Posts Tagged ‘interim medical management’

Physicians are feeling the pain and frustration of lowering Medicare reimbursements, increased malpractice insurance costs, new patient influx on the decrease, and rising overhead. In the meantime, physician compensation is lower. And by the way, the staff would like annual raises. It’s enough to drive physicians and their medical practices nuts!

But, there is a method to relieve those frustrations, as the case study synopsis below shows.

Medical Practice Efficiency: Case Study
We recently completed a long-term engagement with a multi-specialty medical practice. Their situation will probably sound familiar to many of you:

• Multiple service delivery locations – some doing well, some not so much
• Flat revenue vs. climbing expenses (rent, staff, lab, inventory)

Their goals (ambitious, but do-able) were to:

1. Reduce Costs
2. Increase Revenues
3. Increase Efficiency
4. Improve Patient Satisfaction
5. Improve Staff Satisfaction

We began with a medical practice operational and financial assessment, to measure cost structures, service lines, governance and related operations. From there, we were able to implement process improvements that led to millions – yes, millions of dollars in savings.

Waste can kill a medical practice – just look at our overall healthcare system inefficiencies:

• Paper-based systems accounts for 6% of annual overspending
• Administrative inefficiency and redundant paperwork accounts for 18% of healthcare waste
• Billing and administration take up one-quarter of the average US hospital budget
• US doctors spend nearly 8 hours per week on paperwork and employ 1.66 clerical workers per doctor*

Approach and Results
Our approach with the multi-specialty practice was to eliminate non-value added work to achieve better patient, provider and staff satisfaction while increasing revenue opportunities. In other words, implement our mantra: “have the right people doing the right work in the right amount of time for the right pay.”

Using Lean principles (and MGMA cost data benchmarks), we benchmarked costs, redesigned processes, helped with organizational restructure (including executive leadership changes) and implemented new policies. You can find details in the presentation on our website’s media section, but the final results were:

• $3.8 million saved in expenses!
• Increased physician compensation
• Increased lab and imaging profitability
• Improved morale

We’re proud to report that the organization has sustained the improvement gains. Plus, they continue to benchmark and raise the bar with ongoing waste reduction efforts!

Snippet:
“Efficiency is integral to a more cost effective, productive medical practice.” — Barbara Derry & Crystal Nolan

Download the presentation that inspired this blog.

*healthcare inefficiency statistics taken from a report by Robert Kelley, vice president of healthcare analytics at Thomson Reuters.

You’ve measured loyalty, not just satisfaction, in your medical practice. You have a responsive, patient-service oriented staff. Your practice staff is happier than they’ve ever been; retention is solid. Now what?

In an earlier post, we mentioned how airlines, retail stores and luxury hotels – such as the Ritz-Carlton* – can and should drive loyalty through courtesy, but that healthcare’s differentiator is the use of empathy. Empathy, caring and compassion through acknowledgement of patient’s feelings.

So what can your medical practice learn from a world-class hotel? World-renowned service standards. After all, the Ritz-Carlton and healthcare are similar in the way they both deliver a product/service that the customer wants defect-free, when and how the customer wants it, and through providing genuine care and concern for that customer.

Then there’s benchmarking, also familiar to healthcare organizations, the Ritz-Carlton’s leadership constantly seeks out businesses to benchmark, always looking for the best metrics to ensure that their employees find work meaningful.

Last but not least is staff satisfaction, hugely important to success. Management recognizes that helping employees as they seek to deliver genuine care to guests, or swiftly fix breakdowns in a compassionate manner, gives employees satisfaction (hence, retention and happy customers). How do they help employees? By acknowledging what they learn, data-wise, and sharing it.

• Objectives are manageable and anchored to the company’s core values, always open to refinement.
• Corporate storytelling demonstrates how staff can personally make a difference and deliver “Wow” experiences.
• Leadership and staff view the entire business as a two-way relationship – with mutual accountability.
• Corporate values and financial objectives align, clearly showing how living the values results in business success.

Mutual accountability and transparency works – whether in the luxury hotel business or in your medical practice. Think about how you help your staff deliver genuine care and swiftly fix breakdowns. Do you share good and bad feedback? Look for the best in competitors and measure against it? Live the values you promote at work?

We know that achieving Platinum Level Customer Service is one thing, but that keeping it takes practice. It’s definitely do-able, so persevere! If you need an objective, professional helping hand, Derry, Nolan & Associates is here to help you reach and sustain your customer service goals.

DNA Snippet
“Achievement is largely the product of steadily raising one’s level of aspiration and expectation.” —Jack Nicklaus

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As we’ve discussed, empathy is an integral part of customer (and patient) service. In fact, it’s critical for effective anger management. When we imagine ourselves in the other person’s situation, there’s an automatic shift in attitude, because we lower our own defenses. Companies who train employees to use empathy effectively win repeat customers.

Take Disney, for example. The company’s customer service attitude is explored in “If Disney Ran your Hospital: 91/2 Things You’d Do Differently,” by Fred Lee. Lee points to a process Disney employees use called L.A.S.T – Listen, Apologize, Solve the problem, Thank the person – as an example of effectively used empathy. Apologizing with empathy – “I wouldn’t like that either” or “If that happened to me, I would be upset too” – works. Rote, insincere apologies do not.

The same holds true in a medical practice. When you express empathy, you show acceptance of the patient’s feelings, you do not necessarily agree with how they express them. Empathetic phrasings like the below are examples:

“I hear what you’re saying”
“I know what you mean”
“I don’t blame you”
“I can understand that you…”

As part of the empathetic response, try re-framing, helping the patient change their point of view by sharing the benefits of the situation with them. For instance:

Patient: “Why do I have to drink this contrast; it’s tastes terrible!”
You: “I agree it doesn’t taste good. We have several flavors that might make it more palatable to you. Unfortunately, the contrast is necessary for accurate results.”

Selective agreement is another defusing skill. It allows you to agree in part with what the patient is saying and works well if they’re very angry and seem to be taking it out on you. It’s also a helpful tool when you feel yourself beginning to react negatively to the patient’s word or tone. Look for something you can agree with, even if it’s a very small part of what’s being said. Also, for selective agreement to work, remember to use a calm, quiet tone. Perhaps begin with:

“It does seem that way”
“I see your point”
“It’s tough to argue with that”

Empathy is appropriate for responding to frustration, fear or pain. The flip side is that you do not want to use empathy if the situation is out of control, with the patient attacking you, your team or your medical organization (more on this in a later post).

DNA Snippet
“When you choose to be pleasant and positive in the way you treat others, you have also chosen, in most cases, how you are going to be treated by others.” — Zig Ziglar

Medical practice staff juggle many responsibilities. Hectic days breed harassed and flustered employees, many of whom simply don’t have all the answers to patient questions. That’s when it’s easy for patience with the patients to slip.

The other side of the coin is policy. Many times, policy and procedures are set up without providing real life scenarios from which medical practice staff can draw. The simple solution is to be sure all employees have a good knowledge of not only policy and procedure, but also sample responses to tense or difficult situations.

There are all-too-common words to avoid that can kill patient loyalty and create unproductive interactions. But never fear, we’ve given you better words to use that can kindle patient loyalty. These power words and phrases let staff say, “Yes,” offer options, create confidence, get information, and be spontaneous and creative.

Notice the alternative phrasings of “helpful” invite cooperation, automatically placing staff in a positive, rather than adversarial, position.

unhelpful: “I don’t know.”
helpful: “I’m not sure I have the answer to that, but I can find out for you quickly.” or
“That’s a good question; let me get the answer for you.”

unhelpful: “That’s not my job.”
helpful: “Let me see what I can do to solve this.” or
“Let me get the expert for you!”

unhelpful: “We can’t do that” or “I don’t make the rules” or “It’s not our policy”
helpful: “I’m so sorry. I’m unable to because…” (give an explanation, not an excuse) or
“Well, you know what we could do.” or
“I wish I could do exactly that for you. Let’s see what we can work out instead.”

unhelpful: “It isn’t my fault.”
helpful: “That’s unfortunate. Let’s see how we can fix this.”

unhelpful: “The doctor is busy.”
helpful: “I’m so sorry. The doctor is with another patient right now, but I know this is something he’d want to know about. May I ask the nurse to help you in the meantime?”

unhelpful: “What’s your problem?”
helpful: “Why don’t you tell me about the difficulty you’re having.”

unhelpful: “I want you to…”
helpful: “Let me help you (do, get to) so we can figure this out.” or
“What would help us get this moving is if we could…”

Practice the sayings. Come up with ones that fit your particular medical practice and the situations your patients face. Practice some more. If you need help, give us a call! There’s a free one-hour consultation as part of every Derry, Nolan engagement.

DNA Snippet

“To my customer. I may not have the answer, but I’ll find it. I may not have the time, but I’ll make it.” — Unknown

Last post we talked about Patient Loyalty and growing it through excellence in Customer Service. Being empathetic is another way for medical practices to encourage Patient Loyalty. Empathy- the identification with and understanding of another person’s feelings or situation – is a natural part of caregiving, and one of the best ways medical practice staff can help patients feel comfortable in what are often uncomfortable situations.

Practicing empathy means putting yourself in the patient’s shoes. Wouldn’t you like to feel that the people who are taking care of you, seeing you at possibly your most vulnerable, understand what you’re going through? Interactions in a medical situation can easily swing more to a coldly clinical, rather than warmly human, level. Remember to bring humanity to the fore during your exchanges with patients. Sometimes, what we say makes an even bigger impression than what we do.

It can be as easy as introducing yourself when you see a patient for the first time, then following with a reassuring statement or explanation:

“Hi, my name is Ann. I’ll be doing the ultrasound of your leg today that Dr. Jones ordered. Here’s what we’re going to be doing…”

Then close the interaction on a human level:

“Thanks, Mr. Smith, for your patience and cooperation. I know sometimes these things can be uncomfortable. Your test results will be ready tomorrow. In the meantime, are there any questions you’d like to ask? I’ll be happy to help.”

The flip side of empathy occurs when we forget the power of words and inadvertently create difficult situations, such as:
1. Delays – patients wait too long in reception with no explanation or apology
2. Financial issues – patients are confused about bills, particularly the non-insurance portion, and receive abrupt or little assistance
3. General Confusion – maybe the patient isn’t sure they’re in the right place, or where they’re supposed to go or what to do next, signage or verbal directions aren’t clear
4. Anger and Fear – patients are having a procedure that they don’t fully understand, and are fearful either of the procedure or of the outcome

In each situation, medical practice staff is in the position of first responder. Think about those possible responses carefully – what would be most likely to diffuse a situation? What would be most likely to exacerbate it?

Next time, we’ll give you some alternate responses to the usual, less empathetic ones that often lead down a negative path, away from Patient Loyalty.

DNA Snippet

“The greatest gift of human beings is that we have the power of empathy.” — Meryl Streep

After the last post, we realized there was tons of information we could share about good customer (patient) service. Medical practices need to provide an excellent patient experience and there are a few simple cues that can help you initiate the right conversations about the right things with the right people. Watch and interpret patient body language to anticipate their needs. Here’s a sample scenario:

A patient’s facial expression shows confusion as she approaches the front desk, bill in-hand. Rather than waiting for her to initiate the conversation, be proactive, say something like: “Mrs. Smith how are you today? Is there a question about your bill that I can help you with or would you prefer that I get someone from Billing to assist you?”

Such an effortless gesture goes a long way toward creating an atmosphere of caring and concern. It’s so easy to let things go the other way and start off on the wrong foot, instead. Think about it – we’ve all been in medical practices where you approach the reception desk to check in, only to be either ignored or thrown a quick “I’ll be with you in just a moment” while we wait for the employee to finish filing or chatting with a co-worker. Courtesy is more important than efficiency – staff should never be too busy to help a patient.

Take the patient’s point of view. They judge the medical practice’s quality based on their perceptions of the overall experience. If the medical visit begins with them feeling discounted, that carries through the appointment. Even excellent physician “bedside manner” can’t overcome the initial negative impression from reception.

So, remember to focus on things that correlate with the overall satisfaction that builds loyalty. For instance, how’s your staff’s attitude? Are they cheerful and empathetic? Are you (and they) actively soliciting the needs of patients? Do you take the time to say something to the patient that shows your concern for their privacy or well-being that’s maybe not directly related to the reason for the medical visit?

Just because you don’t hear a lot of complaints doesn’t mean there aren’t negative experiences. Only 4 out of 100 dissatisfied customers complain (according to the Technical Assistance Research Program), instead, they punish your practice through negative word of mouth. So focus on providing a positive, proactive patient service instead!

Next time: empathy and diffusing anger.

DNA Snippet
“Isn’t it really ‘customer helping’ rather than customer service? And wouldn’t you deliver better service if you thought of it that way?” — Jeffrey Gitomer, Author