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Practice Management

Front-Desk Excellence: How Your Practice Measures Up Matters to Patients

Jennifer Arnold

Wednesday, September 06, 2006

Patients choose a dermatologist based on factors like referral from another provider, subspecialty, and reputation. But experts say patients evaluate based on an entirely different set of standards once they reach the front desk. "It doesn't matter how good the doctor is - if the patient is uncomfortable with the way he's treated by the staff, he's not coming back," says Gil Weber, MBA, a practice management consultant based in Davie, Fla.

Creating that comfortable atmosphere at your front desk may seem even more challenging than providing excellent clinical care. But successful practices say it doesn't have to be. The first step is to view your practice from a patient's perspective.

First Impressions

"There's nothing worse than coming into an office with magazines strewn everywhere," says Christi Babis, office manager of Fair Oaks Skin Care Center, a four-physician dermatology practice in Fairfax, Va., that sees up to 90 patients a day. "You want it to be aesthetically pleasing. Think about sight, smell, and sound." Fair Oaks plays relaxing music and uses scented oil diffusers to set the right tone. "We don't want [patients] to feel like they're coming into something so sterile," says Babis.

Weber says a patient's first impression is even more important in a specialty like dermatology, where patients are paying for many types of care themselves. "The entire experience becomes different when you're paying out-of-pocket," says Weber. "The frontdesk and reception areas are crucial in making the patient feel that they're going to be treated very, very well." In addition to aesthetics, another key to patients' comfort is making sure that they know what they're expected to do. At Fair Oaks, the direction is clear: "As you come in the front door, your line of sight is right to our receptionist," Babis says. "You can't help but walk right into her area." This type of set-up is ideal, but if the layout of your office makes it impossible, provide signage to direct patients.

But be sure that this signage - and all signage in your practice - has a professional appearance and friendly tone. "This is where many practices fall down," says Weber. "With eight pieces of paper taped all around the reception window, handwritten or Xeroxed notices - they look so unprofessional." Experts say it's worth the expense to have signs professionally made for notices that will apply to all patients.

And make sure the information is conveyed in a pleasant manner. "I hate it when you see all this negative stuff," says Wendy Brown, CMOM, practice administrator at Adult and Pediatric Dermatology PC, a four-physician, three-location practice based in Concord, Mass. "'It's your responsibility for this, that, and the other,' or 'Your copay is due or you'll go to collection.'" Try to think like a patient when you read your signage, and see how a carefully placed "please" or a different word choice might soften the message.

Find 'People' People

Of course, you want your staff to reflect that pleasant, positive outlook as well. Realize that the patient's experience with the receptionist sets the stage for the entire patient encounter. "If a front-desk person is rude to them, patients feel that the physician will be rude to them, too," says Samuel Goos, MD, a dermatologist at Adult and Pediatric Dermatology. "If you don't have [front-desk] staff that is empathetic, the patient won't trust you as a physician."

Finding the right people isn't easy. Although the receptionist position does not require specific educational or professional credentials, experts say practices need to be extremely selective. Instead of zeroing in on candidates' experience (or lack thereof), hire based on personality and attitude. At Brown's practice, the front-desk position is called "greeter," a distinction that reflects her hiring philosophy. "I want someone who has a warm, friendly personality," says Brown. "All the experience in the world doesn't make a good greeter; it's something that comes from within. I'd rather bring them in and train them on what we do."

Successful practices say the best results come from complementing good hires' natural skills with a variety of tools, such as job descriptions, policies and procedures, and regular workshops. At Fair Oaks, Babis uses all three. "Everyone in my office has a job description," she says. "We also have an office policy manual, with policies for each process that staff members go through with patients." Babis also holds monthly meetings with her receptionists to go over issues they may have encountered. "We do role plays a lot to see how different people respond to different types of personality," she says.

Focused Reception

Job descriptions are particularly important to clear expectations. "In a busy practice, you'd like to keep receptionists as focused as possible on welcoming patients, confirming insurance, all that stuff," says Weber. "They shouldn't be making appointments, and someone else should pull the charts."

Brown's greeters have three responsibilities. "Their number one goal is to welcome every single patient who comes in," she explains. "The second goal is to verify that we have all their information correct. The third is to get the patient quickly in the door," to see the dermatologist. Brown's greeters do not answer phones, confirm appointments, or pull charts. "I don't want them to be stressed," says Brown. "If they are, it's going to show to the patient," who can, in turn, become anxious.

And most dermatology practices need to reduce stress wherever possible. A good front-desk operation can help with careful preparation. "The biggest thing is preventing surprises when the patient presents at the reception desk," says Weber. Brown's greeters minimize problems by reviewing patient charts 2 days before appointments and preparing new patients' charts as completely as possible before their arrival.

Don't forget the importance of the patient's last impression of your practice: the check-out process. "We train our check-out staff to ask, 'How was your visit?' and, 'Do you have any questions?'" says Babis. Also, provide some privacy in the check-out area and train staff to refer more complex discussions to a closed-door office.

Reality Check

How do you know when you've achieved front-desk excellence? Ask.

"Practices should always be doing surveys," says Weber. "A well-designed … survey can answer a lot of questions on how patients feel about the total experience." Provide a postage-paid survey, or post it online to facilitate responses. Then provide an incentive, such as entry into a gift certificate drawing, for completing it. At Fair Oaks, "We get 25 survey responses a week," says Brown.

To get the best response, limit your questions and provide space for freeform comments. Weber says the key questions are:

  • Did the doctor answer all of your questions today?
  • Is there anything today that did not completely satisfy you?
  • Would you refer your friends and family based on your experience today?

Office managers should follow up personally on any answers that indicate a problem, and use the information gathered to make changes.

It's easy to neglect the front desk in pursuit of improving patient care. But once you start seeing things from the patient perspective, you'll realize that the front desk is patient care, too. "Everything is a reflection of the physician, even if the physician isn't directly supervising," says Goos. "A patient is thinking, from the minute they walk in the door, 'This is Dr. X's practice.'"

Welcome Patients with Attention

The front-desk area sets the tone for patients' experiences with the dermatology practice as a whole. To make sure the impression created is a patient-centered one, separate the phone function from this area if possible. It's difficult to ignore a ringing phone, even if it means snubbing a person standing right in the room with you. Greeters should instead be free to focus solely on the patients in front of them.

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Disclaimer: The material above has been prepared by Physicians Practice. It has not been reviewed by the DermQuest Editorial Board for its accuracy or reliability. Reference to any products, service, or other information does not constitute or imply endorsement, sponsorship, or recommendation by members of the Editorial Board.