The Patient Experience:

What Goes on Outside the Exam Room Can Have a Big Impact on Your Practice

by Michael Rea

Nobody can dispute that quality outcomes and clinical interaction are important in gaining high patient satisfaction scores, but here is something for you to consider as part of your operational strategy. Research has indicated that as much as 65% of patient satisfaction is based on non-clinical issues (like ambience, communications, expectations, image, and customer service). And here is the important part: a dissatisfied patient will likely tell 20 friends, without being prompted, about his "bad experience." A satisfied patient usually will only tell a few friends, and then only if asked.

We will take a look at three areas that can have a positive impact on your practice. And here's something else to reinforce the necessity of focusing on some of the non-clinical issues: Did you know that attracting new patients costs three times as much as it does to retain current patients? And that 75% of new patients are referred from current, satisfied patients?
  1. Local External Marketing: Let people in your area know you're there - and you're the best! Local marketing covers everything from public relations and advertising to direct mail and effective web sites.

  2. Patient Experience: What does a patient encounter when he or she arrives in your office? A first impression is an opportunity that never repeats itself. Are you doing all you can to give your patients the most positive first impression possible?

  3. Employee Communication, Motivation, Recognition and Reward: Your employees are your greatest asset in creating that great first impression. But they need to be made a vital part of day-to-day activity and communication.

Local Marketing:

While each practice is different, there are common themes among successful practices when conducting marketing programs. Depending on the size of the practice, utilize someone in-house or an outside marketing company to publicize achievements, new locations, new staff additions, published articles, or other changes or accomplishments. Do you maintain an email list of your patients? If not, start gathering those emails today. Sending out a quarterly newsletter is a great (and inexpensive) way to touch current and former patients. Remember, this is where a lot of your referrals are coming from.

Advertising is no longer a dirty word in the medical profession, but if you are still uneasy with the concept, think in marketing terms about your business model. Patient retention and new patient acquisition initiatives are critical to the long term health of your practice. Marketing is simply communicating the benefits of your particular practice to potential patients. There are many different marketing vehicles that you can use: direct mail, internet marketing, and traditional media like radio, TV, newspaper and outdoor. Each has particular strengths and weaknesses depending on the message you are trying to convey and your target market.

Websites are another area to really focus on. Patients are getting more and more web savvy. They'll rarely deal with a practice unless they've visited their web site first and educated themselves about the practice (and their competition). The textbook definition of an effective website is one that presents a positive and professional image, is useful and informative, and gives the user a reason to interact, transact, and return. In the web era, content is king. Information about your practice, doctors, staff, procedures, and patient expectations are all important components. Finally, make sure your site is visually appealing and professional. Use attractive, high-quality photographs that are professionally produced. Your navigation should be easy to use and intuitive, so patients can easily get the information they want.

Patient Experience:

As mentioned earlier, 65% of patient satisfaction occurs outside of the interaction with a nurse or doctor. Place yourself in the shoes of a new patient visiting your office for the first time: Is the reception area tasteful and clean? Do the signs on the wall help the new patient feel comfortable, or do they focus on insurance and billing? Is the receptionist kind and sincere? Are you greeted upon your arrival? Does the staff use your name whenever possible? Are you given enough information to feel comfortable with the check-in process? Once you've seen the doctor, is the check out process simple? Is someone available to answer any questions you might have about the next steps in your treatment? If you can answer each of these questions (and there are lot more areas to look at as well) positively, you're in pretty good shape. If not, it's time to reassess facility, process, and/or personnel.

For the actual clinical interaction with the patient, here are some areas to look at:
  1. Be prepared for the patient. Always review the patient's chart before you enter. Your ability to know and remember information will impress patients. Knowing their spouse's first name, can help you make the personal connections that are important to patients.
  2. Create a favorable impression in the first 60 seconds. The amount of time a physician spends with a patient contributes significantly to the patient's satisfaction with an office visit. It's not always possible to dedicate as much time to a visit as a patient may want, however, if you give a patient your undivided attention for the first 60 seconds, you will leave the patient feeling that he or she had a meaningful interaction.
  3. Put the patient at ease. Be alert to factors that might hinder physician-patient communication. One patient decided to look for another physician because his physician had his back turned. Another patient opted not to return to a physician who greeted him wearing a surgical mask. The physician never explained why he was wearing the mask, and the patient never asked.
  4. Focus first on the patient's needs. Every member of your practice should keep this at the forefront. When your receptionist asks about insurance first, before asking how the patient is feeling, the impression is created that you care more about the patient's insurance than his health. Early in the visit, find out what issue is on your patient's mind. It may not be problem clinically, but when you address this concern first, the patient can relax and listen to what you have to say.

Employee Communication, Motivation, Recognition and Reward:

A recent study conducted by Northwestern University found there is a direct link between employee satisfaction and customer satisfaction, and between customer satisfaction and improved financial performance. Recognition and reward systems can play a key role in a company’s effort to engage employees. Key components of a RRS are typically:
  1. a strategy built around organizational goals
  2. support from senior management
  3. appropriate training and communication
  4. attractive awards - compensation and/or formal recognition
  5. an administrative and reporting system
An “engaged employee” does two things very well – they produce a high volume of high quality work and they help create change. The quality and volume of work is a result of an understanding of the overall goals of the practice and the understanding of how the employee's efforts impact those goals. The ability to create change is driven by the awareness of all the components that make up their work and their willingness to challenge the status quo when they see an opportunity to do things better. An engaged employee “owns” their work and may regularly contribute beyond their exact job description. They generally hold a significant amount of tacit knowledge regarding “how things get done” in their sphere of influence and are happy to share that knowledge. Most people really want to be that type of employee, but often become frustrated if there is not a system in place to encourage growth.

One of the most common complaints inside the workplace is lack of communication. Employees at all levels must understand the importance of their roles in the overall success of the practice. If you plan to undertake some form of employee recognition and reward system, make communication one of your highest priorities. Not only do you need to explain the system very well, but let each employee know how their performance effects the entire organization.

If you plan to implement an RRS system, the first step involves taking a high-level look at your practice. These "big picture" questions will help develop an environment in which employees are highly engaged. What is our current culture of the practice? What would you like the culture to be? What are the key drivers to organizational success? What are the behaviors that relate to those key drivers? How does work get done in your practice? What behaviors contribute to getting the work done? How best can we recognize those behaviors?

It’s important to understand that undertaking a true group wide RRS initiative is a complex process that will, in some ways, serve as a “cultural audit” for the practice. At the end of the day, a company will come to a core set of beliefs in what makes their enterprise important, and have an understanding of why current and potential employees would want to be a part of their effort in the marketplace.

If you do not feel that your practice is ready for a formal recognition and reward system, you can still implement many of these ideas informally. One of the best things you can do is to "catch someone" doing things right. A simple nice job here and there goes a long way. Recognizing someone who is engaged will further that behavior and encourage others to adopt similar behaviors. It still takes some time on senior management's part and needs to be done on an ongoing basis, but you will be surprised how much effect that a simple "Thank you" at the end of the day from one of the doctors can have on someone in the front office.