Editor’s Note: I have a surprise for you at the end … but you have to read the whole article … 🙂
By Michael Tetreault, Editor-in-Chief, Concierge Medicine Today, Host, The DocPreneur Leadership Podcast
I am a Patient too.
I know what it’s like to sit on the other side of the exam room. I have kids, a wife and we have our share of health problems, accidents and office visits and even specialist visits too. I have a great Doctor as well and while not perfect, he’s making “progress.” 🙂 No one is perfect, not even Doctors. And as a Patient, we don’t expect perfect, but we do want and we should expect … progress.
I’m here today to talk about the idea that “Five words from you … [to a Patient], mean more than fifty words about you.”
I know this to be true because it’s happened to me, more than once.
I love this statement because it drills down to the core of the Patient-Physician relationship built inside Concierge Medicine to be more specific. We could care less about your biography or C.V. on your web site or the degrees on your wall. While they make the statement that you have the education needed to help, we still don’t necessarily Know You, Like You or Trust You, yet. No degree, years and years of education can replace personal relationship. That takes time and intentional energy. Note the word intentional.
What we really want is you!
We are demanding as a Patient, we get that. We want your time. We want your expertise and by golly, we want a remark-worthy and remarkable experience when we visit your office. We want to tell our friends something positive. We’re waiting for you to impress us and be kind to us. We want you to call us by our first name and we have a whole list of questions we’re anticipating you will answer … every one of ’em. 🙂
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Burning Bridges With Patients
This happens more than you might expect. Maybe it had nothing to do with the Patient-Physician encounter or communication. Maybe it had to do with the lunch that was left out near the gloves and tongue depressors on the counter. Maybe it was an interaction with your staff. You just never know.
On the other side of the coin however, Doctors in our culture today have an impossible job, to say the least.
There are relentless demands, pressures and constraints on you that we’ll never understand or fully be aware of. Hats off to working in a tough, challenging and stressful place we somehow call ‘healthcare.’ We all as Patients owe our reverence and respect to you and you’ve certainly done more for our communities than we will ever know. You may never receive the thanks you deserve for all we as Patients have put you through, but you deserve more than we could ever do for you. So, thank you.
“Growing up in a small town, my doctor knew me personally,” said one Functional Concierge Medicine Physician in a recent interview with us. “And it was never a high volume practice. So I always felt like I had a great experience when I went. As I got older, that changed drastically. My doctor didn’t know who I was or anything about me. I also got shuffled off to specialists. So there was no personal connection. And by the time I got into practice, that was just how it was. Busy, hurried, and impersonal.”
Now, understanding the spirit at which we are looking at both sides [eg. the Patient and Physician], let’s talk about a gap that exists in the relationship between the two persons and how we can narrow that gap, or better yet, build a bridge to a deeper relationship between Patient and Physician that also creates more efficient communication.
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One Simple Piece of Paper Could Change Everything and Cement the Relationship Between Patient-Physician.
This is a suggestion. Remember the goal here is Progress, Not Perfection.
A couple of weeks ago, we asked a busy New York City Concierge Medicine Physician “If Doctors want to concentrate on the individual Patient alone, they have to first understand their local market as a whole and then adjust to each individual Patient. What lessons or nuggets of wisdom have you learned from your Patients that help your Patients to know, like and trust you better?”
He replied, “Listen to them. Give them the time to discuss all of their issues. Return phone calls the same day. Get diagnostic testing results to them ASAP. Do it by phone so they can ask questions and not through a portal. Send a summary letter [or note] of their annual physicals for future reference. Availability, availability, availability.”
Every one of your Patients needs a small deposit of your time, over time. Patients worry about receiving a collection notice from you or a summons or threatening letter that if they don’t pay their bill, your taking the ‘necessary steps to collect.’
The wrong kind of letter burns bridges. It’s not progress. And I think you’ll agree, that’s not your target or goal either. Afterall, if it wasn’t for the Patient [eg. Customer], there would be no practice [eg. business]. Right?
WHAT IF … the next time you see me at a conference or call me you say this … “Hey Michael, I sent a handwritten note to a Patient [or colleague] and here’s what happened …”
Living In The Land of ‘No.’
We followed this question up by also asking the New York City Concierge Physician this … “How much has the experience of being a Physician-Business Owner changed because the expectations of the Patient/Customer today may be different than 30 or 40 years ago?”
He responded by saying “Less patient loyalty. More frustration over insurance delays, denials and obfuscation. It is the “land of no”.”
We’ve all been there haven’t we?
The land of “No.”
As a Physician, it’s an awful place to live. People and insurance companies may have put you recently in an awkward place. It’s the albeit perfect position that you’ve been placed in to be the bearer of bad news about a Patients coverage, or just the bad guy in this scenario.Maybe and unfortunately, you’re now the relay messenger carrying bad news. No matter which street you live on in the land of No, it’s nowhere you want to be. It’s not a good place to work and often it isn’t even your fault and worse yet, there’s nothing you can do about it.
“Most are employees and have no idea of the day to day business anymore,” said another Internal Medicine Concierge Physician last month from Texas. “Administration is busy telling everyone the outcome with out understanding the concept if how medicine works beyond the finances. [Years ago …] There was a bond between provider and patient. Trust was given both ways. Then…Once industry became involved, patients were like inventory. A lasting relationship was forgone to build help accumulate masses, not relationships.”
From a Patient perspective, we’re also used to hearing “No.”
It doesn’t make us feel good.
In fact, it makes us feel like we don’t matter at all. It also makes us less likely to say good things about the Doctor, the practice and the experience as a whole. Which is why early Patient Surveys in our 2020 Non-Concierge Medicine Patient Poll are seeing comments and trends that tell us when the general public [eg. not under the care or enrolled in a Concierge Medicine practice] are asked the question, “If Your Doctor Went Out of Business, How Much/Little Would You Care?” — Nearly 90% of Patients [eg. the general public] said “It Would Be Inconvenient But I Didn’t Have A Relationship/Care Either Way With Physician.” or “Not At All. Glad They’re Gone. I Wanted A New One Anyway.”
If this stings a little, it should.
This is both an indictment [noun: a thing that serves to illustrate that a system or situation is bad and deserves to be condemned.] on patient care today in our society and an opportunity.
“We have the privilege of practicing medicine and being entrusted with a patient’s well-being sometimes at their most vulnerable,” adds the Texas Internal Medicine Concierge Physician. “Our goal is to comfort, allay fears, but to be honest and supportive.”
We have all received PAST DUE notices, even from a Doctor or a Hospital. They aren’t fun. They’re confusing and Patients do not understand them. There’s also no one on our side of the mailbox who is patient enough to explain what everything means. You and I both know from experience there is no ‘thank you’ from the medical practice down the street waiting for us when we pay that medical bill before the deadline. I’ve never even received a ‘Thank You’ from my mortgage company and I pay them on time every month! And, you and I have probably never received a ‘thank you’ for paying that car payment on-time for the past several years either. And, where is the fan-fare from the Hospital for paying that bill, on-time, again, for the 10th month in a row?
You and I know the answer. Crickets. Nothing. Silence. Notta.
Hold on, until, you’re a few “days” late. Then you get all the attention you want, right?
Uggh. This is so frustrating. Has this happened to you?
What is a Patients recourse? Well, you’ve probably read their stinging comments on Yelp! or elsewhere. That’s where those unremarkable moments go to live and they’re dividing Patients from the Physician one review and one Doctor at a time.
But let’s step back for a moment. Is this building a relationship or is it more like assembling the bulldozers and dump trucks around the bridge that are prepared to ‘take ’em down?’
We know the answer and it happens more frequently than we like to admit. In fact, you might even be a little embarrassed that you’ve been the one sending out the past due notice. What is even crazier is the practice [and staff] and to some extent the Doctor as well, believe we’ll act like cattle do and come into the corral and sign-up for our next appointment before we even leave the building so we can start this [frustrating] process all over again?
Something has got to change. Leadership experts will tell marketing managers this and I think its relevant to Physicians everywhere. You have got to make yourself “small” and help their others feel “big.”
So what does that mean? I’ll explain.
‘I Just Don’t Have Time To Do That.’
I hear you. No one has a dedicated moment in their day to write down something thoughtful, put a stamp on it and mail it out.
It’s understandable and most medical offices operate in this way. Some have no choice. Others know what it takes to overcome their reputation but are so overworked, burdened and crushed by paperwork that taking the time to do something like a handwritten note to a Patient [or maybe 5 patients] is just another thing on the list to do.
“If you dismiss the notion of handwritten notes as a ‘nice thing but who has time for that?’ … you get in line behind the rest of the world.” ~Jeff Henderson, Author/Communicator
We read A LOT.
We also listen to A LOT of audio books and typically try to share with you what insights might actually have those golden nuggets you tell us you want to hear year after year. Recently, I read Jeff Henderson’s book, Know What You’re FOR. In the book he mentioned that ‘You cannot be known for everything but you must be known for something and the successful businesses of today and tomorrow are going to be the ones that become raving fans of their customers.’
What an amazing opportunity this provides FOR DOCTOR #fordoctors to become raving fans of their Patients. Unheard of today right? But you know and I know that the Concierge Medicine Patient-Physician relationship is so close, so relational and such an important part of your business that it would take a bulldozer to come and rip it apart.
Doctors also tell us every week … ‘I did not take business classes in medical school. They never taught us that stuff.’ Add to that sentiment, thousands of Physician voices over the past years and years that have also said “When I go to a medical conference, I want to learn about how to market my practice … and …”
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And, there you have it. We’ve uncovered something really important here.
If you want to create a happier, more satisfied Patient and is remarking positively about your practice when they leave … give them a great experience. Give them something worth sharing and talking about with their friends. Change the narrative of the typecast Doctor that’s been placed upon every Physician in our society.
type·cast/ˈtīpˌkast/Learn to pronounce | verb: typecast; 3rd person present: typecasts; past tense: typecast; past participle: typecast; gerund or present participle: typecasting; verb: type-cast; 3rd person present: type-casts; past tense: type-cast; past participle: type-cast; gerund or present participle: type-casting; assign (an actor or actress) repeatedly to the same type of role, as a result of the appropriateness of their appearance or previous success in such roles.”he tends to be typecast as the caring, intelligent male”represent or regard (a person or their role) as a stereotype.”people are not as likely to be typecast by their accents as they once were”
However, to market your practice, sometimes that means doing something out of the ordinary. It is about finding a unique way both of you can communicate with each other, better.
With Patients, [like me] and simple things like handwritten notes, a birthday card (signed by YOU, my Doctor with a personal note …. not your staff. And yes, we can tell! We’re pretty smart as Patients too!) you can go from zero to hero in a matter of moments in my eyes!
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Why Is Collecting Patient Payments So Difficult?!
What a ray of sunshine on a bright day receiving a handwritten note from our Doctor might be, well, should be.
Truett Cathy, the Founder of Chick-Fil-A once said “If a person is breathing, they need encouragement.”
I love that. And, it’s perfectly applicable to Doctors today.
All too often we are used to as Patients receiving a short list of “to-do’s” from our Physician. We’re then left with these ‘orders’ and have no guidance. No cheerleader and no real coach to help us achieve these goals. Our Doctor and what we see happening in Concierge Medicine in particular, is that these Physicians are creating unique opportunities to build relationships with Patients outside the four walls of the practice. They’re saying things like “You can do this…” or “I believe in you.”
Remember how we started this conversation today, “Five words from you … [to a Patient], mean more than fifty words about you.”
The Havas Group recently published a study about what makes organizations and businesses last. What they summarized and learned was “‘The world is looking for organizations that are making our lives better and making the world a better place to live.’”
As a Father, I couldn’t agree more. As a Patient, I completely agree.
“My patients want to know that I relate to them. Forming a connection that can’t be formed in a traditional office setting allows for a greater depth of trust and almost friendship, which allows for more transparent communication” ~Dr. A.P., Functional Concierge Medicine Practice, New Rochelle, NY
So, the next time your medical office sends one of these dreadful notices that says something like ‘Your urgent attention is required. To prevent collection efforts and additional costs such as attorney fees, please remit payment in full…’ consider an alternative approach first. Actually, well before the notice is even on the printer … you should be cultivating a better and closer relationship with the Patient.
Often understated and overlooked, the ‘Thank You’ Note.
Truett Cathy also said “A raving fan from their (Chick-fil-A) perspective is someone who does three things: pays full price, visits more often, and tells others about the business.”
Henderson discussed in his book a central theme I think is really important for all of us in customer service. That is … ‘When you get small and personal, your patients will want, albeit downright demand that you grow bigger.’
RELATED STORY | FOR DOCTORS | WATCH NOW
SO What do PATIENTS “Really” EXPECT from their DOCTOR? Explained …
‘Thank you’ are two words Doctors and their team members don’t say enough.
These two powerful words can encourage any Patient and significantly increase patient retention and patient loyalty. I’m a big fan of Doctors who use these two words.
“The relationship is a partnership between the physician and the patient. It doesn’t work any other way.” ~Cardiologist/Int. Med., Feb 2020, NY, NY
True story from a medical practice in Ohio from just this week.
Just yesterday while talking with a Doctor from Ohio, we paused on this topic for a few moments. She said “Before I opened my [Concierge Medicine] practice I used to dread the calls to collect the unpaid payments in my practice. My staff hated those calls and even worse, knew that by sending out those letters, arguments would ensue. It was always a struggle. It created tension between my staff and my Patients. But today, it is much easier. The secret I discovered was I starting using ‘thank you’ notes. I know, it sounds silly. I wrote thank you notes to my patients. They were short and sweet and in some cases for the most random things.”
Personally, I have a goal of writing three to five thank-you notes a week as the Editor of Concierge Medicine Today. It’s a surprisingly simple and cost effective act of kindness. And, I feel I have a lot to be thankful for.
A pattern-interrupt is a good thing. If you do it enough, it just might become a habit.
Over twenty years ago while at my college job I was taught the value of one piece of paper. The ‘THANK YOU NOTE.’
I chose embossed stationary with the initials of my first and last name, not the business or logo. I wanted something ‘more personal’ — less office-like. Despite the digital age, hand-written notes or cards will always be one of the simplest and best ways to say ‘Thank you’ because it’s personal and intentional.
I will conclude today with this final thought.
Every one of your Patients needs a small deposit of your time, over time. It helps a Patient feel like you care about it, even in your busy schedule. It gives us the encouragement we may need to make those healthier decisions that we so often want to but just don’t. Remember what Truett Cathy said, “If a person is breathing, they need encouragement.”
So, take the time to care about what’s going on in their personal lives, and genuinely caring and remembering what they’re going through. Try this through a random act of kindness in a short note and snail mail something to someone. It doesn’t have to be a Patient. But, maybe you start with a colleague who squeezed a Patient in for you. Write them a note. The important thing is you took action.
This is important, not only because it creates a closer bond with your existing Patients [or your colleagues], but also because it helps them help you. It reminds us all that you really do notice the small things in our lives.
We as your Patients are spreading the word about you to our friends, many of whom might not be a current Patient. Help us build your practice.
In the spirit of thankfulness, let me take just a minute to thank you!
I so appreciate that you take the time to read what we have to say, come to our FORUM and email and call us each and every week. I know there are a million different places to find information about practicing medicine, this and that and what not. So, THANK YOU for checking in with me from time to time. It truly amazes me.
Grateful and thankful FOR DOCTORS,
Your HOMEWORK Assignment
If something in this story resonated with you, you started or are going to start sending Patients Handwritten notes … send us a ‘Thank You’ Note or card. In turn, we’ll send you a gift of our own and personal note to also show our ‘Thanks FOR all you as a DOCTOR~ do for your community. Thank You! 🙂
You can mail your Handwritten Note To Our Editorial Dept. at:
Concierge Medicine Today
C/O: Michael Tetreault/FOR DOCTORS Thank You Note Campaign
4080 McGinnis Ferry Road
Building 800, Suite 801
Alpharetta, GA 30005
P.S. Pay Attention To The Details In Your Practice, Please. Little Eyes Are Watching Those Screens Too!
PS – Food for thought … If you have a TV in your medical office, please be sure you are using it. At the very least, run some educational slides about your practice or have age appropriate content on. Be mindful, little eyes may be watching too! For example, we visited an UCC in Atlanta recently and noticed the lobby had inappropriate content on for children and yet, dead silent tvs in the exam room. The DMV however, had educational slides about how to make their process easier. DMV = 1; Doctor’s Office = zero.
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