Drew Stevens, PhD

The New Year has begun and many physicians will attempt numerous methods to be more efficient and operate a stable and thriving practice. With constant changes in health laws, insurance, and competition, there is much to do and so little time. So what are some items that doctors and their staff need to be aware of to operate a great practice in 2015?


We have entered into a new phase of patient convenience. The proliferation of the Internet has enabled patients to discover all types of information. Patients desire fast, free, friendly, and local urgent-care centers and clinics, and that has taken a small bite out of patient volume.

One method of ensuring sustainable patients despite this challenge is with proper patient experience and overall customer service. Patients today desire trusting relationships with doctors and they venture to other clinics because the current service they receive might be poor. Doctors and staff must ensure that they can quickly accommodate patients, that patients are happy, and that they provide quick feedback to patients. Should you notice a drop in volume or other forms of attrition, you might use a “mystery shop” or survey to better understand the experience and make changes where needed.


Ask any doctor and the patient volume is increasing annually. My cardiologist for example, is seeing more patients due to two large issues: a) The announcement last year about statins and b) The university that employs him is driving harder on key performance measurements.

However, at no time must quantity overshadow quality care. Your Hippocratic Oath states that your meaning in life is to cause no harm to the patient. To that end, ensure you practice good time management or have your office or practice manager help you better facilitate time with patients. Use electronic forms for new patients in order to alleviate waiting room time, pre–order patient records, and alter your office policy so that you have full disclosure of information for a patient's visit. Redundant appointments for the same symptom only delay treatment and waste tons of time.


In the age of self-diagnosis comes the age of self-treatment, and many patients are running not walking to many new pain management centers. These centers (as you know) administer a host of narcotics to ease pain. Even states such as Colorado are using marijuana to treat numerous maladies. Yet, you are the doctor, therefore you need take the lead in patient care and recommendations. The better the relationship you have with your patients, they less fishing they do behind your back.


One of the things about medicine is that you can make a killing or it can kill you. You need to work your passion and not kill it from overwork. Too many doctors suffer from divorce and other issues because they do not have a life after work. And, many aren’t able to practice what they preach due to stress. The only way to “remain on your game” is to create a healthy active life beyond work. This requires you to delegate, honor lunch hours, and take breaks on a regular basis. Poorly managed stress and health will lead to burnout and apathy. We all know there are fewer doctors each year and more patients. Therefore, you need to ensure that you take care of you so that you can take care of them. When your life is more balanced, your diagnosis is better, your quality of care is better, and your practice is more efficient.

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Here are four issues that doctors and their medical practice staff members need to be aware of to operate a great practice this year.

Four Issues Physicians Must Watch in 2015 

In the age of technology, everyone, including patients, is seeking faster alternatives to communicate. With a wealth of social media, blogs, websites, and video there is a barrage of information. To that end, patients seek easier means to communicate with physicians and their staff. It appears with doctors' offices busier and visitation gaps longer, patients desire easier ways to connect with doctors about their health - enter the patient portal.

With the use of a dedicated server and a third-party software, patient portals (depending on the options doctors desire to make available), enable patients to schedule appointments online, e-mail doctors about prescriptions or issues in health, gain valuable information in the form of a newsletter, view health information, and so on.

In addition to providing convenience and access to patients, patient portals boost patient engagement because they provide patients with a means of self-managed care.

According to research from the Pew Research Center, 

 of U.S. adults have gone online to figure out a medical condition; of these, half followed up with a visit to a medical professional. And, according to the Pew Internet Project, 

 of adult cell phone owners now use their phones to go online, a figure that has doubled since 2009. In addition, 34 percent of these Internet users say that most of their online use is via cell phone.

With this type of usage, more patients will begin using their phones to attempt to access your patient portal. Make sure your portal is mobile friendly.

Portals also bring significant benefits to practices. Call volumes might decrease with the plethora of data instantly available on the portal. Further, these new electronic means actually diminish work flow, paper, and time lags, allowing both the doctor and staff to attend to other important tasks.

As conducive as portals are there can be some limitations if staff, physicians, and patients are not fully on board. 

If physician leaders explain the benefits and uses of the technology as a means of better efficiency, then all will quickly adopt it, including staff. Discover today what a portal might do for your practice.

If physician leaders explain the benefits and uses of patient portals as a means of better efficiency, then all will quickly adopt it, including staff.

What a Portal Could Do For Your Practice and Patients 

Did you ever call your practice to try to understand the first impression your patients are getting? If you have not done so, you might be placing your reputation and your practice volume at risk.

Many practices today, due to volume or bureaucracy, tend to follow the path of many large corporations that use voice response systems, but that's not always the best method to establish a positive and lasting first impression.

Patients today seek a relationship with the doctor, and poor telephone technique is a patient relationship barrier. So what is a practice to do?

In order to justify an automated system, your practice must review call volume and more importantly, review how many calls are unanswered, placed on hold, etc. Observe the issue and decide what needs to change.  In other words do you have the proper people answering the calls? Can they handle the volume? Do they spend too much personal time and not address the true issue? Are they procrastinating and not accepting calls within certain guidelines? Finally, do you have a call process for them to answer calls?

 The only way to understand any issue is to call anonymously and determine gaps in telephone response. Do calls get answered after the fifth or sixth ring? What is the demeanor of the staff member addressing the call? Is there a standard message communicated to the person with each call such as, “Good Morning. This is Amanda and you are calling Stevens Clinic, how might I assist you today?” And, is there a proper salutation at the conclusion of the call such as, “Thank you for calling and is there anything further I can assist you with?”

 For example, my practice for the last 25 years is that if someone leaves me a voicemail I reply in 90 minutes, guaranteed. How many practices can uphold this standard? Many practices feel they are too busy, or they use the excuse that the voicemail requires a response from someone else (such as a physician) who is unavailable. However, what is wrong with a simple return call from a staff member that states that the doctor will return the call before the afternoon or the close of the business day? I recently required surgery for a detached retina and called the doctor about suspicion of a developing cataract. It took four days to receive a return call. Unacceptable.

4. Review your call and return-call method. 

There are some doctors (not all) that decide to have calls forwarded to a cell phone, return calls via cell, or even opt to avoid standard landlines and instead use voice over IP lines. Using such methods depicts an office apathetic to the proper patient experience. First, cell phone service is not always as vivid as a general landline and words may be misconstrued and lines unclear. Second, some doctors tend to answer their phones wherever they are, which includes shopping malls, department stores, gasoline stops, etc. If you want to illustrate a professional image, then your telephone must be part of it. There are many services today such as YesTrak, that enable users to obtain a private number via the Internet and someone will answer the call at any time. These Internet related professional answering services are now pennies on the dollar while also providing you the best in patient communication.

Every practice requires a good first and lasting impression. For any business, great phone service and telephone customer service can establish your professionalism, empathy, and communication. The question to answer is: What impression are you leaving?

Did you ever call your medical practice to try to understand the first impression patients are getting? If not, you might be placing your reputation at risk.

Improve Phone Customer Service at Your Practice: 4 Tips

We have all experienced a multitude of changes to the healthcare industry in the last year, and that trend of constant change is going to continue into 2015. The medical practices that thrive in the new healthcare environment will be the ones that take a proactive approach to managing these changes.

Here are six action items I recommend for every practice in 2015:

 Clearly patients today desire the ability to know more about their issues as well as communicate more to their practitioner. Long waits both in the waiting room and when attempting to make appointments has damaged patient relationships while also creating numerous communication gaps. The family practice that communicates more effectively with patients will gain more referrals and be more highly respected within the community. In the coming year, focus on developing your portal and promoting its use to patients (or purchasing one if you do not have one). Many portals allow patients to order medication refills, obtain lab and test results, and even e-mail staff about appointments or schedule changes. The new technology creates not only better communication, but also less need to request an appointment because data is available online.

2. Implement an EHR, if you don't already have one. 

If your practice does not already have en EHR, it's time to get one. While there are many practitioners still using files and travel cards, EHRs provide better efficiencies for billing, reimbursements, audits, etc. Admittedly, there are more systems (so it seems) than doctors, but acquiring an EHR allows better practice efficiencies and perhaps more money for the practice.  

Doctors in 2015 need to think in terms of the patient. On the day I wrote this article, I found that 1.67 billion searches had been made on Google. Doctors and their practices will be required to develop and implement websites so that patients can find them. True, many insurance companies refer prospective patients to physicians, but the fact remains that most patients conduct their own research. A great website will ensure that patients find you.

 of Internet users used social networking sites, according to the Pew Internet Project. Understand that not every form of social media is useful, but doctors and staff that engage in social media will create pockets of community to discuss the doctor and help with external marketing efforts. Additionally, social media forms such as Twitter or even Facebook enable staff to communicate messages to patients such as, “The doctor is running late," or, “The office is closing early due to inclement weather." 

 Many medical practices have very limited knowledge and resources to consider cyber security, but they must. The 2012 Data Breach Investigations Study by Verizon shows that in 855 data breaches they examined, 

 occurred in businesses with fewer than 100 employees.Similar to the manner in which many large corporations have prioritized cyber security, so must medical practices.

According to one survey from practice management

 Software Advice, 62 percent of respondents said they turn to online reviews in order to find a new doctor. These review sites include Healthgrades Yelp, Vitals, ZocDoc and WebMD. Doctors that become more attentive to these sites will protect their reputations because they can monitor both positive and negative comments. Those that are more attentive to their reputation will have better searchable results on the Internet as well as have more visitors in the waiting and treatment rooms.

In order to thrive in the new healthcare environment, medical practices must take a proactive approach. Here are six key action items I recommend.  

Six Action Items for Every Medical Practice in 2015 

Typically, when reporting on information that is helpful to the family practice community, I report on cases from clients and former clients. However, in the most recent weeks, I personally ran into a situation that is helpful to share.

Approximately six weeks ago I was headed to a meeting when my vision became impaired. After a quick check up with my optometrist, she indicated my need for emergency surgery as I had superior lattice degeneration, or in lay terms, a detached retina.

My optometrist's passion, empathy, and desire to assist me were notable. She made an appointment with my retinal specialist, visited me in the hospital, and followed up several times. I have since referred 10 new patients to her in just the last three weeks.

Unfortunately, not all healthcare providers share the same qualities. Many think in very tactical ways upon entry into the office. They look at the calendar; they jump from patient to patient; they forget about the most important asset of the practice: the patient.

The patient experience is so vital to your future success because it guarantees referrals, leads to great reviews on websites such as Yelp and Healthgrades, and finally, develops community that provides brand value.

So what can a doctor and family practice do to ensure success?

Everyone in your practice must operate with the perspective of the patient in mind. Your front desk is your first line of patient interaction, so their attitude toward patients is critical.

During my recuperation from my retinal surgery I was required to look at the floor for 10 days. During that time, I had a dental hygiene appointment scheduled. I called and let the front desk know that due to surgery, I would not need my appointment for a while. Without calling to send sympathies, the front desk placed my name in a text rescheduling system and this technology starting sending me new appointments via text the following day.

Attitude is latitude and when your front desk is apathetic your patients simply leave.

2. Don't just do something because that is the way it has always been done. 

I was recently hired to assist a major university medical hospital in customer service. In reviewing appointments I discovered that doctors were frequently late to clinical appointments by 90 minutes. No one thought to alter the schedule.

Another example: The director of cardiology at one hospital contacted his hospital in a nonprofessional capacity when his father was having chest pains. He was placed in queue for several moments and when the clerk finally came on the line, she indicated the next possible date for the father's appointment was four weeks away. The cardiologist's father wound up having a heart attack and required an emergency visit.

Avoid issues like these at your practice by mystery shopping or mystery walking your practice. Determine what systems create unnecessary or damaging obstacles.

 Relationships go a long way. I certainly understand that you have too many patients, not enough time, and a tired and stressed staff. However, a patient relationship with your practice only lasts as long as the patient believes in the rapport he has with physicians and staff.

You and your staff can easily send thank you cards, birthday cards, and anniversary cards to patients. Or, even if it's not necessary, a brief phone call to follow up on procedures, medications, illness etc., can foster strong relationships.

A little effort goes a long way for the patient experience.

A great patient experience guarantees referrals, leads to great reviews on doctor rating websites, and enhances your medical practice's brand value. 

Three Ways to Boost Patient Satisfaction

Did you ever manage a staff but not really manage a staff? Do you have issues among staff members but are not certain what to do? Do you find yourself speaking to staff only to have them look at you like you are Charlie Brown's teacher? How about shouting into a canyon only to hear your echo return? Sounds a bit like work doesn't it? Unfortunately many physicians and practice managers experience these problems.

If you are one of them, the problem might be that you don’t take the difficult steps and make the difficult decisions that are required of a strong practice leader. While it's never appealing to confront staff members about poor performance, or to let repeat poor performers go, failing to do so could do some serious damage to your practice. 

If you wait too long to address poor performance, your good employees may leave because the work environment will become intolerable to them. Even if it doesn't come to that, the undermining of your authority by the poor performer may permanently damage your authority.

After all, if you are willing to let a staff member continually perform poorly, do you think others will continue to maintain their faith in you? Probably not. Their esteem for you as a doctor/leader will likely plummet, and, in turn, their productivity and motivation will plummet as well.

The key to dealing with problem medical practice employees is moving quickly to fix the behavior.  Here's what I recommend:

Document it when employees demonstrate poor performance. Include what happened and when. If you do not have a poor performance documentation template, I recommend the book "101 Sample Write-Ups for Documenting Employee Performance Problems." This is a great resource when you need to document everything from substandard work quality to absenteeism to e-mail misuse.

 When you detect a performance problem, intervene early. Think of it this way, the reason why there are issues is because over 80 percent of the time, the issue is not addressed or corrected. So correct it.

Counsel the employee and try to determine the cause of the poor performance. Look for issues such as lack of training, motivation, burnout, or some other cause (e.g., personal tragedy or conflicts with coworkers).

I definitely suggest a one-on-one meeting to help the staff member understand that there is an issue and it must be immediately corrected. Provide a neutral setting and rather than constantly berating the staff member, explain what you need him to do differently, and then provide the opportunity for him to provide suggestions for how he can improve. 

 Provide the employee with the opportunity to demonstrate acceptable performance after discussing his performance problems with him. Write down this "opportunity to improve" and establish a timeframe by which his performance should improve. If performance does not improve, you may reassign, demote, or remove the employee following a prescribed set of rules established by law.

The key to dealing with problem medical practice employees who question your decisions is moving quickly to fix the behavior.  Here's what I recommend.