Physician Office Issues


When you’re no longer on the “inside” of the practice of medicine, you see what the general public has to put up with from hospital departments and physicians’ offices. It’s disturbing! Now, as a health care consumer who lives in an area where no one knows who Dr. Gilkison is, I see how poorly run and managed many, if not most, offices are. My goodness how frustrating contact with offices can be.

As I’ve written before, doctors have gotten lazy and complacent and seem to care little about how they’re perceived. From things like complicated “phone trees,” to “hang up and dial 911,” to having the entire office closed on Fridays, the abandonment of responsibility for patient communication and care is rampant. Customer service for medical offices needs a real awakening.

For instance, try making an appointment! Most practices nowadays have multiple physicians so when you call, you have to listen to a “phone tree” which can contain up to 9 options. One of those is “make an appointment.” You then listen until you find the person who schedules for your doctor. Finally, you reach that individual, but find she/he is on another call, and you’re told to leave a message. You’re also told it may be “1 to 2 business days” before you hear back from them! Really? But you wanted an appointment today, or tomorrow, at worst, because your problem has been going on for weeks, and you’ve been to your family doctor already.

Or you have an echocardiogram that’s already been scheduled for two months. Three days before you’re to have it, they call you to cancel it because they don’t have a technician that day. When you try to reschedule the echo, the soonest appointment you can get is 4 weeks away. When you try to schedule at other locations, the wait is even longer. What? When they called you to cancel your appointment, why didn’t they right then and there offer you another time? Why not set up an appointment then and not make you call later and get frustrated and angry!

Or you make a new patient appointment on Wednesday at 2:30 pm, and when you arrive at the office, your name is not on the appointment schedule. What? How does that happen? I was told to arrive 30 minutes early to fill out paper work, which I did. Then I’m told I don’t have an appointment. The front office personnel apologized, asked the doctor if she could see me, and she fortunately agreed to do so. However, it was her nurse practitioner who spent most of the time with me. The doctor gave me 5 minutes of her time, which may be all she had, but I appreciated not being treated like an idiot and being sent home to return who knows when.

Or the doctor’s office tells you about their “patient portal”—their webpage where you can view results of your lab work, get a summary of your recent office visit, and be reminded of what additional procedures you’re to have. This is the new age of patient communication; that over-used word: TRANSPARENCY. The problem comes when you try to access the site and can’t, or your lab results never appear, and email messages you send are ignored or never received. You know because you’ve heard nothing in return. Communication?

Or the office that has very limited time when they answer the phone. Access from 9 to noon and 1:15 to 4:30 is not uncommon. They don’t answer the phone at lunch time, which is the only time you have available to call because you’re at work all day. Bummer! Then there’s the office that is completely closed, phones and all, on Fridays. On Fridays it’s you and the ER. You have no recourse.

I think doctor’s offices need to shape up. Sensitivity training, learning personal responsibility, and having a caring personality are needed. Why is it so hard to have live people answer incoming calls? A 20+ physician cardiology group in Indianapolis had one woman who answered all incoming calls by saying, “Indiana Heart Physicians; how may I direct your call?” She alone triaged every single call efficiently and quickly. No waiting to hear nine options; you told her what you needed and you were connected immediately. And none of this “hang up and call 911” baloney. That’s dodging your responsibility on a grand scale. I personally would want my staff to tell me Mr. Smith called with an emergency so I can be ready for the call from the ER.

All semblance of customer service is gone. Concern for others’ time and feelings is gone. Following through on things you tell the patient and being certain a message is delivered or a lab result explained is gone. Doing things for a patient, such as making specialist appointments, is gone. Compassion and concern for others are gone.

My solutions to the problem:

  1. Eliminate phone trees
  2. Have a live operator direct your call.
  3. Have separate numbers for lab results and billing issues
  4. Give patients a dedicated number to contact their doctor and/or his assistant
  5. Answer the phone when it rings ASAP. Don’t be lazy and let it go to voicemail. It may be a true emergency!
  6. Follow through on your promises to the patient.
  7. Answer questions truthfully, be patient, and call patients back to check on them.
  8. Have enough employees to handle the volume of calls received.
  9. Return calls ASAP. You may not like that patient, but call him/her back right away, anyway.
  10. Try to keep the doctor on schedule.
  11. Provide ample “same-day” appointments to accommodate patients’ acute illnesses.
  12. Never send a patient to the ER without the doctor speaking with them first, or at least knowing about their situation.
  13. Never send a patient to the ER who could be seen in the office just as easily.
  14. Remember the patient is in pain, anxious, or upset. Don’t be curt or rude. Listen and respond.
  15. If you must reschedule a patient’s procedure or appointment, provide a list of alternative times when you notify the patient of cancellations.
  16. When the patient has been waiting for the doctor for a long time, politely inform him/her the doctor has been delayed and why.
  17. Be aware patients have other places to go and other things to do—respect their time.
  18. You are the first, and maybe only, person the patient has contact with at the office so be patient, kind, courteous, and helpful.
  19. Give patients some guidance or options when they are frustrated. Apologize when it is warranted.
  20. Express concern for people, care about them, and be a nice person.
  21. Speak slowly and understandably.
  22. Resolve the patients request or problem today. Never “let” messages lapse into tomorrow.
  23. Don’t leave the office until all messages and tasks are completed.

That’s my rant! Medical offices have lost all sense of concern and efficiency. Of course not every office is a mess, but a lot are. Doctors also have a hard time keeping on schedule because patients come in with things that often turn out to be more serious than thought, or they have additional concerns they want addressed. That’s understandable. It’s the tone, demeanor, and procedural (business) aspects of the practice that are more likely to aggravate people. Those traits need buffing up a lot. When the first impression a patient gets is negative, the doctor could be Michael DeBakey or Christian Barnard, and he would still be upset with his staff. Let’s hope some changes are forthcoming.

Reference: Personal experiences and opinions of William Gilkison MD

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