Tips for Minimizing Interruptions in the Physician’s Exam Room

We are all busy physicians. Being the busy physicians that we are, how do we best create an efficient process for message delivery without interrupting patient encounters in the office? There are several methods of skinning the proverbial cat. I will describe a few ways that I am available to my patients during the day, yet still manage to minimize the interruptions with patients in the office.

It is important to have an efficient messaging system. I want to be able to address any concerns that my patients might have for me; however, I do make it a priority to limit interruptions from patients who are not scheduled for an appointment.

First of all, any time a patient comes to the office without an appointment but has a question for me, my staff is instructed to receive the patient’s question or concern and send it to me in electronic message form with that patient’s chart attached to the message. This is very easily done with my EHR system. I am able to view messages on my tablet PC in between patient encounters and send a response back to the staff. Most questions are easily answered and do not require that the patient schedule an appointment.

However, for patient questions that cannot be easily met with a quick sentence or two, I will ask my staff to schedule an appointment. Most patients are well accustomed to this process and follow it easily. They appreciate the fact that when they are in the exam room, my full attention is given to them. My practice also has an online patient portal that integrates with my EHR. Patients are freely able to send secure messages to me and know that they will receive an answer within 24 hours. I encourage such contact to be completed for those questions or concerns that are not considered to be urgent.

I do not carry my cell phone into the exam room. We have signage posted all throughout the office asking patients to either turn off or silence their cell phones. Even though patients' cell phones do ring and ding, most of them will appropriately turn them off if they do ring. I am available to respond to emergencies, however, and do wear a pager on my belt. My patients understand that I am a busy doctor and will occasionally have to exit the exam room to answer a hospital or nursing home page. While my cell phone does consistently ring and ding, it does so on my desk and I am able to check it for important calls or texts in between visits if needed.

It is important to frequently call those who frequently call you. An example here would be the local nursing home where I have several patients admitted as residents. In the early days of my practice, it was not uncommon for the nursing home to page me at least four to five times each half day with the usual non-urgent questions. To remedy this problem, I informed the nursing supervisor at the nursing home that my nurse will call them each morning at 11 a.m. and afternoon at 4 p.m. During these scheduled calls, my nurse is able to field questions in batched form and I am able to answer them in like fashion. Not only has this decreased the frequency of the pager ding, but it also gives the nursing home staff comfort in knowing that they will be routinely called to check on the residents to see if anything is needed. This has greatly improved my efficiency in the office. I employ the same practice for patients on the hospital wards.

It is very important to make yourself available to your patients. Even though doing this may potentially bring interruptions to your daily work, your patients will appreciate your concern for their well being. Plus, their overall satisfaction with the care you provide to them will increase exponentially.

Find out more about J. Scott Litton, Jr., MD, and our other Practice Notes bloggers.