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For many doctors the idea of treating patients as customers
is repugnant. For many doctors , “ consumers “
is a dirty word, partly because many doctors are still angry
about the fact that their services have been included under
the consumer protection act. Doctors regard themselves as
being above traders and shopkeepers, because they feel that
the doctor-patient relationship is special. However, rather
than get upset at the idea of treating patients as customers,
we should focus on how learning customer service skills can
help us to improve the medical care we provide to our patients.
In the final analysis, the health care industry
is the ultimate service industry, and we can learn
from the billions of dollars the hospitality ( Taj
Group of Hotels ) , leisure ( Walt Disney parks)
and retail industries ( upmarket departmental stores)
have invested in improving the services they offer
to their customers. It’s even possible for
low-budget outfits to provide excellent quality
customer care, as evidenced by the worldwide success
of McDonalds, which offers excellent quality service
to all its customers, with no bells and whistles.
You may not like the food, but you have to admire
their service ! Even when they are very busy, they
will greet you with a smile.
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The right attitude is to regard all your patients as discerning
customers who expect , and demand a high-level of service.
You need to realise that giving patients excellent service
is critical to ensuring that your practice thrives. Customer
service simply consists of listening to, understanding and
responding to your customer's needs . Patients today expect
the same quality of service they get in a 5-star hotel. To
meet these demands, many hospitals in the US teach their staff
the importance of positive, service-oriented interactions
with patients. You too can improve your practice's customer
service , right from the time a patient makes the first telephone
call , to the actual visit itself , to any follow-up visits.
You first need to learn to improve your own patient-handling
skills. While your medical treatment skills may be superb,
unfortunately few of us are taught how to treat patients well.
Remember, that patients care more about how much you care
for him, rather than about your technical competence, and
it is important to let your patients know that you do care
about them as individuals. This is actually surprisingly easy
to do, if you just remember the Golden Rule – treat
your patients the way you would like to be treated ! While
this may be easier said than done, if you make a conscious
effort, it’s easy to learn the skills which patients
often refer to as good bedside manners.
It’s not enough to just improve your own skills
– you need to improve those of your staff
as well – remember, that they are your public
face ! You then need to train your “front-office”
staff – your receptionist, peon, clerk and
nurse . Unfortunately, the key role these staff
members play is undervalued by most doctors, with
the result that even though the doctor may be very
polite and professional, his staff isn’t.
Remember, however, that your staff are the representatives
of your practice –they are the ones your patients
turn to for information regarding appointments,
referrals, medication refills, and lab tests. For
example, telephone calls are the lifeline of your
practice. Yet, most receptionists, who serve as
the link between the practice and its patients,
are often untrained , and yet are expected to answer
the phones, make appointments, and greet patients
and answer their questions !
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It’s important to train your staff in basic customer-service
skills. Here , for example, are some telephone policies and
protocols your practice could consider adopting.
• Always answer calls by the third ring.
• Prepare a script for answering the phone in which
staffers greet the caller, identify the practice name and
themselves, and ask the callers how they can help them. Do
not transfer a caller more than once.
• Take down the patient's name, number and request or
question and have the appropriate person call the patient
back within a specified time frame.
• If an answer is not available, return the call and
tell the patient when someone will be able to get back with
the needed information.
Of course, you need to start by recruiting the right staff,
and the trick when looking for clinic employees
is to “ hire the smile and then teach the
skills”. If you find a helpful clerk in a
departmental store, she is likely to make a good
employee – and individuals who have spent
a summer working at a McDonalds are much easier
to teach, since they have already received basic
training in keeping customers happy . A simple question
to ask each prospective employee is – “
Who is the most important person in this clinic
? “ - and the right answer is – the
patient ! Pay your staff well – while good
staff members can be expensive, the wrong staff
members are much more expensive in the long run.
You get what you pay for, and pay for what you get.
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When you deal with patients, remember that your staff will emulate
your behaviour. Rude doctors usually have rude staff members,
who are adept at turning patients away ! How do you know you
and your staff are doing a good job ? Simple – just ask
your patients ! It’s easy to carry out patient satisfaction
surveys – and these could be as simple as asking them
to fill up a form. We encourage our patients to fill in a Complaints
and Compliments book ( anonymously, if they wish), which we
read religiously in order to identify problems and solve them.
Most patients are happy to provide feedback – after all,
their input allows you to improve the services you offer them
!
The First Law of Patient Service is : Patient Satisfaction =
Perception – Expectations. If your patient perceives service
at a certain level but expected something more or different,
then he will be dissatisfied. Remember that both perception
and expectation are states of mind, and you need to consider
these if you want to keep your patients happy !
You can learn a lot from the unhappy patient. While
it’s not much fun to deal with complaints
from an angry patient, this is far less painful
than losing them to another doctor because you could
not be bothered to listen to them. Learn to see
each problem as an opportunity for improvement –
“every complaint is a gift” ! In fact,
difficult patients are often the ones that will
make your practice better, because they are a challenge
to you and your office staff. If you can successfully
deal with a difficult patient, then you can successfully
deal with every patient !
Here are some steps in dealing with difficult
patients:
1. Don't box yourself in. Choose the best time of day to deal
with a difficult patient. If you are tired or preoccupied, the
patient will feel as if you do not care about his or her concerns.
2. Don't downplay the seriousness of the patient's complaint.
Let the patient tell you his or her side of the story without
interruption.
3. Apologize after you have heard the complaint. Whether you
are right or wrong, the patient is seeking an apology. Offer
it so the patient can move forward.
4. Express empathy. Let patients know that you understand the
problem and are concerned about their feelings.
5. Establish a rapport with the patient. Patients need to
hear that you are on their side and are willing to do whatever
it takes to solve their problem.
6. Do not go on the defensive. You are certain to lose the
patient if you become confrontational.
7. Take control of the situation. Once you have heard the
patient's side of the story, take the appropriate action to
resolve the problem.
8. Ask the patient what he or she wants. You may be surprised
to find out that the patient's solution to the problem is
both fair and simple.
9. Once the plan of action has been established, sell it.
Explain to your patient how the plan will solve the problem.
10. Ensure that the plan has been carried out and the results
are acceptable to your patient – followupto ensure your
patient is happy with the way you have handled the problem.
By following these simple steps, your most difficult patient
can become your most valuable. Statistics show that
satisfied patients will tell three other people
of their experiences, whereas a dissatisfied patient
will tell 20 others. However, if you can satisfy
an unhappy patient, he will tell at least 50 others,
and become your most valuable ally !
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Learn from other doctors. Visit well-run patient-friendly clinics
– for example, “upmarket” clinics which offer
esthetic surgery, since their survival depends upon keeping
their patient happy – they can teach you a lot ! A patient-friendly
clinic must be designed for the patient’s convenience.
Pamper your patients as much as possible ! For example, if you
are a pediatrician , make sure you have enough clean, 6unbreakable
toys for your children to play with, so they are happily entertained
while waiting for you.Most patients want easy access to their
doctor , and you can use modern technology to ensure that it’s
easy for your patients to get in touch with you. We encourage
our patients to access our website at www.DrMalpani.com,
which has extensive information on the services we offer , and
encourage them to stay in touch with us by email .
Remember that providing high-quality service is not expensive
– and in fact, not providing quality service is much more
expensive, since you will lose your patients to someone else
who will. Most of it is applied common sense - treat your patients
the way you would like your wife to be treated by her doctor
! If you treat all your patients as VIPs, not only will you
enjoy your practise much more, you will also have lots more
patients !
A good way of looking at patient satisfaction comes from the
research done at Texas A&M University. The researchers described
customers' experiences of service quality in 5 dimensions, summarized
with the acronym, "RATER"
Reliability: This is defined as "the ability to provide
what was promised, dependably, and accurately."
Assurance: "The knowledge and courtesy of staff and their
ability to convey trust and confidence."
Tangibles: "The physical facilities and equipment, and
the appearance of personnel."
Empathy: "The degree of caring and individual attention
provided to the customer."
Responsiveness: "The willingness to help customers, and
to provide prompt service."
You can use this as a useful framework when trying to assess
how satisfied your patients are with you.
Remember that patients prefer to be treated as special human
beings, not just as a number. Here are the 10 Commandments for
patient relations which you and your staff should live by.
I.The patient is never an interruption to your work –
the patient is your work ! Everything else can wait !
II.Greet every patient with a friendly smile. Patients are people
and they like friendly contact. They usually return it.
III.Call patients by name. Make a game of learning patients'
names, and see how many you can remember.
IV. Teach your staff members that for patients, all staff members
are as important as the doctor !
V.Never argue with a patient. The patient is always right (in
his/her own eyes). Be a good listener, agree with him/her where
you can, and do what you can to make him/her happy.
VI.Never say, "I don't know." If you don't know the
answer to a patient's question, say, "That's a good question.
Let me find out for you."
VII.Remember that the patient pays your salary - treat him like
your boss !
VIII. Choose positive words when speaking to a patient –
this is a valuable habit that will help you become an effective
communicator.
IX.Brighten every patient's day. Do something that brings a
little sunshine into each patient's life, and soon you'll discover
that your own life is happier and brighter.
X.Always go the extra mile, and do just a little
more than the patient expects you to do . For example,
make it a habit to phone the patient after discharge
from hospital, to ensure he is doing well. Exceeding
patient expectations is the best way of keeping
your patients happy – and keeping them your
patients for life !
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How do you know if your patients are satisfied with the care
they receive at your clinic? The answer is simple - ask them!
Patient satisfaction surveys are an easy tool you can use to
answer this question , and they can help you identify ways of
improving your practice – which translates into better
care , happy patients – and a happier doctor!
To perform a formal patient satisfaction survey, the first step
is to prepare a flow chart which follows the patient when he
enters the clinic.
For example, one sequence might be:
1. Phones clinic for appointment;
2. Approaches receptionist;
3. Provides necessary information;
4. Waits in waiting area;
5. Goes to exam room;
6. Provides information to nurse;
7. Waits for physician;
8. Meets with physician;
9. Pays bills’ and
10. Leaves.
Based on this flow chart of a patient visit, the satisfaction
survey needs to measure two aspects at each point of the patient/clinic
interaction. The first question should focus on how well the
clinic met the patient’s expectation regarding the interaction.
Thus one question should be: “How well did the receptionist
meet your expectations?” The answer could be given on
a scale of 1 to 5 (e.g., much better than expected, better than
expected, as expected, worse than expected, much worse than
expected, respectively). In addition, for each point of patient
contact, a second set of questions should be asked: “How
important is the receptionist to your overall satisfaction with
your clinic visit? The answer could be given on a scale of 1
to 4 (e.g., very important, somewhat important, somewhat unimportant,
not important at all, respectively). This information can then
be analysed , to help you :
(1) identify which areas of your practise patients are not satisfied
with( and therefore which need to be improved);
(2) and will also allow you to prioritise the improvements
( starting with the areas which patients feel are
most important to them).
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An easier way is to print a patient satisfaction survey card
, and request each patient to fill out and hand this in at the
time they leave. On the card, instruct the patient to mark a
response of 1 to 4 (1 is strongly agree and 4 is strongly disagree)
to statements such as the following:
• It was easy to get an appointment.
• I was greeted in a friendly manner when I arrived.
• I waited a reasonable amount of time before I was
seen by the doctor.
• My doctor answered all my questions.
• I would recommend this practice to family and friends.
Also include space on the card for the patient to jot down comments
and suggestions. Open ended questions such as: 'What do you
like best about our practice?' and 'What can we do to improve?
are also very helpful and will provide you insight into your
patient’s viewpoint. While you don't have to act on every
suggestion that your patients give you, you should take action
on the key items that are causing dissatisfaction. Remember
that your goal is to improve quality, not to place blame.
Most doctors in India still think that they are
doing their patients a favour by treating them.
It’s high time we changed our perspective
, and treated patients as valuable customers ! Adopting
a customer-oriented approach will help you to see
things from your patient’s point of view ,
and become a better , more successful doctor. As
you learn to see your patients as interesting, valuable
people who are giving you the privilege to serve
them, your own life will be immensely enriched by
your patients !
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