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The Bigger Picture: Stop the Telephone Madness


Too many practices are devising telephone protocols for their convenience rather than that of their patients. Turning off the phones isn't a solution. These tips can help you provide better service without overwhelming your staff.

Poor telephone etiquette is a great way to frustrate patients and lose business. Yet it's rampant in today's medical practices.

I just tried to return a phone call from a physician. An automated message told me to call back during "normal" business hours. There was no option to leave a message.

Then came the ordeal.

"We are available by phone Monday, Wednesdays, and Fridays from 9 to 11 and 2 to 4, Tuesdays from 11 to 5, and Thursdays from noon to 5."

Good thing I had a pen handy.

I literally set an alarm on my Outlook calendar to coordinate my call. Otherwise, I'd never remember when. And I'm just trying to help the physician with a management issue.

This was not an aberration. On the contrary, telephone mismanagement is increasingly rampant. It's always been one of my pet peeves. But it seems to be getting worse - and frankly, it's starting to make me nuts. Most practices run their phones for the convenience of staff, not patients.

It's understandable - to some extent. Staff are overwhelmed, and their phones ring off the hook.

But turning the phones off isn't a solution. It's poor patient service and just delays the call to another time. It doesn't do away with it - unless the patient is so frustrated he leaves your practice.

So here are some suggestions for providing better service without totally overwhelming your staff:

  • Keep the phones on. Most practices see a jump in call volume just before lunch, just after lunch, and on Mondays. It's no coincidence. There is pent-up demand from callers who can't get through when the phones are shut down. That flood of calls swamps front-desk personnel, who are also trying to deal with check-ins. The easiest way to keep the flow consistent and avoid these spikes is to keep your phones on as much as possible.

Stagger lunch breaks and cross-train staff so someone is covering your phones all day.

On the weekends, consider letting callers leave messages, and then have one staff member come in early on Monday to sort through and answer or redirect them. Or pay your nonphysician clinicians extra to rotate handling weekend calls - most of which will be clinical questions or refill requests.

  • Try the Web. If keeping the phones on just isn't possible, give callers another way to access your practice.
    A secure online form for prescription refills or appointment requests at least gives some patients another medium for taking care of business. While you have patients online, show off your clinical advice. Offer solutions to the questions you and your nurses are asked most often. Provide links to medical Web sites you respect.

But don't expect this to happen overnight. You'll need to find ways to let your patients know your Web site is there for them. And remember that you don't need everyone in your practice using it. Redirecting even 5 percent of your phone traffic will help staff on the front lines.

  • Know your phones. Make sure you know what's happening with your phones. After all, you're the owner. Call in sometime to see what happens. Train staff on how they should answer the phone and role-play what should happen if an angry patient calls. In other words, make it clear through words and deeds that you expect a patient-centered approach.

  • Set rules and stick to them. You should have policies for scheduling, fulfilling refill requests, and replying to clinical questions. Too many staff get stuck between the written rules and the reality of what physicians expect of them. For example, I heard from one practice in which a physician told a patient to schedule a visit in three days to review scan results. But the physician had previously asked his scheduler to arrange all such reviews a week out to ensure patient results were in hand. Should the scheduler follow what the physician told the patient or what the physician told her? In this case, the scheduler offended the patient and refused to make her appointment when she wanted it. For my part, I feel better already for getting this off my chest.

What's your biggest practice management pet peeve? Tell me about it. Write to me at



This article originally appeared in the April 2006 issue of

Physicians Practice


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