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Mystery Patient Discusses Common Oversights at Physician Practices


If a mystery patient popped into your practice and rated it on appearance, visit satisfaction, and overall experience, how would it fare?

If a mystery patient popped into your practice and rated it on appearance, visit satisfaction, and overall experience, how would it fare? 

If you believe longtime mystery patient and healthcare consultant Meryl Luallin, a partner with Sullivan Luallin in San Diego, your practice might have some room for improvement. Luallin, who spoke during the MGMA11 Conference session “Secret Service Revealed: Customer Service Tips from ‘Undercover Mystery Patients,’” discussed the key areas practices often overlook that can impact patient satisfaction and care.

Here’s what this mystery patient has found, and how to avoid getting bad marks from your patients in the future.

Practice/Staff Appearance

When it comes to office appearance, yours scores an A plus. Or does it? According to Luallin, many practices have had aging décor in place for so long that they forget how unappealing it is.

Case in point: A bathroom at one of the practices Luallin visited was decorated with a worn wood table topped with two giant rolls of toilet paper and a basket of “ten-year-old potpourri.”
Often, décor faux pas happen because practices get so used to their surroundings and don’t notice how uninviting it is, Luallin said. This also extends to the reception area.

“If you’re going to have a TV, be careful with what you have on the screen,” said Luallin. “We were in a practice in Massachusetts, and this practice had Fox News on it. In case you didn’t realize it, this part of Massachusetts is very very liberal. In another practice, they had Jerry Springer.”

Luallin suggested practices opt for neutral programming at a lower volume, such as “Animal Planet,” the Food Network, or the Cartoon Network.

She also chided practices that don’t keep up with their flora, fauna, and aquariums in the reception area.

“I went to a practice in Brooklyn and they looked like they hadn’t watered [its plants] in two month,” said Luallin, noting that fake plants should also be dusted off regularly. “If you have an aquarium, those are great, but scoop out the dead fish.”

The Actual Visit

Want to improve your patient satisfaction scores? Then make sure your physicians are conscious of everything from wait time to bedside manner to personal appearance, as all of these factors can affect ratings.

Mystery patients look for pleasant ambiance, whether a physician/clinician is wearing a nametag, and little courtesies, such as whether the doctor knocked before entering. Of course, the doctor needs to actually enter the room where the patient is waiting, too.

When Luallin asked how many practices “have forgotten a patient in a wait room,” six or seven people raised their hands.

“There are times I have been kept on ice for at least a half an hour,” she said, advising practices to establish a protocol where every 10 to 15 minutes a staff member peeks into a room and says “I haven’t forgotten you.”

Like a reception area’s appearance, a physician’s appearance is also important.

An American Journal of Medicine survey in November 2005 revealed 76 percent of patients said they preferred doctors to wear a white lab coat. Just 10.2 percent preferred scrubs, 8.8 percent preferred business attire, and 4.7 percent preferred casual.

“Madison Avenue has done some heavy duty research,” she said, “and they have found that the most credibility comes with a white lab coat and a stethoscope.”

Whether or not they’re donned in lab coats, physicians also need to be conscious of their professional demeanor, too. Luallin said she once shadowed a physician with bad patient-satisfaction scores to find that he fell short when it came to communication.

A patient said, “I have a lump in my breast, and it’s really painful,” and his first response was, “wow,” before he asked, “how long has this been going on?” A better response would have been a more empathetic one, Luallin said.


Attire also counts with your check-in and check-out staff.

“When I’m there, sometimes I’m seeing more than I want to see,” said Luallin, adding that “sleeveless stuff, smocks, low cut shirts are out.”

When in doubt, practices should have staff wear scrubs.

“When you walk in, and everybody at the front desk is wearing nice scrubs … you feel as if these people know what they’re doing,” said Luallin. “It’s much better than someone who looks as if she’s going on a hot date at the end of her shift.”

The way a receptionist greets patients is also important.

While Luallin found that 70 percent of receptionists greeted patients appropriately, some 30 percent simply spit out terse one-liners, such as “name?” and “who are you here to see?”

Luallin said she’s also encountered intake nurses and medical assistants who simply beckon patients with their fingers, rather than greeting them and introducing themselves.

“You won’t believe the number of medical assistants who turns to me with head and eyes down,” she said.

And when it comes to check-out time, plenty of practices miss the mark.

“If nobody has said to me, ‘be sure to stop by the cashier,’ I don’t volunteer to pay,” said Luallin. “That’s because I’m testing your system.”

Luallin shared a story of a practice checkout person took a cash deposit of $250 before she entered. When Luallin was presented the invoice of $89 for the service and tried to get the cash deposit back, the receptionist refused to give the money. Luallin had to choke up and pretend it was her Christmas money before the receptionist called the office manager, who gave the OK to return the cash.

“You’ve trained your people to say ‘good morning, can I help you?’” said Luallin. “You don’t train people to say goodbye.”

Luallin advises practices to ensure their checkout person asks the patient “did you get all of your questions answered,” and volunteer to get the nurse if there are additional questions.

“You want to do today’s work today,” said Luallin. “You don’t want that patient to call back tomorrow.”


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