Front-Desk Excellence: How Your Practice Measures Up Matters to Patients
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.
"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.
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
How do you know when you've achieved front-desk excellence?
"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,"
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
- Would you refer your friends and family based on your
Office managers should follow up personally on any answers that
indicate a problem, and use the information gathered to make
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
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.