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Practice Management

Training Staff in Patient Education: What Dermatologists Need to Know to Improve Patient Understanding

Wednesday, January 03, 2007

Perhaps surprisingly, whether or not your dermatology practice has a formal staff training program in place for patient education is not the most crucial piece of this particular puzzle. The one key factor to keep in mind when training staff: Avoid misinforming the patient at all costs. "The concern is always on the physician's part to not just educate the patient," but also employees, says Kathy Moghadas, RN, a principal of Associated Health Care Advisors/Topcat in Deer Park, Fla. "So many [physicians] are very cautious about who's trained and what kind of information is given." Elaborating on information about which you don't have adequate knowledge is a definite no-no. "It's better [for staff] not to teach at all than to teach bad information," she stresses. However, "the better [staff is] prepared to answer questions the patient might present, the higher the level at which your practice will be viewed," notes Moghadas. And crucially, opportunities for improved patient knowledge and satisfaction will be realized.

Who Should be Trained?

Ninety-nine percent of the staff training done in a dermatologist's office is delivered by the physician, according to Moghadas. "Patient care coordinators are usually the ones who are responsible for educating the patient, and they are trained on the job directly with the physician," she says.

Joshua L. Fox, MD, is founder and director of Advanced Dermatology PC and The Center for Laser and Cosmetic Surgery in New York City. His practice is fairly large, but he personally trains medical and physician assistants. "For medical assistants [MAs], we try to limit staff education to things that are repetitive … and [topics] that are documented on paper so that they can refer to it," he states. "There's less room for error. The PAs can do excellent patient education; that's really their role. We think medical assistants should really not be doing that unless it's something we have on paper that they're just reiterating or rephrasing." Fox explains that MAs may summarize some of the things he has said, but he prefers that they follow the dermatologist's lead. "That is in contrast to if they're explaining what to do for a patch test or what the procedural aspects are to a patient. That is something we like them to get very involved in."

Bev Aldridge, dermatology coordinator at Sutton Ryan Dermatology in Lincoln, Neb., oversees staff training along with an assistant. "All new staff goes through a 6- to 8-week training period … to learn the flow of the clinic," she says. "Front-office staff have a 4-week training period. The staff also have annual safety and OSHA training." When new equipment or procedures are implemented, she provides in-services. "There are times when we will initially train a couple staff members, and then those individuals will train the staff," she explains. "Educate everybody. Don't keep the front desk in the dark just because they're answering phones. They are the first point of contact most of the time, and I think doctors make a mistake sometimes of not trying to educate [those in] reception," Moghadas adds.

Techniques of the Trade

A wide variety of staff training techniques for patient education can be used, both on and off the job. For one, companies that sell services and products in dermatology will often send their representatives into a practice to educate staff. "The reps will come in and provide educational content when they are bringing in supplies or samples," notes Moghadas. "Depending on the procedure or what the product might be - something as simple as Derma Cleanse, for example - they might even have the staff try it and see how it works for themselves," she says. "A lot of teaching material is made available by the drug reps [and] all staff are encouraged to read."

"The American Academy of Dermatology [AAD] produces a great deal of literature on topics that are sometimes sponsored by vendors," Moghadas says. "They set up practice parameters on how to take care of certain disorders, which can be very helpful." In addition to this, AAD and other professional societies offer educational training conferences, and dermatologists often bring key employees to breakout sessions at these venues. As far as seminars and conferences go, Fox says his practice does a little bit of that. "Mostly, we'll have someone come in. We generally don't send our staff out." Other training sources may include multimedia materials such as videos, CDs, and DVDs that can be brought into the office.

Moghadas recommends that practices have a training logbook. "As the physician receives information that he feels the employees can absorb, he'll take a copy of an article and put it in the book so they have a chance at their leisure to read and initial that they've read it. It becomes a very effective tool for educating."

Fox has a training manual, too, which includes commonly used drugs and commonly misspelled medical terms. "We have a training program the first few weeks when someone first starts. It's not formal in the sense that we have these 30 topics we're going to cover. Generally, though, if you go through the course of a day, you will see these patients. These topics will come up. There will be a few of the rare cases or unusual scenarios that they may not see."

According to Moghadas, most of the time training is on the job, where the dermatologist is instructing staff while actually performing a procedure. The method is direct, and staff is actively engaged as the physician uses whatever situations arise as learning opportunities.

What this Means to Patients: An Example

Let's now put the staff training principles to work, using an eczema regimen as an example.

  • Assess what the patient knows before the teaching session. Never assume he needs to be taught everything about eczema. Choose three or four essential concepts and teach those. Once the patient has a general understanding of the condition, you'll want to discuss treatment options such as topical medications, antihistamines, and so on.
  • Again, don't overwhelm the patient with information. Keep it simple so that the patient can readily understand it. Let him know that some antibiotics are applied to the skin; others come in pill or liquid form. Phototherapy and stronger systemic medications, such as corticosteroids and cyclosporine, may be discussed as treatment options.
  • Never present any information that would intimidate or scare the patient.
  • When teaching a patient a regimen, take the time to watch him practice these skills and demonstrate on subsequent visits.
  • Reinforce the information by asking the patient to restate what you have taught him so you're sure he understood.
  • Use visual aids and/or written materials for teaching and for patients to take home. Patient instruction sheets and handouts should be available discussing any lifestyle changes that may help, such as short, daily baths or showers in warm, not hot, water. Other topics on which to provide education for eczema patients might include avoidance of fragranced soaps and detergents, gentle skin drying and application of a moisture-retaining emollient cream, and choosing clothes that allow the skin to breathe.

When training staff for patient education, each dermatology office will have its own protocol - a key point because it allows less room for error. For some practices, a formal staff training program might just be what the doctor ordered, as patient education should be considered one of a dermatologist's most important responsibilities.

Make Sure Patients get the Message

Several repetitions may be needed to impart key information to dermatology patients. "Educate everybody," advises Kathy Moghadas, a principal with consulting firm Associated Health Care Advisors. "Don't keep the front desk in the dark just because they're answering phones. They are the first point of contact most of the time, and I think doctors make a mistake sometimes of not trying to educate [those in] reception." Other tips for educating staff to provide top-notch education to dermatology patients include emphasizing demonstration skills, maintaining training logbooks that include literature and other materials collected by the physician, and bringing external resources like product representatives into the practice for staff development.

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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.