The Patient-Physician relationship has eroded for most Patients to the point today where Patients have been under-served, over-charged and underwhelmed by their primary care or family Doctor. They lack trust in you and now, it’s up to you to rebuild that relationship and exceed their service and relational expectations. But here’s some encouragement, it’s easier than you might think.
— Editor, Concierge Medicine Today, October 2023, Concierge Medicine Forum, industry keynote address

The Bottom Line

Patients expect a battle for their rights and needs to be met in today’s primary care, family medicine and overall, our entire healthcare culture. It’s so easy to ruin your reputation in minutes by being another medical office known for delivering dreadful customer service. While Patients, like me, can be quite forgiving, there also comes a time when every Patient has ultimately had enough and leaves your practice. They’ll leave you in their wake and find what they need somewhere else. It's not fair, but you and I know this to be all so accurately true. As author J.H., writes in his book 'Know What You Are For', he writes, “In order to ensure consistent growth, the goal of everyone in the organization should be to make the answers to ‘What do we want to be known FOR?’ and ‘What are we known FOR?’ match.”

This is the most important challenge for any Doctor in today’s inhospitable healthcare culture.

I'm not a Physician, but I am a Patient ... so the perspective that provides this article today is that I know exactly what it's like to sit on the other side of you!

From a patient perspective, I can tell you first-hand, there is no such thing as an emotionless visit.

I can also tell you with certainty, that everything communicates!

And I mean everything.

Every Patient feels the vision you have for them within seconds of walking into your practice. In fact, the message your communicating to your Patients and community actually started weeks ago with the phone call I made to schedule today's appointment.

Then there was the convenience of the location. Then, the parking spot. Then, the design elements outside your office.

Everything communicates.

If it is true that every Physician ends up somewhere in life wouldn't it be great if at the end of your career you and your Patient(s) ended up somewhere you intended FOR them to be?

Easier said than done, right?

Especially because you don't have control over the parking, the plants outside that I walk past nor, how strenuous and difficult it is to simply be my Doctor in today's need it yesterday culture.

I'm a student of healthcare experiences.

I certainly don't have all the answers but what I do know and have learned over the years working in and talking to Concierge Medicine Doctors, who have the patient experience pretty well planned, I want to share.

So when the topic of customer service (or lack thereof) in healthcare comes up it is important to me because I'm a Patient.

I recognize that you have a vision for me. You have a pathway to health you'd like for me to listen to and follow. You want to be my guide and I want you to fulfill that role and be that voice in my life as well.

But all this little stuff gets in our way, doesn't it?

From the staff greeting to the temperature of the office, all these little things get in the way somehow and distract you and I from really connecting. Then there is the interior design decisions in your practice and the artwork choices on the wall.

In Concierge Medicine for example, I see this organized and done pretty well.

For me, it's one of the most unique spaces in the healthcare delivery marketplace right now that is informing every Physician, administrator, technology developer, marketer and health system that healthcare could be and should be for designed to be better FOR the Patient. It should be less about paperwork and bill payment methods and more about patient experience and communicating your vision of health and wellness in every encounter with staff and your practice.

But, not everyone understands this, agrees with this delivery model nor want to think of Patients as customers and set a standard of customer service so high that it magnifies the problem of mediocre experience inside other offices in your community like a semi-truck with it's high-beams on barreling at 60mph towards you.

Concierge Medicine pays attention to every detail and has learned that gratitude is where the patient journey begins and ends. These doctors and their teams have curated a culture of hospitality inside their offices that we now see health systems, hospitals, urgent care clinics and more independent medical practices are trying to live up to.

To me, Concierge Medicine serves as a guide or, a north star.

Don’t Underestimate the Importance of a Greeting

Horst Schulze, in his book, Excellence Wins: A No-Nonsense Guide to Becoming the Best in a World of Compromise, shares some tips that he employed at his hotels under a guiding principle of “we are ladies and gentlemen serving ladies and gentlemen.” In the book he notes the importance that when you come to work you come to work to create excellence, not just to work.

Pausing here for a moment. Let's address how this concept impact Physician morale and burnout.

You see what we're learning in Concierge Medicine and observing is how it's providing yet another treatment FOR Doctors for the plague that we call Physician Burnout.

One example Horse shares in his book is that it’s important that employees look guests in the eye and say, “good morning, welcome.” He notes that it is not enough to just say “hi.” You have to lift them up and elevate the experience. A part of elevating this experience means addressing guests by “sir” or “ma’am” and to do so when you’re within 9 to 10 feet of them. The first 10 seconds are essentially important. Within 4 meters, 9-12 feet you recognize the guest and can say, ‘Welcome!’” He continues to explain that when you’re within this spatial distance with guests, you’re giving them the proper attention to make them feel welcome and let them know they’re important.

I know what it’s like to sit on the other side of the exam room from you. I know what it’s like to sit on the other side of sliding glass service window in your waiting room.

I listen to the lack of priorities which your staff chat about while I'm still patiently sitting in an empty waiting area with my daughter.

This frustrating patient experience isn't just my story either. It's happening millions of times each day and very few Physicians have the courage, the freedom and the spirit to do something to address it.

This frustratingly disappointing patient care journey is something we as Patients have all now succumb to in today’s overly complicated healthcare environment.

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The tension occurs between Patient and your medical staff (and you), when a Patient feels you (and your staff) feel they have compromised on their low and albeit, generous amount of patience and now have unmet expectations which they cannot afford to ignore any longer.

Patients recognize and respect that their Doctor is busy. They respect you're in the business of problem solving other people's problems and ultimately, caring for them as well.

There’s a number of reasons we all can rattle off which to debate the merits of making the patient experience better and putting time and energy into staff training to mitigate customer service problems. Those issues might include: prior authorizations; charting; third parties; to even the more recent role of Apology Laws in the Medical Malpractice space.

But what can you as a great Physician, a leader in your community and now the Physician-CEO of your practice are responsible for is the preferred future of your Patients.

Are your hands so tied because of a litany of environmental excuses beyond your control that you are paralyzed to want to build a better scene, a better relationship with your Patients that could truly change my life and your career satisfaction?

To me, and it's going to sound naive, but in my observation and discussions with great Doctors who already do this ... the primary treatment for Physician Burnout is found in gratitude FOR the Patient, no matter where or under what restrictions you practice under.

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I’m one Patient who is patiently still waiting to meet with you.

I'm one Patient who is your biggest fan.

In fact, I can't wait until we meet again.

But if you keep treating me this way, I'm going to leave. I will vote with my feet.

You see, as your Patient, I am forgiving, to a point.

Let me give you an example we can all relate to.

Have you ever been surprisingly bumped up into first class before a flight?

My wife and I have and it was quite a trip!

But as we boarded, sat down in our slightly larger seats with more legroom and were given our one beverage early, it occurred to both of us that this type of treatment, this type of experience is acknowledged as amazing when in reality, it should be expected anywhere.

As a passenger on a place I accept mediocre. As your Patient, I expect more because I respect you!

Five words from you carry a lot of weight with me.

Five words from you could change my life in an instant.

And five words from you mean more than fifty words about you.

You see as your Patient, if you and your team don’t deliver it (eg. excellence) each and every time I visit your office, I have to make your life miserable.

That sounds humorous but there is a hint of truth in that sarcasm right?

I'm sure you have patients tomorrow that you know so well that will hold your feet to the fire (metaphorically, of course) related to scheduling, staffing and customer service and have pretty strong opinions about your staff, their behavior and even the cleanliness of your office, right?

If you're like most Physicians I know, you will never compromise on what you think is best for your Patients.

So why aren't you making a first class experience for every Patient when every other medical office environment around you is doing the bare minimum, cattle call.

We can no longer accept just okay or celebrate mediocre.

Are you calling something first class service in your practice that should be the bare minimum?

Fortunately, this acceptance of the low bar and mediocrity is starting to change. Patients are noticing first-class service and it magnifies what they haven't been receiving elsewhere.

If you and I reject these ideas and say "These are good ideas but who has time for that?"

Or, this stuff isn't really going to change anything in healthcare because this is how we've always done it and it works.

Well, I can tell you from my side of the exam room, it isn't working.

And, I dare say that your colleagues and peers wrinkles and rants will tell another story.

The impact on Patient care that you can have by improving the patient journey in the smallest of details, even just a little bit ... will help your practice more than you know and create a sales force of patient referrals like you have never seen before.

I received an email not long ago from a Concierge Medicine Physician's husband and he wrote "Michael, I'm amazed at how easy it is to impress a patient! We're just doing a few things different and it's making a huge difference!"

Therein lies the same story about getting bumped up to first-class, just inside the Doctors office, right?

Patients, like me, are starting to notice areas where we've become the frog in the boiling pot.

If you want to reject these ideas as fantasy, that's okay. You're entitled to do that. Just realize that when you do that you and I can go get back in line and sit down and will wait with the rest of the millions accepting that status-quo of patient experience and nothing will change and we can all keep citing stats and complaining about physician and patient burnout.

Leaving things at the low bar for the Patient -- it ultimately impacts my health and your career satisfaction and dare we say it, you're now on the fast-track to Burnout City.

You're not trying to be better than your colleagues. You want to do better because it affects the Patient.

Why are we making going to our Family Doctor, our Pediatrician or Primary Care Office less inviting than inviting a close friend into our living room for a conversation?

As a Patient, I’m of the belief that ‘Five words from my Doctor carry a lot of weight.’ And that five words from you mean more than 50 words about you.

Yes, I have generous expectations for my Patient-Physician visit because I understand that your insights, your education and the words you speak into my life have a persuasive influence on me that ripples into every other part of my life, my family and my work. Every patient, from every member of your team should come to expect and received every time they visit your practice the joy that you (and your team) have to serve people, a place of peace, patience and self-control (from your team) and particularly patience from their Doctor, your kindness, your time, gentleness and dare I say, a smile. :)

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I don’t expect perfection. As a loyal Patient however, I do expect progress. So when it comes to customer service and hospitality in our healthcare culture today I believe that every medical conference and staff will tell you that’s what they want to do better. But few actually do anything about it when they return to the office Monday morning.

If you are as frustrated as I am and you are one of the few Doctors that is still reading this, I think you can make progress in the area of improving patient relations and truly provide a great patient experience. Here’s three helpful ways you may want to consider that we think can help that we've seen in other practices, including Concierge Medicine.

Here Are Three Habits To Cultivate Great Patient Relations

1. Greet Everyone

A thoughtless, unemotional greeting from an administrative staff member should not be the first encounter a Patient receives when they walk through your door. Additionally, an empty, unattended desk or service window is unprofessional and inattentive to patient needs. Make it a must to greet all patients verbally and with a smile. Let’s recall what Schulze mentioned earlier “Service starts the instant you make contact. The first 10 seconds are essentially important. Within 4 meters, 12 feet you recognize the guest and say, ‘Welcome!’”

2. Stop Ignoring the People Patiently Waiting In Your Lobby

As a patient, we can see that you and your team are very busy. But so are we. Ask your next Patient about the process they had of scheduling their appointment. Did they have to take off work? How many stops are they fitting-in and errands do they have to make before they get back home today since they're on this side of town? Did they have to arrange child care? Is there some place they have to be immediately after they leave your office? How difficult was it to get a date on the calendar that worked with yours and their schedule? When a Patient arrives and sits down after ‘checking-in’ they typically won’t ever tell you that they feel ignored and dismissed by your staff. In one case, one Patient we heard from, she called it ‘purgatory.’

So, we get it. You’re busy. And you would probably agree that most patients are very respectful your time. Dropping your head to the chart in your hands and quickly walking by uttering a few words to the nurse as you ignore the patients waiting makes every patient whom is patiently waiting ‘Feel like a number.’

And I know for a fact having worked, interviewed and sat kneecap to knee cap with Doctors for over 20 years about improving patient relations … that that’s not how you want them to feel whatsoever.

Next time you see a Patient or three waiting and sitting in the exam room, tell them one of your corny dad jokes or pop your head into the waiting room and talk with each of them about the weather and how you’re looking forward to catching up with them in just a few minutes.

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This might seem like a cursory attempt to be friendly, and there will always be Physicians you and I encounter that will dismiss these ideas as silly … but let me ask you two rhetorical questions. What are you known for? Second, what do you want to be known for?

Answer those two questions and align them with your leadership, staff culture and team values and you’ve created what every Doctor on the planet wants … the ‘word of mouth, new patient referral.’

3. Generic, Impersonal Emails Are Like The Three-Page, Stapled Christmas Letter. "I'm just not that interested in reading it." So, Do Not Expect An Email Newsletter To Do Your Job For You. It Diminishes Your Hard-Earned Degree & Erodes My Trust In Your Expertise.

I use email everyday. It's an invention we all love, use and loathe.

As a Patient, when I personally receive a generic email with a lot of links and generic health fact and educational excerpts about things like the cold and flu from my Doctor's office ... I unfortunately and mentally file this piece of literary work into the same category as the three page (with a staple!) standardized Christmas letter, mass-produced, of which we all receive from that one family during the holidays. lol.

Yes, I just typed lol in a healthcare trade publication article. Deal with it. ;)

We've all been there, right? The reality is you and I are probably not that invested in or interested in reading this piece of non-fiction prose from a person we haven't seen in weeks, months or even years.

When it is potentially relevant to our local community health situation(s), sure, I might once-over it for a minute or three. Usually however, the content is not applicable, not specific enough, provides no clear action steps and I hate to say it, is a big waste of my time as your Patient when it's got with information that let's be honest ... we can find anywhere on Google in a few seconds.

I know, that's harsh. But, that's both of our realities in today's healthcare culture.

Like it or not, it's not fair for either party, but it is true.

So, if you expect a weekly email newsletter to do your job for you, to me, I feel you diminish your hard-earned degree and our trust in each other ... and ultimately dismiss me as a Patient who is just as ignorant and unimportant as everyone else on your patient panel. And, I know for a fact, most Doctors do not feel that way.

All of this might sound a bit harsh but the data over the years about patient burnout and why patients leave their current Doctor to find a new one proves this out time and time again. And that is, the number one reason why a Patient leaves their Doctor is "I feel like a number."

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So, get small, get personal. Then, as your Patient, I'll demand you grow bigger because 'Five words from you mean more to me than fifty words about you!'

I am your Patient. I see you, I believe in you and believe it or not, I want the best FOR you!

Next Steps

In summary, this all sounds pretty easy, doesn't it. But come tomorrow morning when you're met with the first delay or challenge it will be forgotten. I understand. But, for those in business models like Concierge Medicine, these are office culture routines that are at the forefront each day. They're not perfect by any means, but no Patient expects perfect. What we need is progress on the front lines in medical offices today that doesn't make the Patient feel 'like a number.'

For medical offices struggling with confrontational staff, constant interruptions, the rude Patient, the squeaky wheel, those prior authorizations, a specialty referral hassle, etc., just try one of these ideas tomorrow and see what happens. What do you have to lose?

I know you can do this!

We see you, we believe in you and we are FOR you ... we are FOR Doctors.

And as we say a lot around here ... "It is no longer about being the best Doctor in the world anymore. It is simply about being the best Doctor FOR the world, FOR your Patients and FOR your local community."

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OTHER RESOURCES FOR PHYSICIANS
https://members.fordoctorsforum.org/
www.ConciergeMedicineFORUM.com
www.ConciergeMedicineToday.org
www.ConciergeMedicineToday.net

DISCLAIMER AND USE: In no event is this information considered medical, legal, tax, financial, accounting or other professional advice (Please see full disclaimer below). This Podcast Is Subject to the Terms and Conditions of Use (https://conciergemedicinetoday.org/tcpp/) and is recorded/hosted by Concierge Medicine Today, LLC. Concierge Medicine Today, LLC., our representatives, agents or employees accept no responsibility or liability for direct, indirect, special, incidental or consequential damages or financial costs or claims made by the Physician(s) interviewed or our guests.

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