Learning to become an effective communicator does not always come
naturally to practice managers, practitioners or their staff. It is not always
an easy task, particularly within the challenging and demanding environment of
a busy medical/surgical practice. There are some techniques that can be useful
to facilitate and encourage an enhanced relationship with practice patients.
First impressions count! Getting the 'front end' right
should be part of every management plan for you and your practice.
Patients start formulating their opinion about the practice and their
practitioner from the moment of first contact. This opinion is based on the
entire 'cycle of service' which encompasses:
- the first point
of contact with the practice (usually by phone with the receptionist)
- the first direct face-to-face contact at the reception desk.
- the consultation process
- the invoicing process (post
- any recall/follow-up services.
‘cycle of service’ should be viewed from an overall perspective of
practice staff contact, products/services and processes/systems that
support the core business - the medical consultation. Throughout the
'cycle of service', all staff and doctors must ensure they maintain the
'consistency of message'. Issues arise for patients when they hear
different information from different people; this is especially so for
doctors as many patients will respond with the phrase “... the doctor
The moment the patient phones, contacts or
attends your practice to make the initial appointment is the ideal time
to familiarise the patient with your practice and its policies.
Provide new patients with written information in the form of a
pamphlet/brochure that familiarises them with your practice. This can assist
in avoiding misunderstandings, unrealistic expectations and complaints
about ‘service’. You might include the following:
- practice hours
- appointment scheduling
- key practice
- the days and hours of work of each doctor
- after-hours or emergency care availability
responsibilities and expectations
- zero tolerance policy
- requirement for patients to advise staff when a
long consultation is necessary
- requirement for patients to advise
staff when their appointment cannot be kept
- whether the doctor will
take telephone calls during consultation hours and/or when they will be
- the procedure if the doctor is delayed or called to an
- whether medical information and/or test results are
available by phone
- policy regarding repeat prescriptions
- practice fees and billing arrangements
regarding referral requirements
- other healthcare/allied
health services available
- information regarding privacy and
- any other relevant information you would like
patients to be aware of.
Advise and apologise to your
patient if the doctor is running behind for their scheduled appointment.
Listen to patients and respond to their needs and preferences.
Respond to patients in a way they can comprehend and
Empathise: acknowledge their situation or
Use silence effectively, allowing patients enough
time to express thoughts or feelings.
Explore: ask the
patient questions and invite them to ask you questions, ask their opinion and
seek their expectations. Ask the patient to repeat to you what they have
understood of your discussion.
Focus: don’t make the patient
feel rushed. The last thing staff or a doctor should do when pressed for time
is to behave as if pressed for time. The patient is more likely to leave the
consultation with 'unfinished' business.
the doctors to explain what they are thinking and openly discuss their proposed
management and treatment plan. Patients about to undergo a procedure should be
informed what to expect during and after treatment. Consider the following
- Discuss the possible side effects and how they can be
managed and dealt with.
- Provide instructions as to when the patient
should seek advice after a procedure.
- Discuss the consequences of not
complying with instructions.
- Provide information on follow-up
appointments. Advise if assistance will be required after the procedure.
- Advise the patient if time off work or away from other responsibilities
will be required.
- Ensure the patient has a clear understanding that the
final desired outcome could take some time.
- Inform the patient of all
possible fees. Have a “talk money up front” policy. There should be no
surprises in relation to fees.
provide the patient with options and the time to consider them. Determine the
patient’s level of understanding by using a questioning strategy that will
allow you to identify any deficit in this regard.
feedback: feedback from patients can be obtained either from
complaints/compliments received or through structured patient satisfaction
surveys. While actively seeking feedback from patients will elicit both
positive and negative responses, the information obtained is invaluable in
directing and supporting practice improvement. This can also be an effective
mechanism for communicating with and obtaining the patient’s opinion of your
You must make sure, wherever practicable, that arrangements are
made to meet the patient’s language and communication needs. Where particular
arrangements need to be made for patients, it is best to have these in place
for when the patient attends for their consultation.
Complaints handling systems: avoiding complaints would be the ideal,
however the reality is that you will probably encounter a complaint at some
time in your career. It is important to have a protocol in place for handling
complaints and for dealing with them promptly and professionally.
Manage patient expectations: staff and doctors can be drawn into
arguments and then give in to patient demands “because they felt sorry for
them” or wanted to “do them a favour” or just could not say “no”, against their
clinical judgement. In the long run, this places a great deal of strain and
pressure on the staff and doctor and sets up the patient’s expectation for
treatment in future consultations. For instance, there are limits to what
medicine can achieve: some illnesses cannot be cured, advertised medications or
procedures may not be suitable for a particular patient, or a cosmetic
procedure may not restore a patient's happiness.