Building a strong physician-patient relationship is in many ways a complex process. The patient expects the physician to respect his time; provide a good clinical outcome; and improve his quality of life following treatment.
However, rather than dwell just on the physician's responsibilities, it is important to remember that staff members play a significant role in helping the physician connect with patients. Here are a few staff strategies that will help make the physician-patient relationship more effective.
1. Identify different types of patient visits. There are at least four different categories of patients who will be seen in the office on any one day. The key is to understand that each patient category presents with a different expectation. While it is impossible to approach each patient in exactly the same way, ask your team, "What can be done ahead of time to prepare for each of these categories of patients?"
• The patient in need of diagnosis and possibly quick treatment;
• The patient who presents for treatment, e.g., procedure, infusion, injection;
• The patient who has a chronic condition; and
• The patient who is seeking a wellness visit.
You should have a general discussion with your staff about what patient expectations may be for each type of patient visit, and what can be done to meet those needs.
2. Conduct a clinic huddle each morning. It is extremely helpful to hold a short clinic huddle just prior to the day's patients; not only to review who is scheduled, but also to determine where there may be a potential road block or opportunity for a shorter visit.
3. Prescreen patients at scheduling. Ask your front-desk staff to do a better job of pre-screening patients with the initial appointment call by asking, "What is the reason for your visit?" and, "What will you need from the physician?" Get all the paper work, demographic verification, and insurance authorization issues completed before the patient arrives.
4. Clearly delineate staff roles. Make sure you define the appropriate roles for the triage/screening team in terms of vitals, documentation, etc. Is a role duplicated by the physician? Has there been adequate communication between the physician and team members to insure that the necessary questions have been asked and documented?
5. Monitor patient wait-times. The most-common patient complaint is about a long wait time or a delay in treatment. Ask your team, "Have we gotten the patient into the exam room in a timely manner?" and if not, "What caused a delay or what might have gone better?" Don't always focus on problems, look at what worked and replicate it if possible.
Another issue to examine is the role your EHR plays in patient delays or fewer patients being seen. Consider how you will reconcile the external demands for more patient documentation with your need to be more efficient in seeing patients. Ask yourself if it is possible to hire a scribe to assist in patient documentation. If the result will be less stress for staff, a positive encounter for patients, improved documentation, and increased revenue, that may offset the cost for a scribe.
6. Develop staff scripts for challenging patient encounters. Once you have identified the different types of patient encounters, develop scripts that will enable staff to assist you in managing extra demands on your time. Here are two examples:
"Oh, by the way…" Put in place systems to let patients know ahead of time that the physician will only be able to address one or two issues during their visits. Let them know that it will be necessary to schedule another appointment to cover additional concerns — to insure that other patients are treated fairly.
Tag-along patients. Be alert to tag-along family members who may wish to be treated during the patient visit; letting them know that they will have to pay a second copay will usually stop this from happening again.
The key take away is that in developing the physician-patient relationship, each physician has her own style. The staff, with adequate discussion and planning, can enhance that relationship by being aware of these differences and focusing on what is best for each patient.
Owen Dahl, FACHE, LSSMBB, is a nationally recognized medical practice management consultant and author of “Think Business! Medical Practice Quality, Efficiency, Profits,” “The Medical Practice Disaster Planning Workbook,” and coauthor of “Lean Six Sigma for the Medical Practice: Improving Profitability by Improving Processes.” He can be reached at [email protected] or 281 367 3364.