Developing a no-excuse practice

When practices focus on solutions rather than excuses, patients feel supported and respected. Not accepting excuses is an opportunity to turn complaints into praises for your practice.

Imagine calling a practice for a complaint or problem, and the receptionist solves it while the patient is on the phone with a positive attitude and not making any excuses. That’s what turns a Moment of Misery™ (complaint) into a Moment of Magic.*

The Oxford Languages’ definition of the word excuse as a noun is “a reason or explanation put forward to defend or justify a fault or offense.”

Vocabulary.com defines an excuse as “an explanation for something that went wrong.”

An excuse is an explanation we give to justify a failure, inaction, or a mistake. Giving a patient an excuse is a way to deflect responsibility for something we didn’t do, didn’t do well, or did do but was a mistake. Whether it's “We were short of staff,”  “I didn’t have enough time,” or “The report is not available,” excuses tend to mask the deeper reasons we didn’t take action. A deeper reason may be that we think patients will be understanding and tolerate mistakes.

Excuses often come from a fear of failure, fear of not being good enough, or fear of retribution. Excuses protect us from the discomfort of facing our own shortcomings. But the more excuses we make, the less we grow, and the more we stay stuck in a cycle of avoidance. Practices that make excuses have lower patient satisfaction scores and fewer stars from online reputation management sites.

Providing an explanation as to why a problem happened is acceptable, but it shouldn’t be an excuse. If you choose to give an explanation about why a patient is complaining, follow up with “Here’s what we are going to do about it.” That ensures the problem is seen as an explanation and not an excuse.

Having a no-excuse mentality comes down to accountability.

Every excuse a practice makes erodes credibility. This results in a loss of credibility and trust in the doctor and the practice. Making excuses is a failure to accept responsibility. However, when you decide not to make excuses, you start finding solutions.

Taking responsibility is the answer. The problem may not be your fault, but it presents an opportunity to make it right for the patient. And you receive credit for great patient services. If you tell the complainer, “Here’s what I’m going to do about it,” then the patient knows you’re not trying to shirk your ownership of the problem. You’re going to listen to the problem and find a solution.

To become a no-excuse practice, I might suggest the following:

• Make the commitment that you and your staff will not make excuses.
• Share with your staff that they can safely without retribution report to you or to another staff member that an excuse was made. Of course, this should be done in privacy and not in front of patients.
• Let the complainer know you'll find a solution to the problem in a timely fashion. Then follow up to let the complainer know the problem has been resolved.

Bottom Line: Excuses maintain the status quo. Solutions move patient care forward. By focusing on solutions, even small actions can create a positive impact.  Finding solutions instead of making excuses is an opportunity to provide patients with a positive healthcare experience.

*Title of a book on solving problems and motivating a patient to share their experience with others.

Neil Baum, M.D., is a professor of clinical urology at Tulane University in New Orleans, Louisiana. Dr. Baum is the author of several books, including the best-selling book Marketing Your Medical Practice: Ethically, Effectively, Economically, which has sold over 225,000 copies and has been translated into Spanish.