information clarification.
It is important to remember that phone issues are equal opportunity irritants; they are a nuisance for patients, staff, and providers. The suggested remedies deliver notably improved patient service for significantly less practice labor.