Running On Time?

Do you measure whether or not you are on time based on finishing your clinic at 5:00? If so, you are an inwardly focused business. Now, how many of your patients would say you are on time? Results for many patients surveys nationwide report that "wait time" is their number 1 complaint about their doctor. In fact, of all the various metrics used to measure patient satisfaction, wait time rates the poorest....consistently. Most service industries strive to be outwardly focused. That is to say, these businesses are focused on providing the best in customer service possible to ensure customer retention and future sales. Medical practices should be doing the same.

There are many tactics you may choose to improve your overall efficiency, but simply implementing without first knowing the cause is like doing surgery when the patient presents with a cough. Surgery may be indicated, but it probably is a decisions reached by first understanding the cause of the cough.

Medical practices, like many businesses, look to improve revenues by adding patients to the schedule. Certainly this is a reasonable solution, provided you have the capacity in terms of physical space, adequate staff and proper provider scheduling to execute that plan. I would suggest you first invest in a professional flow and efficiency evaluation. This evaluation reveals efficiency leaks that rob you of productivity and potential practice revenue.

About a year ago, I was asked to conduct such an evaluation for a fairly busy dermatology practice. While the evaluation revealed several areas for improvement, their biggest inefficiency came from medical assistants answering patient phone call regarding biopsy reports, blood tests, etc. Here, the recommendation was to hire another staff position, preferably an RN, as the phone nurse. Her responsibility was to field patient's phone calls and to add an extra level of expertise in the back office. At first the physician felt that adding another staff position, an RN no less, was a budget breaker. After determining the improved efficiency that allowed the doctor to see 2 extra patients per day, AND, improve overall wait time, the practice realized a cost pay back in just a few months. All revenue after that fell straight to the bottom line. In this case, the practice realized an additional $75,000 in revenue after expenses. Not bad!

More than anything else, you have the opportunity to improve your patients experience when they visit your practice. You also have the opportunity to begin and finish your day with greater satisfaction. Your patients and staff will appreciate it.

Customer Service

Over the years I have worked with many medical practices conducting surveys and efficiency studies. Oftentimes physicians fail to recognize that their patients, dare I say customers, measure the customer service from a single perspective...their own. That is to say that your patient's customer service quotient is the same for all business. From the local coffee shop to the mega department store to your office, the quotient is the same. So what does that tell us?

In short, you the physician owner, is competing not only with other doctors, but also every other business in your community. Question: How many of us would tolerate a restaurant telling us there is an hour wait before seating even though we have a reservation? I suspect very few of us would wait. I also suspect most of us would have something to say to the management. Yet, too often, this is common, or even expected, when we have a doctor appointment.

Most people are really not looking forward to their next doctor appointment. Partly because of what the doctor might tell them, but also because of undue wait time which the patient interprets as poor customer service. Taking steps to improve overall patient flow, realistic scheduling and a welcoming smile and hello go a long way in providing good customer service.

Here are few additional tips your patients will appreciate:

• Doctors, please introduce yourself. It is not enough for patients to assume you are the doctor. Remember, patients are already nervous. Make sure they know who you are.
• HIPAA already requires patient privacy. Make sure your receptionist is conversing with your patient in a secure fashion regarding reason for visit, insurance verification, co-payments. Believe it or not, I have observed the receptionist calling out across the reception area verifying this information.
• When patients are escorted to the exam room, protect the privacy of other patients. Make sure doors are closed. When entering a room, make sure other cannot peek in.
• Knock before entering an exam room. This holds true for all back office personnel.
• Schedule accordingly! If you are comfortable seeing 4, 6, or 8 patients an hour, then schedule that way. There is no reason to book, or double book, patients. It serves no one's best interest.
• And for the last tip - BE ON TIME! If you clinic starts at 8:00am, you and your staff should be seeing you first patient. Tardiness to the office only makes you run late, it also says something to your patients about your practice. And it is probably not very good.

Delivering superior customer service is really not hard. Here's an exercise for you. The next time you are in your local coffee shop, your favorite restaurant or department store, check out their customer service. Imitate those activities you observe; your patients, and your balance sheet, will appreciate it.

Primer on Patient Flow

Improving your efficiency with patient flow increases your patients' overall satisfaction. Let's face it, no one wants to go to the doctor. To the extent we can improve the patient's office visit experience, the more likely you'll have better patient satisfaction. You will also improve your patient retention and gain more referrals...and that's good for business.

There are many traps in patient flow and efficiency. Too often physicians automatically think consultants suggest, "Book more patients." Nothing could be further from the truth. There are cases where more patients make sense, but only after fully understanding the capacity of the practice. That is to say,

• How many patients does the doctor feel comfortable seeing each hour?
• Is the staff adequately trained to manage the patients?
• Is your staff allocated correctly?
• Is your office layout optimized for improved flow?

These are but a few of the areas a good flow and efficiency analyst will observe in an on-site study.

Labor Day Best Wishes

It is Labor Day weekend any many of us are enjoying a long weekend with friends and family. It is important that we take a moment to think about all the women and men in military service. These Americans take upon themselves to serve on the front line protecting you and me. It is also important to remember their families. Everyone knows a friend or family who's loved one is overseas. Thank them for their service and sacrifices.

Best Wishes on this Labor Day!

Is It Time To Move On?

A prospective client asked me this week, "How do you know it's time to let an employee go?" Well the answer is, it depends.

Making a decision about dismissing an employee can have an emotional, and, potentially legal, implication. Depending on your state's employment law, you may be faced with a formalized disciplinary process prior to the dismissal.

I have long been an advocate for holding employees accountable to their actions. And this includes accountability to their job description. Thus, here is the point. Do you have adequate and up to date job descriptions for your employee staff? If not, then dismissing an employee for failure to perform job duties becomes cloudier.

Good job descriptions become the basis for your relationship with your employees. This document describes what the employee's job function is, and, directs their daily activities. For employees who fail at their job duties, disciplinary actions are in order.

First, you must communicate, both verbally and in writing, your dissatisfaction with the employee's inadequacies. Second, you are well served to provide the non-performing employee some measure of time to improve their performance. If their performance improves, you are better off as you have now developed the employee. If their performance does not improve, then dismissal may be appropriate.

It is important to ensure that each of your employees is fully trained to perform their job duties. And this is your responsibility. Too often, employers dismiss poor performing employees because the employee was poorly trained. If you establish a relevant training period for your new employees, you will benefit from better performance.

The dismissal of an employee is never pleasant. It is expensive and time consuming when you consider having to replace this employee. Having a quality interviewing process will help you avoid making hiring decisions that ultimately lead to poor employee performance and potential dismissals.