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leading practice management experts who may or may not be
employed by Physicians Practice. On average, Physicians Practice
receives 170 questions per month from physicians, office managers,
office administrators and others. Have a question about the
operation of your practice? Visit www.PhysiciansPractice.com.
Your question will be answered within three business days.
Q.
When we send
samples to the lab for testing, we tell patients that we will
let them know if there is anything wrong. If they don't hear
from us, they can assume the results are normal. Lately, I've
been hearing this is not a good policy. Why?
A.
The "no news is good news" approach to test results
has been around a long time and is still very popular. Practices
think it saves them the time and money involved in calling
or mailing a note to every patient. It does that, but there
are still some good reasons to consider trying a different
model, namely one in which you contact all patients.
First, you generate patient
loyalty and satisfaction every time you "touch"
a patient. Instead of being a spendthrift, set your patients'
minds at ease and let them know you care. Let them know everything
is OK and throw in a little information about sport fitness,
diet over the holidays or whatever. Better yet, tell them
what the results mean. What steps should the patient take
to make sure she stays healthy?
Second, given the disorganized
state of most medical practices, a patient would be foolhardy
to simply trust that your office got the results back from
the lab, actually reviewed them carefully and remembered to
call. Contacting every patient helps you with risk management.
It is completely possible that a positive or abnormal lab
result could come back and never be communicated to the patient.
Since the patient isn't really expecting a call, she'll never
know. Better to encourage positive interest from patients.
Third, you may not be
deflecting as many calls as you think. Track the subject of
your calls for a month. How many are patients asking about
results? It may be better to prepare for this totally justifiable
curiosity on the part of patients than to assume you can get
rid of it and then have no good system in place for managing
the calls efficiently.
Fourth, your patients
are getting smarter. Most patients know their cholesterol,
and it is often the subject of conversation. As patients become
more and more interested in their own health care, they will
demand information about tests that you are performing on
them. You can be on the forefront of this patient empowerment
trend.
Finally, there are now
great telephony systems — software systems that work
over the phone — that can make communicating lab results
relatively easy. Some systems allow patients to call into
an automated voice system, enter a PIN number and get results
at their convenience. No one has to run to pull the chart,
and the patient doesn’t have to call from her cubicle
at work and ask about a Pap smear.
Q.
Patients forget their physician's directions and end up calling
back. How can we reduce these follow-up calls?
A. It's
said that people only retain about 30 percent of the information
they hear. Follow-up calls from patients are unnecessary when
there are so many innovative ways physicians and their staff
can communicate during the face-to-face encounter. Many medical
practices have ample supplies of brochures that explain common
conditions or procedures the practice's physicians deal with.
Practice Web sites can be customized for each patient, or
simply provide links to pertinent clinical or support information.
When there is something
more complicated at hand, say a surgery, some physicians are
videotaping their explanations as well as pre- and post-operative
information for patients. Then patients can take a tape home
and review it at their own pace and whenever they want a reminder.
Others use simpler technology,
including paper and pencil, which can work just as well as
a video as far as providing patients something to review when
a question occurs to them or they can't remember something.
For example, an oncologist in the Southeast uses a flipchart
to outline his treatment plan for his patients. As he talks
to a patient, he uses a colored marker to draw a quick and
simple timeline of the treatment process on a flipchart. What
his patients really seem to value is that they can take the
oncologist's chart home with them to keep. Many refer to it
often.
If patients do not speak
English, or if it is a second language for them, it is still
the provider's duty to make sure the patient understands what
the physician says. Use of qualified interpreters or translated
patient education materials may be necessary.
Q.
I'm sick of all
the follow-up calls we get because patients don't get all
the information they need during their visit. How can we improve
things?
A.
Here is a checklist of information that every patient should
be able to get during his or her visit. You can reduce follow-up
phone calls by asking staff, physicians or nurses to make
sure they supply everything listed here:
- When and how the patient
will receive his/her test results
- When and for what
the next visit is to be scheduled
- The diagnosis (presented
in a way that patients can understand)
- The treatment plan
- How and where the
patient can receive additional educational information related
to the complaint/diagnosis
- If applicable, written
orders for the employer (e.g., return to work), prescriptions,
etc.
Q.
My phones ring
off the hook. I can't afford more staff and am afraid patients
will hate an automated attendant. What can I do about phone
traffic?
A.
Instead of spending money to add more lines or staff to handle
call traffic, try to find alternative ways to do the business
you do on the phone. Or, find ways to reduce demand. For example,
schedule follow-up appointments before patients leave the
practice. That way, they don't have to call back later.
Or, if a patient calls
with a question for a physician, tell the patient what time
to expect a call back. Otherwise, in two hours, he/she will
call again.
You also might post a
Web site with directions, office hours, and other basic information.
Give patients some other way to get what they need.
Make sure you know how
much of your call volume comes from what source. It's no good
to control demand from patients if most of your calls come
from referring physicians.
Q.
What measurements should I use to see how my transcriptionists
are doing?
A. Measure
the performance of transcription staff by:
- average words/month;
- average minutes/month;
- average words/day;
- average minutes/day;
- average days to complete
a tape;
- average tapes/day
and
- accuracy.
Don't leave out accuracy.
It's no good to be fast, but wrong. |
