Patient Relations: Five Easy Patient Pleasers

For you, “patient-centered” is not just a marketing buzzword; it’s how you aspire to practice medicine. You know that happy, satisfied patients are critical to your success. But, sheesh, there are so many other things to do, what with the new EMR you’re still getting used to, reviewing and (maybe) re-upping expiring payer contracts, and, oh yes, don’t forget about reminding the practice manager to figure out once and for all why you keep inexplicably running out of tongue depressors no matter how many she orders. Add in dozens of phone calls, e-mails, and hallway tête-à-têtes before the day’s out, and at least one drop-everything emergency. Small wonder actual patient encounters feel almost like afterthoughts.

Still, you must keep your patients happy. This is in fact your most important task. Think about it: You can’t treat your new EMR for strep. You can’t get reimbursed for excising a mole from a payer contract. You need patients for that, of course. No patients, no revenue, no practice. How to keep them smiling and coming to you?

With another buzzword: patient-pleasers.

Pleased patients are loyal patients. They are also good referrers. As such, patient-pleasers must top your to-do list. But does that mean you should call in an expensive decorator, knocking out walls or reflooring with organic bamboo? Buy an espresso bar? Offer a “frequent patient” program, where patients rack up points to cash in for free care?

Of course not. People don’t need such expensive trappings. Rather, try the following five suggestions. They won’t cost much, but the potential payoff is enormous.

#1: Dignify them

Joe Geraghty, vice president of operations for ImageFIRST Healthcare Laundry Specialists, says the public perception of a medical practice’s service quality is based on the weakest link in the chain. “You could put all your money in the surroundings and the architecture, but then you hand a patient a paper gown,” he says.

Do you ask your patients to disrobe for an exam and use what’s essentially an oversized paper towel to cover themselves? How embarrassing for your patient. Even the “deluxe” throwaway gowns with the stretchy plastic tie - engineered to snap from your patient’s waist 10 seconds before you walk in the room - put convenience above dignity.

“Patient comfort is important to the viability of the practice,” says Geraghty. “Comfortable patients will come back. Comfortable patients will allow you to perform tests.”

The Lancaster, Pa.-based company provides healthcare linen rental and laundry services to hundreds of medical practices in 26 states and Puerto Rico. Rather than the backside-brandishing gowns typical of many hospitals, Geraghty says his company’s offerings are not revealing and they’re clean, with each one individually repackaged after laundering.
To use a garment rental service, you simply specify:

• Quantity: About 100 per provider per week, usually.

• Style(s): Varies depending on your medical focus.

• Size(s): Adult and/or pediatric, and a couple of oversized ones.

• Frequency: Pickup/delivery could be weekly or even daily.

You can adjust your order anytime if your needs change or if your number of providers changes. There are no upfront costs to your practice, but do expect to sign a three- to five-year contract. A typical gown rental costs about 70 cents a week. So, for a two-provider practice using an average gown style and price with once-a-week delivery, that’s $140 a week.

Consider that economy-grade disposable gowns cost about 50 cents apiece, or $100 a week. Cheaper? Not really, says Geraghty. “You have to look at disposal costs, if you dispose the way you’re supposed to.” Disposable gowns are medical waste, a biohazard, and the CDC has very definite opinions on proper disposal techniques. Also, bear in mind that paper costs are on the rise.

What about buying your own gowns and laundering them? Sure you can, says Geraghty. But you’ll need a commercial-grade washer that can get water to 160 degrees, as required by the CDC. Do you have the space for a washer and dryer? More importantly, who’s going to do the washing? “You’ve got to have a focus,” Geraghty says. “If you have your nurses or staff become launderers, you’re losing your focus. Outsource that function, and then do what you do best.”

#2: Entertain them

Can anything make a person fidget more than waiting-room boredom? Our brains seem hard-wired for constant stimulation; it’s the rare person who can sink into a meditative state at will, thinking of nothing but the peaceful sound of air flowing through nostrils. Too bad, because waiting for a doctor’s appointment adds an additional layer of anxiety, as patients reflect on their impending exams.

Distracting nervous clients with reading material is customary, and it’s fine as a general principle. But take a good look at what you’re offering. Chances are the choices include a weekly news periodical, a ladies or parenting mag, maybe a consumer-grade financial journal, and something sports-related - coincidentally the sport you’re personally into?

What a snorefest. More importantly, how ineffective in making your patients feel comfortable before an exam. You’re already spending money to get this reading material into the waiting room, and a small shift in a usual experience can really capture a person’s attention, so why not offer something slightly offbeat?

For example, parenting magazines have real value with their child-rearing tips and how-to articles, but go a step farther with Brain, Child magazine.

And although there’s nothing wrong, per se, with the usual news magazines, what about The Economist? It’s sharp and witty with an international focus and independent viewpoint. And the cover art is stunning.

There are hundreds of lesser-known but worthwhile reads out there. Regional magazines should also top your list, as you’re helping to forward what’s good about your local community. Avoid controversial material that could spark unease in your patients.

But don’t limit your waiting room library to just periodicals. Coffee table books are sturdy and offer highly diverting pictures. The latest “Guinness Book of World Records,” almanacs, trivia or obscure fact compendiums also work well. Does your patient panel include youngsters? Supply “gross facts” books (also appreciated by many adults). Any of these can be had for about $20 or less. Comb the bargain aisles of your local bookstore or bulk merchandise stores for good deals.

#3: Accommodate them

Whoever coined the phrase “presentation is so important” is so right. And as with fine jewelry, less is more. If your waiting room tables are cluttered with stacks of books and magazines, resolve to get rid of most of the mess.

Cull the stacks regularly - nobody cares what Oprah deemed worthy of her “O List” three years ago - and keep only what’s current and attractive and truly interesting. The room will look neater and calmer, which will go far in promoting a peaceful and pleasing atmosphere for your patients. It will also communicate the message you want to send: This practice is run well, stays current, and takes good care of its patients. 

One problem, though, that plagues waiting room reading material is the patients’ habit of ripping something of interest from one of your magazines. This not a considerate thing to do, and of course it destroys the look and use of the raided magazine. But how to stop it from happening? Take a suggestion from Stuart & Labbe, a Greenbelt, Md., orthodontic practice: On each waiting room magazine cover, paste a large sticker that says, “Did you like an article in this magazine? Please don’t rip it out! Our front-desk staff will be happy to make you a copy.”

Another common waiting room diversion is a TV playing DVDs. That’s fine, although accept the fact that you’ll never please everybody. But you’ll please nobody if your staff forgets about the fact that when a DVD concludes, it reverts to the main menu and loops the same 10-second sound bite ad nauseam - head-bangingly unpleasing to patients.

Finally, make sure your furniture fits your clientele. Are the bulk of your patients elderly, or do they have mobility challenges? Couches can be difficult to get out of for these people. On the other hand, moms and kids like to huddle together; big, comfy couches will be much appreciated.

To combat the inevitable staining perpetrated by your crumb-grinding patients - no matter how many “No food in the waiting room, please” signs you put up - go for busy fabrics; better yet, washable slip covers.

#4: Help them to help others

Volunteering is currently at a 30-year high, with 27 percent of Americans donating time to charitable organizations, says a report from the Corporation for National & Community Service (the nation’s largest grantmaker supporting service and volunteering).

Sixty percent of these volunteers are “episodic,” meaning they participate in a specific volunteer effort. You can tap into this habit of helping out and please your patients at the same time by providing a volunteering opportunity right in your practice.

One such possibility is through Changing Images Art Foundation Inc. Co-founded in 1997 by Arlene Sullivan in Towaco, N.J., Changing Images beautifies hospitals and other institutional settings with painted murals, ceiling tiles, window shades, and six-inch painted canvas butterflies that can “fly” anywhere with wallpaper paste. The painting is largely done by volunteer groups, who then send their work back to Changing Images, where Sullivan outlines them in thick, black borders.

Sullivan got the idea for Changing Images when her then-infant son had to be hospitalized in intensive care for two months. “There was nothing to look at,” she says. “You start breathing to beeps.”

She agrees that setting up a “painting station” in your waiting room would work well. For a $100 suggested donation, you’ll get 50 butterflies and painting supplies. Simply set up a table with a sign that explains the program and invites patients to help out by painting a butterfly while awaiting their appointments.

It doesn’t matter if they finish it, says Sullivan, nor if it’s Picasso perfect. The point is that they’ll feel good knowing they did something to brighten someone else’s bleak environment - and kudos to you for providing a way for them to do that. “A lot of people do want to do something for someone else, but they don’t know what to do,” says Sullivan. “Here’s something while they’re sitting there that they can color - how cool is that?”

#5: Respect them

This last patient-pleaser is actually a collection of heads-up tips about you and the messages you may be sending your patients with your actions. For happier patients, consider the following:

• Start on time. Barring a true emergency, your first appointment should be exactly when you said it would be. Consider that the patient who scheduled it likely did  so because she’s got a busy day ahead of her, too. If you find yourself running 10 minutes behind from the get-go, then rethink your morning routines, and make whatever adjustments necessary, so 8 a.m. truly means 8 a.m. and not 8:13.

• Take a deep, cleansing breath before opening the exam door. Tight schedules can cause even the friendliest, most laidback physician to start barreling through his day like a golden retriever on a duck hunt. Stop for two seconds to help put a period on the previous encounter so you can fully focus on the next one.

• Make eye contact, shake hands, and sit down. If you’re too rushed to make this basic communication connection, then perhaps it’s time to revisit your fundamental practice operations. Never doubt how quickly your patients will notice your distracted body language, and draw conclusions you don’t want drawn.

• Listen - really listen - for the first three minutes after asking the requisite, “So, what brings you here today?” And this means no interruptions, except to ask clarifying questions. Patients often need some time to divulge all the details. You’ll make it up in the end because you’ll gain a more comprehensive picture of what’s going on with your patient.

Shirley Grace, 

senior writer for

Physicians Practice

, holds an MA in nonfiction writing from The Johns Hopkins University. Her articles have appeared in numerous publications, including

The Washington Post

and

Notre Dame Business

magazine. She can be reached at sgrace@physicianspractice.com.

This article originally appeared in the November 2007 issue of Physicians Practice.