“I don’t know if anyone’s ever told you that half the time this business comes down to ‘I don’t like that guy.’” ~Roger Sterling, Mad Men, Series

By Editor, Concierge Medicine Today

It has been a minute since my wife and I watched Mad Men.

I still remember a few quotes, though. I recall Roger Sterling’s sage marketing and business advice (above) with ease.

Unrelated, my wife and our close family friends recalled just last week how we found Betty, a fun character with a few quirky phrases of her own pretty memorable as well.

Remember when her son Bobby said, “I’m bored.”

She replied, “Go bang your head against a wall…Only boring people are bored.”

It was not great motherly advice, but her character was entertaining, to say the least.

Back on point: According to a new report published by the American Medical Association, between 2012 and 2022, the share of physicians working in private practices decreased by 13 percentage points — from 60.1% to 46.7%.

Additionally, Slate.com wrote, ‘Doctors who run practices are essentially business owners, but many have never learned to manage a staff.’

Fierce Healthcare reported that ‘Medical graduate students are at a disadvantage when they don’t get trained on the business elements of medical practice.’

Finally, Harvard Business Review writes, ‘Most physicians have been trained to keep emotion out of the job, and are not comfortable showing vulnerability in the workplace.’

With all of these sources informing Physicians how difficult it is or will be to run a practice, navigate payor relationships, get paid, manage emotional or needy staff, and treat a demanding patient population, it is no wonder Physicians are selling out to large systems, pursuing specialty care, or retiring early.

But if you’re still fighting the good fight and running a practice today, you know that managing and training your staff to handle all the administrative tasks and address those mundane and routine patient FAQs with with patience, professionalism and a smile requires every Physician [i.e business owner] to be a little vulnerable at times.

More often than not, every Physician has learned that his/her job requires that they be a bit vulnerable with not just a patient, but when it comes to training and equipping your staff on how to overcome patient frustration, be friendly in difficult times and even, be nice.

It’s a widely understood business and leadership axiom that ‘People don’t quit their job, they quit their boss.’

If that’s true of you and you happen to be tasked with being a Physician/CEO, then you know and understand how important it is to hire for your weakness. Meaning, every practice needs a capable and experienced Office Manager or Practice Administrator whom you can rely on to assign the right personalities and people to the right places within your practices to keep your business running and patients cared for, served and treated well.

But with that Practice Administrator’s job comes the need for that person to provide your team with helpful and regular training about how the team must remain efficient yet personable and patient with every one of your patients.

According to HealthcareSuccess.com, historically, the main reason that a patient would change providers was due to an attitude of indifference. There was no drama in “firing their doctor,” they simply went elsewhere.

Even Time Magazine recently noted And the customer service sucks. U.S. patients are tired of waiting weeks or months for appointments that are over in minutes. They’re tired of high prices and surprise bills. They’re tired of providers who treat them like electronic health record entries, rather than people. That could dissuade them from getting medical care at all—and if that happens, America may get a whole lot sicker than it already is. Patients are, in a phrase, burned out.

Another leadership maxim I think is widely held in healthcare and probably true across most medical office operational personnel is that ‘relationship’ saves all.

This means that if you have operated and run a medical practice for, let’s say, over a year, you’ve undoubtedly realized that healthcare is a customer-facing business and that when complaints sprout up like weeds in our driveway, among your staff and your patients, relationship saves the day.

Isn’t it true that someone who knows you is more likely to be more patient with you if you make a mistake? How often in your practice do you hear your staff complain about patients? If an attitude of gratitude by your staff is not clearly on full display whenever your staff interacts with your patients, it doesn’t matter how great of a Physician you are, you won’t be able to save that professional relationship because the patient doesn’t feel cared for, served or treated with respect by your staff.

I’m not naive to the fact that some still working in healthcare today would view calling the patient a customer as sacrilegious in the practice of medicine. But outside the exam room, that’s precisely what we are. How do I know? I’m not a Physician. I’m a Patient and I need your staff to care for and serve (notice I didn’t say treat) me as your patient as a paying customer with the patience, kindness and respect a customer demands in the few short moments we share together.

You know better than most that whom you put at the front desk to greet patients matters when patients arrive. Whom you select to make the appointment reminders over the phone matters. And how you train your team in handling the small moments we call “handoffs” or “scene transitions” whereby one staff person’s responsibility ends and another begins matters. In these moments, patient complaints grow far too quickly. Miscommunication from one team member to another either exceeds a patients expectations or gives them the allusion that a team member is trying to save time in the name of efficiency or evade responsibility.

Unfortunately, in these important “scene transitions,” emotions often rise, frustrations mount quickly, and feelings get hurt. And if you know, you know, right?

In many medical offices you and I might frequent today, we all know there is a natural tendency and pull towards meeting the internal needs of the practice. Particularly in healthcare, efficiency gets in the way of relationship. You hear things like “That’s not how we do it here.” Or, “We’ve always done it this way.”

We all see a certain amount of tension when we bump into new ideas that propose, ‘How do we make what we do better?’ And, many of us tend to evaluate new ideas through the lens of our training and past experiences. This means crossing our arms and typically becoming instant critics. Given my seat in a waiting room as a husband, parent, and patient, I have noticed that only a few medical practices are truly persuadable on customer service and malleable about the importance of hospitality and regular staff training exercises in our healthcare marketplace when it concerns how they address moments of patient frustration between staff and patient.

For the next couple of minutes, let’s discuss “handoffs” or “scene transitions” from one person to another in your practice.

These are those nerve-wracking moments for many patients where communication often breaks down from one person to another on your team. Patients are often left in the wake of having to repeat themselves to someone entirely new and start all over again explaining the issue at hand.

If your team is untrained on how and when these scene transitions occur in your practice, impatient, careless, or dismissive, and all too quick to pass the patient on to someone else, the relationships with both administrative and medical team members will suffer.

Why?

Because emotions are now involved and feelings get hurt. These moments of transition are often not handled properly and in some cases with patience and kindness amongst your team.

It’s poison to a workplace culture and these scene transitions can lead to poor customer service reviews and more.

Patients rely on and presume everyone on your team is well-trained, resourced, and equipped. Patients don’t expect perfection [when it comes to customer service and hospitality in healthcare handoffs], but they do expect progress. To a patient in today’s customer-centric culture, your team should do everything morally, legally, ethically, and within their scope of responsibility to make each scene transition or handoff to another person or provider as simple and seamless for the patient as possible. That’s a tall order, but whether it is a billing issue or a clinical situation, your team should handle these handoffs with planned thoughtfulness, preparation, practice and patience in the future.

Simply stated: every patient is on a journey and they’re going to tell a story after they leave your practice. Each new “scene” they encounter [in your practice and with your staff] will either be a place (i.e. feeling) of healing or hostility. Are they going to encounter a villain, an ally, or be served and cared for in such a way that they feel like an inconvenient obstacle that our healthcare culture would rather view as a number than a name?

If you remember the scene with Gandalf and Frodo from The Fellowship of the Ring, by J.R.R. Tolkien, you might recall Gandalf saying to his close friend, “You step onto the road, and if you don’t keep your feet, there’s no knowing where you might be swept off to.”

Scene transitions are all of the moments in healthcare when necessary handoffs occur in your medical practice. They require one person to identify where their role in assisting the patient ends and when another person’s role should come in to assist next. Whether it be administrative issues, billing of clinically related, the same training and preparation is required. And I don’t have to tell you how important that patience, good communication skills, and the ability to problem-solve in these scene transitions and handoffs are to your reputation as a Physician in your local community.

But here’s the rub: Medical offices today like to think in terms of “functions.”

That’s fine. You must clearly define each person’s role, describe to them their daily tasks, and provide weekly accountability without micro-managing your team to run your practice effectively and keep the lights on and patients cared for. But despite everything happening around you, Office Managers and Practice Administrators will assign certain team members the task of welcoming Patients and making them feel comfortable. Hopefully, they’re choosing these people well.

For example, who will open the office each morning? What personality is required to help intake Patients? Who is the right person to escort Patients to the exam room? Who will handle pre-authorizations? Who will be the bulldog to manage payments and payor relationships? Who will take the patients temperature and weight with a smile and a note of compassion? Who will handle the paperwork and accounting to pay your employees? Who will answer, make & return phone calls?

The list could go on, of course.

Patients don’t care about the responsibilities one team member has to accomplish today or how many phone calls they must make. Patients don’t care about how many pre-authorization calls or appointment reminders still need to get done. Patients want what they want. For better or worse, it’s your team’s job to care for and serve the Patient.

Patients hope (and demand) that your team orchestrates a comprehensive dissemination of information in every handoff. To help you manage your team more effectively and provide some level of business insight, which we hope may help your practice thrive, we put together for your Practice Administrator or Office Manager’s consideration a modern patient expectation workflow graphic that breaks down administrative and clinical areas in your practice into three categories: “Care, Serve, Treat. Repeat.” Every practice is different, and no business consultant, blog, medical group or non-clinician should ever tell a healthcare provider how they should practice medicine. So, please know that this infographic’s “Treat” part is as sacred to us as it is to you. However, caring and serving is where your administrative team members should take more responsibility and step up. We’ve observed that these are the two areas where clinicians in just about any primary care, family medicine, OBGYN, pediatric practice, etc., can take a less administrative role and allow their administrative team to do what they do best and help you be the best doctor FOR your patients and let them care and serve the patients better!

Remember, your role is part caring and serving as well as being the patient’s treating Physician. But as you well know, you thrive as a happy Physician in a practice environment best when you’re allowed to have a more preventative and closer professional relationship with your patients. We simply want to help you and your team understand better how to do just that. So, we hope this workflow, which is included in our new book No More Waiting Rooms, helps define your team’s roles more clearly. Bear in mind, it’s not perfect. But it is a good start.

Remember, it’s no longer about being the best Doctor, Office Manager, Practice Administrator or patient liaison in the world, it’s about being the best Doctor, Office Manager, Practice Administrator or patient liaison FOR the world, FOR your patients and FOR your local community.

If you liked what you’ve read or the infographic below, please feel free to comment or email us at editor@conciergemedicinetoday.org. Better yet, check out our resources, books, online courses, webinars, and podcasts and register to attend our annual industry conference this October 17-19, 2024.

Register online at www.ConciergeMedicineForum.com.