THE DOCTOR WILL SEE YOU NOW!
By Meryl Luallin
"Sign in. Have a seat. We'll call you when the doctor is ready." That's how the receptionist welcomed Ms. McGreavy as she arrived for her appointment.
With a look of resignation, Ms. "Mac" trundled off to a seat in the "waiting" room, and thumbed through Sports Illustrated's 1996 Olympics issue while hoping against hope that the doctor wouldn't be more than a few minutes late. So she waited.... and waited...
It doesn't have to be this way.
Some physicians are great at staying on schedule, while others wish they could. Here - from our extensive experience as shadow coaches and mystery patients - are some of the methods top-scoring providers use to stay on time even through work-ins and "oh by the way's."
Arrive 15 minutes before the first scheduled appointment
Seems obvious, but it's surprising how often doctors arrive just as the first patient is being roomed. Then it's off to the coffee room...handle a few issues at the nurse station...return an early phone call...boot the computer...well, you get the picture. And for physicians who make hospital rounds, the extra time adds a little "slush" to the schedule and accommodates unexpected inpatient issues.What do those 15 minutes buy?
It's called a...
The best way to avoid time-consuming glitches is to anticipate them. A few minutes with the clinical team is all you need to make sure that charts are ready (referral notes and test results)...educational materials are on hand...financial status has been confirmed...etc.
And don't forget to invite receptionists! They're your first-line troops for making patients glad they chose your practice. (Sadly, our employee satisfaction surveys often show a "morale gap" between back-office staff and front-desk people who don't feel like valued team members.)
And once in the exam room, providers should...
Nothing slows a doctor down like constant interruptions by the Medical Assistant (MA) who may need to ask a simple follow on question from a patient. Timely practitioners avoid this by making sure the patient's questions are answered before exiting the exam room. Further, one Midwest doctor has a clipboard on a hook outside the exam room where simple issues (prescription refills; yes/no questions; quick signature; etc) are posted by the MA. As the physician leaves the exam room, he can handle the issue without having to find and confer with the Medical Assistant.
Managing interruptions also helps the provider...
...stay in control of the encounter
Fact: Many patients come with a list of questions which they raise one after the other. Fact: Doctors are trained to focus on one issue at a time. This combination spells trouble!
Providers can exert at least some control over the length of the visit by seeing all the issues at the outset -- which means getting the list from the patient as quickly as possible. It's easy - after the patient responds to the doctor's "How can I help you today?," the best follow-on is "All right, before we address that issue, is there anything else you'll want to discuss?"
It works even better when providers use a...
Doctors can identify the patient's multiple concerns even before entering the exam room! Just ask your receptionists to give arriving patients a simple form with two questions they can answer while waiting to be called back:
"The most important issue I'd like to discuss with Dr. Sutureself is..."
"If there's time, I'd also like to discuss..."
The form sits in the chart-holder outside the exam room, where the provider can review the issues just before knocking gently and entering. That way, doctors can work with patients to prioritize issues according to the amount of time scheduled for the appointment.
And finally, it always helps to...
...set patient expectations quickly
When asking physicians how long a patient believes the appointment will last, answers range from "all day!" to "five minutes" with a variety of responses in between. Actually, no one really knows what patients expect because no one ever sets those expectations.
The world's best scheduler, when confirming the appointment slot, tells the patient, "Ms. Bell, we have you scheduled for a 15-minute visit with Dr. Sutureself. Will there be anything else?" That way, if the patient brings in a long list, the doctor has a compelling reason for prioritizing the issues since the patient knows that the appointment has an ending time.
Staying on time is both an art and a mindset. In a consumer-driven marketplace where patients believe their time is as valuable as the doctor's, people are drawn to practices that show respect for their schedules.