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AAOS Now

Published 9/1/2014
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William R. Pupkis, CMPE

What Your Practice Says About You

Associated services, attitudes shape a patient’s opinion

Marketing can be defined as the business activities involved in moving goods from the producer to the consumer, which goes beyond selling, advertising, and promotion. When applied to medicine, marketing is a system of coordinated activities centered on the interchange between patients and a medical practice. If the practice is organized to ensure that the level of services delivered meet the expectations of patients’ needs and desires, the likelihood of success dramatically increases.

A decade ago, a study indicated that patients cannot judge their doctors by the delivery of basic medical care alone. That’s still true today. Most people find that core concept too complex or too elusive to comprehend. Their perception of their care comes from the associated activities rather than the delivery of the core service. They base their opinion on the most basic activities—the facility, the staff’s attitude, the ease of making appointments, and so on. Well-managed associated services will enhance the core service of any orthopaedic practice by positively influencing patients.

The first impression
Many patients base their first impression of an orthopaedic practice on that first telephone call. Receptionists and telephone operators should adhere to the following guidelines:

  • No eating or chewing while on the phone.
  • Smile while you are talking.
  • Do not place the caller on hold until he or she gives permission to do so.
  • Check back every 30 to 60 seconds and get the caller’s permission to be put on hold again.
  • If the caller does not want to be put on hold, ask for a return call phone number.
  • Remain calm and helpful when dealing with an angry patient; understand that the patient is not upset with you personally.
  • Never diagnose conditions or give medical advice over the phone; that is the physician’s responsibility.
  • Treat patients with respect and empathy; never talk down to a patient.
  • End the conversation by thanking the patient for calling and wait to hear the patient hang up first.

A visit to an orthopaedist’s office is an important event in a patient’s life. Patients usually pay attention to everything that the physician says and does in an attempt to evaluate the physician’s concern and compassion for them personally—as well as to assess the physician’s competence.

Patients are not trained to judge physicians on a medical basis, but they will still make judgments. The physician’s attitude regarding cleanliness, service, and value must be apparent throughout the practice from the moment the patient calls for an appointment. Patients come to see “the doctor,” and the staff assisting patients take their cues from the doctor as well.

How a physician handles patients is evidence of his or her philosophy on practice enhancement.

Delegate appropriately
Whenever possible or allowed by law, orthopaedic surgeons should delegate appropriate medical tasks to licensed, well-trained, educated assistants. This will give the surgeon more time to devote attention to those tasks for which he or she has been trained to perform.

Delegating also demonstrates the confidence the surgeon has in staff and fosters initiative and enthusiasm. Effective delegating can help the surgeon finish on time, reduce stress, and create an environment that enables the surgeon to practice medicine as he or she had originally intended.

The following steps can help physicians delegate appropriately and cost-effectively:

  • Jot down as many tasks as you can think of that you perform on a regular basis.
  • List the resource people in the practice who have the potential or training for assisting with these tasks.
  • Before delegating, write a description of the task and how it should be completed. This step leaves little room for misunderstanding.
  • To further ensure that a task is performed to the appropriate standard, remember that “You get what you inspect, not what you expect.”

Manage referral sources
Managing referral sources is vital to the growth of an orthopaedic practice. Satisfied patients will tell the referring physician about the level of care they received, thus increasing the physician’s trust and willingness to refer future patients. In developing an effective referral program, the orthopaedic surgeon should understand who the referral sources are, why they are referring to the practice, and how service to them can be improved.

My surveys of primary care physicians revealed that half wanted in-depth reports and half preferred synopsis-type reports. Based on that, asking which style of report referral sources want would be helpful. A key element in building a good referral base is providing the service that the referring physician expects. The following factors influence referrals:

  • friendliness with colleagues
  • report turnaround times
  • attempting to fit referral patients into your schedule
  • never sending a referred patient to another physician without first clearing it with the initial referral source

Next steps
Before making a diagnosis and choosing a course of treatment, every physician takes a patient history and performs a physical exam. The business side of the practice needs a similar approach.

It is no longer possible to practice medicine without analyzing what was done well and what perception patients have of the practice. Patient demands are more critical today. The following questions will help you identify and nurture those aspects of the practice that contribute to future growth:

  • What are the chief complaints that patients have about physicians in the area?
  • What services do other physicians offer that you do not?
  • Why do patients come to the practice?
  • What are the strengths and weaknesses of the practice?

William R. Pupkis, CMPE (Ret.) is a healthcare management consultant and a member of the American Association of Orthopaedic Executives (AAOE). This article was adapted with permission from the AAOE eNews, May 27, 2014.