Bob Levoy

Patient satisfaction doesn't guarantee patient loyalty. On the contrary, satisfied patients frequently change doctors because of insurance coverage, convenience, and long wait times among numerous other reasons. Something more than satisfaction is required to achieve loyalty: an emotional connection that makes patients feel valued, cared for, and understood and keeps them coming back.

Making an emotional connection with patients

Establishing that emotional connection, combined with your expertise, will differentiate your practice in ways that will be profoundly meaningful and appreciated by your patients.

is the author of seven books and hundreds of articles on human resources and practice-management topics.

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Establishing an emotional connection with patients will differentiate your practice in ways that will be profoundly meaningful and appreciated by your patients.

In a national survey, Consumer Reports asked 1,000 Americans to rate typical complaints about doctors on a 1 to 10 scale with 1 meaning "you are not bothered at all" and 10 meaning "you are bothered tremendously."Seminar audiences of physicians often guess "waiting," or "inconvenient office hours." They're indeed bothersome to people but not as much, it seems, as an "unclear explanation of problem," which was number one on the list of patients' gripes with a score of 8.3 on that 1 to 10 scale.Other complaints included being "rushed during office visit" (7.8); "side effects (of medication) not fully explained" (7.6); "long wait for doctor in exam or waiting room" (7.6); "inconvenient office hours" (6.5); and "doctor takes notes on device, not looking at patient" (6.2).Let's deal with that number one gripe: unclear explanation of problem. Here are some tested tips for avoiding this complaint.To view the slides in PDF format, click here. 

We know patients feel frustration with their physicians on some level. But, surprisingly, it's not always about the long wait.

Patients' Biggest Gripe About Physicians

Employees who are "engaged" have greater psychological commitment to the practice at which they work, often go above and beyond their basic job descriptions, and put more discretionary effort into their work. Engaged employees are also more motivated, productive, and likely to stay with the practice than the average employee.

, only 30 percent of U.S. employees are engaged in their jobs, while 18 percent are actively disengaged - meaning they are uninvolved and unenthusiastic about their jobs, and tell others how bad things are. In-between those two extremes, employees are sleepwalking through their workday, putting time - but not energy or passion - into their work.

Fortunately, physicians and office managers can take steps to improve the level of employee engagement in their practices. Here are three of the ways it can be done:

As simple as it sounds, start with the hiring process. If you simply look for skills and experience, you'll often miss the signs of 

that identify candidates with a high probability of being fully engaged. To refine your selection, include interview questions such as the following - the answers to which (or lack thereof) can be most revealing:

• In your last job, in what accomplishments did you take most pride?

• In your last job, when you finished your work ahead of schedule, what did you usually do?

• In your last job, if you were asked to do something that wasn't part of your usual duties, how did you feel about it?

• Do you prefer a job where you are given a lot of responsibility or a more highly structured job with more supervision?

Another way to foster engagement is to give staff members a voice in the decisions that affect them - often called "participative management."

Physicians and office managers who use participative management consult with their staff before making a decision that affects them - not only to get their input, but also to tap into their 

Sharing decision-making demonstrates respect for employees and their expertise and increases the likelihood of better decisions. It also helps employees develop a sense of ownership in their jobs which makes their work more motivating and satisfying and results in higher levels of engagement.

Equally important, when employees feel they have some say in the decisions that vitally affect their work, they're more highly-motivated to perform with distinction, than if they feel they're merely being told what to do.

Staff members who feel cared about and appreciated are invariably more engaged, productive, and loyal.

This point was driven home by the medical assistant who told me, "My first job was in a practice that focused on efficiency and financial performance. Employees were only a 'means to an end.' This practice," she said, "is totally different - one that puts people first - and manages from the heart. I love working here."

 in the lives of your employees outside of work: hobbies, family events, graduations, and the like. These discussions needn't be lengthy. Even a brief remark, such as, "I hope your daughter does well in tonight's gymnastic competition," lets the person know you cared enough to remember it. (Asking employees, "How's it going?" or, "How's the family?" doesn't do it.)

 Give employees the skills they need to advance their careers and increase their value to the practice. Such training sends the message that your employees are valuable enough to invest in.

Time off, particularly around the holidays, is highly appreciated. If your practice is especially busy during the holidays, arrange if possible, alternative work schedules to give people additional time for holiday-related tasks and responsibilities. Your employees will be grateful all year long.

 When you tell an employee why you're glad he is on your team, that person is what I call, "emotionally rehired." For example, when you say, "Amy, your incredible attention to detail makes a huge contribution to our efficiency and patient satisfaction. I'm glad you're here," - you have emotionally rehired Amy in 15 seconds. The statement is sincere and Amy knows it and it will contribute noticeably to her level of engagement.

By focusing on these efforts, physicians and office managers can create an atmosphere that promotes engagement; where employees want to come to work; where they spend the time to make sure things are done right; and where they have the passion and energy to go that extra mile.

is the author of seven books and hundreds of articles on human resource and practice management topics. His newest book is "222 Secrets of Hiring, Managing and Retaining Great Employees in Healthcare Practices" published by Jones & Bartlett. He can be reached at 

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Employees who are "engaged" have greater commitment to the practice, and often go above and beyond their basic job descriptions.

How to Engage Your Medical Practice Staff

No medical practice can afford to make hiring mistakes, which can lead to errors, inefficiencies, and costly staff turnover. They also create ripples of negativity that affect teamwork, productivity, and patient satisfaction.

Getting the right people onboard however, is no easy task. Here are five common mistakes made when interviewing and how to avoid them:

It's one of the most common errors in interviewing: the failure to establish rapport. As a result, no substantive discussion takes place; the interviewer learns nothing about the applicant's priorities, expectations, or job-related needs; and the interview never gets off the ground.

Looking for more ways to boost performance at your practice? Join experts Rosemarie Nelson, Lucien W. Roberts, Owen Dahl, and others as they help improve your medical practice and your bottom line at 

, a new conference for physicians and office administrators. Join us Sept. 19 & 20 in Philadelphia.

Recommendation: Don't be misled or turned off by an applicant who appears nervous - thinking he or she may not be able to cope with a stressful job. The interviewing process itself can cause nervousness and it may have little bearing on a person's ability to perform a job.

The first task therefore, is to put the job applicant at ease. The interview should be a pleasant informal conversation in which the person has an opportunity to talk freely and spontaneously to someone who is genuinely interested.

2. Placing too much emphasis on technical competence

Business office skills or clinical skills are often the most frequently discussed subject during job interviews because they're easy to assess. But such skills alone are a poor predictor of whether a newly hired employee will succeed or fail. Do such skills really matter if the employee alienates coworkers (or worse, patients); lacks motivation; or has the wrong personality or temperament for your practice?

"Beyond skills and experience, what's the most important trait you look for in a new employee?" is a question I've asked countless doctors. The answer given by Steven Garner, a veterinarian in League City, Texas, was, "Nice. We can train people to do almost anything," he said, "but we can't make them nice."

Recommendation: Have in mind the five or so personality traits you deem most important for the smooth running of your practice. Doing so will greatly simplify the task of finding the person you seek.

Many interviewers make the mistake of doing most of the talking during job interviews. They mean well - often providing pertinent information about the position or the practice - but in doing so fail to learn what they need to know about job applicants.

Recommendation: A good rule of thumb is to let the applicant talk at least 80 percent of the time. Don't rush to break a silence.

Wanting to hire a highly qualified applicant may lead to promises about job responsibilities, salary increases, vacations, flexible hours, infrequent overtime, etc., that can't be kept, or if kept, would lead to a staff mutiny.

 Don't oversell a job by promising more than you can deliver or, conversely, by downplaying the negative aspects of a job. When the facts become known, a new employee will either become demotivated or quit. Face the facts: a job 

 what it is. One solution: Rethink the position. Can the appealing aspects of the job be broadened? Can less desirable aspects be traded or possibly divided among other staff members or done by part-time staff or perhaps be outsourced?

This seems so obvious but surprisingly, is overlooked in many practices. There are risks involved in not checking references. Eighty percent of all resumes are misleading according to Hire Right, a firm that specializes in employee background checks. Furthermore, 20 percent of resumes state fraudulent degrees; 30 percent show altered employment dates; 40 percent have inflated salary claims; 30 percent have inaccurate job descriptions; and 27 percent give falsified references.

Recommendation: One of the best ways to avoid hiring those who are less qualified than they claim to be or who have falsified their resume in other ways, is to have job applicants sign a waiver that attests to the accuracy of the information they provide and authorizes you to seek relevant background information. In addition, this consent form should also give potential references permission to discuss the person's background with you. A reluctance, let alone a refusal, to sign such a consent form should raise a red flag.

Checking references in this day and age is a "must." If you neglect to do so, don't be surprised if you get surprised.

: Hiring the right people for your practice is the best present you can give yourself. It will result in happier patients, less turnover, greater productivity, and significantly less stress.

Hiring mistakes can be costly, resulting in high turnover, reduced productivity, and lackluster moral. Here are some easy ways to refine your interviewing skills.

Five Common Interviewing Mistakes Made at Medical Practices

When your staff members are out of the office, what do they say about their jobs? About you? About the office manager? Is it positive, perhaps negative, or something in-between? Is it "just a job" for them or one that they really "love"? Or is it one they actually "hate" but "tolerate" because they need a job? Such distinctions can impact staff morale, productivity - even patient satisfaction.

One of my seminar surveys asks staff members in attendance to write on index cards what they like or dislike about the doctors or office managers for whom they work. I require no signatures to encourage forthright answers, without concern for repercussions.

I've compiled a few of these replies, both favorable and unfavorable, in the hope they'll provide insights into achieving a happier, more productive workplace.

• "When the doctor receives candy, wine, fruit, and other gifts from patients, he shares these with the entire office staff - letting us know we're part of the team."

• "I'm the caretaker for a seriously ill family member. The doctor has been wonderfully supportive in helping me juggle my schedule to meet my needs in this situation. He lets me know that family is the number one priority, and does not make me feel guilty about the time off that I need. That relieves me of additional pressures. I make sure I give back in return."

• "I'm given considerable freedom to do my job as I see fit. Unlike my last job, no one looks over my shoulder or harasses me about times and details."

• "She has a great sense of humor which makes it pleasant for everyone - patients included."

• "I feel appreciated. I left another practice after nine years where the doctors always made you feel like you were just a number. I love it here."

• "He's been very understanding of my child-care responsibilities, and adjusted my hours to accommodate my hectic schedule."

• "Over the years there have been several patients who were rude, insulting, and made inappropriate remarks to us (staff). When the doctor was told about these patients, he took them aside, told them if they 

 repeated this behavior, they would be dismissed from the practice. And he meant it. Putting us first was greatly appreciated."

• "The doctor gave me (and another person from the billing department) the opportunity to attend coding seminars and achieve certification which advanced our careers (and salaries). It also resulted in higher reimbursements."

• "Moody one day, nice the next. You never know what to expect."

• "Staff members who shouldn't be here are allowed to stay."

• "I'm often asked to stay late, which is a terrible imposition. To make matters worse, it's not appreciated."

• "The doctor yells at us in front of patients. It's humiliating."

 business being in charge of anything. She has 

 listening skills, talks over you when you try to speak, argues with you, and talks 

• "A new employee was hired - with far less experience than I have - and is being paid more than me - and I've been here four years. And who do you think they asked to train this new employee? Me!"

• "The doctor never says thank you for anything - ever!"

• "The work load has increased and we're way understaffed. The pressure to keep up is extremely stressful."

• "We've been told there's not going to be raises - and if you don't like it, you can find work elsewhere. The office morale stinks."

Good staff morale isn't a nicety. It's a necessity! Unhappy employees don't perform as well as those who truly like their jobs and the people for whom they work. They're not as interested in what they do or how well they do it. They tend to be more careless and they're not as pleasant to patients. And that can take a heavy toll on patient satisfaction and your reputation.

 is the author of seven books and hundreds of articles on human resource and practice management topics. His newest book is “222 Secrets of Hiring, Managing and Retaining Great Employees in Healthcare Practices” published by Jones & Bartlett. He can be reached at 

It's hard to know what your staff really thinks. However, finding out is important: good staff morale isn't a nicety, it's a necessity to the health of your practice.

What Is Your Medical Staff Really Saying About You?

In the course of conducting seminars, I've asked more than 2,500 doctors to consider the following statement, "I let my employees know when they're doing a good job," and then rate themselves on a scale of 1 to 5 (1 = never, 5 = always). The average response is 4.4.

I've also asked audiences of staff members to consider this slightly different statement, "The doctor lets me know when I'm doing a good job," and rate themselves using the same scale. The average response? Only 1.7.

Looking for more on boosting patient satisfaction and utilizing tech tools to improve patient care? Join experts Rosemarie Nelson, Lucien W. Roberts, Elizabeth Woodcock, and others as they help improve your medical practice and your bottom line at 

, a new conference for physicians and office administrators. Join us May 2 & 3 in Newport Beach, Calif.

The difference between the amount of positive feedback doctors

 their employees and the amount employees 

The net result is that many staff members I've interviewed feel frustrated and disillusioned about their work because of this lack of appreciation. Included are those who do above-average work but receive no special recognition or appreciation. Many have said, "I never hear a nice word. The only time I get any feedback about my work is when I make a mistake." And they believe their efforts to do a good job are not even 

If your staff members believe their efforts are neither noticed nor appreciated, it will have a negative impact on their morale, productivity, and loyalty.

Unfortunately, people who feel appreciation, often fail to express it. Some physicians and office managers rationalize by claiming how busy they are or that their staff members are just doing what they're paid to do. Others mistakenly assume their employees' need for appreciation can be 

 met ("She knows she does a good job," or "My employees know I value them - I don't have to tell them"). Even if that were true, a verbal pat on the back or a written note of thanks for a "job well done" provides the kind of psychological satisfaction for which there is absolutely no substitute.

: Good work that goes unnoticed and unappreciated tends to deteriorate, almost without exception.

: Systematically start to thank your staff members when they do good work or make an extra effort - whether it's one-on-one in the hallway or by voice mail, a written thank-you note, e-mail, text message, in front of others at a staff meeting, or in person at the end of the day. I guarantee it'll boost their spirits and make their day.

Praise is not praise when it is idle flattery. A lack of sincerity is transparent and can backfire. The harassed, hyper-busy physician trying to be warm and interested in others is seldom convincing.

 It doubles the impact, reinforces the sincerity, and creates an incentive for doing more of the same. For example, rather than telling a medical assistant, "You're doing a great job," say instead, "Debby, Mrs. Johnson told me how sensitive and caring you were following the bad news she received the other day. Thank you for your thoughtfulness."

 Your most talented or hardworking staff members likely get praised all the time (which might be one reason why they perform so well). However, you should try to include those who get less recognition. It might be that a little appreciation is all they need to flourish.

Validate the importance of your employees.

 Make sure everyone on your staff feels famous for something. You want them to always have a reason to come to work.

Physicians may feel they praise staff members, but, in reality many come up short. Here are guidelines for giving effective praise.