At a time when patient experience in healthcare is becoming so important, evidence shows that this experience is getting worse, said Jeff Gourdji, co-leader of the healthcare practice at San Francisco-based consulting firm Prophet.

Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHP) scores have dropped for many organizations in part because of the increase in industry mergers. It may also be due to different expectations of Millennials, who express more dissatisfaction with healthcare than Gen Xers or Baby Boomers. Their trust in doctors is not as high as in older generations, and they tend to have more loyalty to a brand or entity than a particular physician, Gourdji said.

That being said, patient experience should be an area of focus for any practice, whether growing or established. Think of patients as consumers and identify ways to make their visit enjoyable instead of just trying to avoid making them angry.  In an “era of search and compare,” not making people angry does not create brand loyalty, Gourdji said.

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Reducing stress

Providers seem to understand they do not always do the best job with the customer experience, but they still tend to overestimate their abilities. A Prophet study released this past March found a 20-point spread between how providers and patients perceived the empathy of staff. Fifty-seven percent of physicians thought they were doing very well, while only 36% of patients who responded said the same about their providers.

“The biggest gap in our study was around empathy,” Gourdji said. “And how do you address that?”

Empathy results from resolving issues that create anxiety among your patients, Gourdji said. The greater the anxiety, the higher the priority in alleviating it.

One of the most important aspects of an office visit for patients is being informed about their care. Learning about test results is a large part of that. In the Prophet survey, just over one-third of patients felt that providers communicated diagnostic results in a timely manner. Nearly 50% of doctors think they do.  If a doctor has diagnostic results available on Friday, but waits until Monday morning to communicate that to a patient, “that can be an enormous anxiety creator,” according to Gourdji.

A first impression

Two major components that make or break a patient’s experience in a practice are access and staff interaction. The first place these occur is on the phone.

The Baird Group of Fort Atkinson, Wisconsin, has performed thousands of mystery shopper calls to practices around the country to gauge phone practices. They found that 35% of callers had a bad enough experience that they were not likely to call back. Half of the callers never reached a live person even after some made multiple attempts.

“What they should do is answer their phones,” said Kristin Baird, the group’s president and CEO. “The phones should be answered promptly and in a manner that represents the practice well.”

A proper greeting and closure are the book ends of a phone experience for patients. If you answer with “Hold, please,” and end with, “We’ll see you at 2:30. Bye,” you are missing an opportunity to connect with patients.

Instead, greet patients warmly and end with: “Before we hang up, are there any other questions I can answer for you? We look forward to seeing you at 2:30. Thank you for choosing us. Goodbye.”

Instead of relying on what seems like common sense manners, decide how you want the phone handled and train staff on your standards. If some doctors have full caseloads and others need patients, train staff to funnel patients to the less busy doctors instead of just saying, “Dr. Jones is not taking new patients.” Doing this can send patients to your competitors.

Also, do not set staff up for failure. Survey them to find out what their most challenging calls are and set up a system to manage those. Add additional staff on Monday mornings or other times when call volume is consistently high. Do not overload the front desk the rest of the time. If they are doing 50 different jobs, phone etiquette will be a low priority.

The top down

While much of the customer experience work in the practice will be done by an office manager and staff, providers also have to examine their own bedside manner.

“Physicians sometimes have a lack of awareness of how they come across,” Baird said. “They are going from 1 thing to another all day long, and having to rebound and reconnect multiple times during the day can be a challenge.”

She recommends that physicians work on self-awareness: being mindful of their body language, verbal, and nonverbal communication when entering or leaving a room. Watch for “micro messages” that communicate loudly.

For instance, if physicians rattle through instructions, get up to leave the room and—with their back to the patient and a hand on the door—asks the patient if he or she has any questions, the physicians are sending the wrong signal. “Their mouth said the right words,” she said. “But what the patient hears is, ‘I don’t have time for you. Don’t ask me anything,’” Baird said.

Baird recommends practicing with staff or having a coach shadow you and give feedback and best recommendations.

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