The Journal of the Arkansas Medical Society Med Journal March 2020 Final 2 | Page 10

When an employee answers the phone, he or she needs to be ready for whatever their job is and should answer promptly — by the third to fifth ring — and should tell the patient who they are! You’d be amazed how many offices I call, where employees are afraid to give their name because they’re afraid someone will call back and ask for them. That’s their job. If you ask someone to hold, you should stop and wait for the answer. Calls should not be randomly transferred around. I call it “flip- ping the booker,” … “I don’t know what to do with you, so I’m going to give you to somebody else.” Well, by the time I’ve talked to three or four people, I’m angry. If you take a message for a call-back, don’t just get a number. Get a good message so that when I call them back, I can have an answer and avoid starting a game of phone tag. A proper response if you cannot answer the question is, “No, Mrs. Jones, I’m not sure how to answer this, but I’m going to find out and call you by 4 p.m. tomorrow.” Patient surveys are one of many tools for effective patient communication. is helpful. The act of sitting requires more effort but conveys that you are more invested in the encounter and gives the impression it lasted longer. Move away from the door once you’re in the exam room. AMS: How do clinic phone systems affect communication, satisfaction, and outcomes? Dickens: Clinics should approach phones from a patient’s perspective. Physicians, you or someone you trust should call in randomly to see what your clinic’s phone process sounds like. If it frustrates you, it’s going to frustrate your patients. Phone trees can be necessary, but I call so many that have too many options, or the options are so odd, that I’m left wonder- ing what button to push. Say I’m not returning a call, I don’t need an appointment, I don’t need a prescription refill … is there not just a general information or call-back message option? You and your staff should be trained on phone etiquette because all you’ve got on the telephone is tone of voice. While patients can’t see your body language on the phone, good body language while you’re talking — smile, have good posture — will come through in your tone of voice. 202 • The Journal of the Arkansas Medical Society Finally, when returning a call to a patient, realize that they are busy, too. You may not have caught them at an appropriate time, so be willing to work with their schedule. AMS: What can employed physicians do to improve communication with- in their organization? Dickens: Employed physicians can im- prove their face-to-face time with patients just as private-practice physicians would. As for im- pacting policies, there are arguments they can make to those who are in charge. Most payors are at some phase of measuring patients’ ex- periences. Patient evaluations are being used to rate physicians. So, an employed physician may validly argue that any poor communica- tion practices will eventually impact the orga- nization’s evaluation ratings, and therefore, its bottom line. AMS: How can physicians help pa- tients do their part in effective doc- tor-patient communication? Dickens: To help patients help you, make sure your processes are consistent and pa- tient friendly. As you did with the phones, walk through the process yourself to assess, is it clear, simple? Also, plan procedures for the masses. I see clinics that, rather than dealing individual- ly with one or two problem patients, will adopt policies that negatively affect all patients. Help patients understand the processes you’re dealing with. For the patient that’s wait- ing on an insurance company to approve some- thing … “Mrs. Jones, I want to let you know we’re going to get the paperwork in for you, but it’s Blue Cross Blue Shield that requires this, so we’ll be waiting to hear from them.” One of the best ways to help patients un- derstand what you need from them is the teach- back method, which ensures understanding in a non-confrontational manner. Most likely done by support staff after the physician leaves the room, it is a technique to fight low health liter- acy. One should not ask if the patient can read or write. It is not about illiteracy, but about whether the patient has trouble remembering or comprehending. Be empathetic and affirm that health care is difficult. For example, “Mrs. Jones, the doctor has instructed you take your prescription three times per day. Can you tell me how you will do that?” Or, “Mr. Williams, Dr. An- derson scheduled you for your procedure next Thursday. Can you tell me where you are sup- posed to go and how you will prepare for that?” AMS: Patients and caregivers are of- ten in different age brackets. Could you speak to generational differenc- es and their effects on communica- tion? Dickens: Generational differences are real. The way my mother wants to be communicat- ed with is different from my daughter’s [pre- ferred method]. Elderly patients, especially, need routine and consistency. One of the chal- lenges of taking care of older patients is that you likely have their children or grandchildren in the room with them. You’ve got to communi- cate on multiple levels. Patients of every generation value com- munication, privacy, and trust. You can work to provide that by creating a patient-friendly process, connecting to the patient, approach- ing things from a positive, talking to patients in terms they can understand, and assessing their understanding before reinforcing where you need to. These things are not going to work with all patients, but if they work with 20-30% of them, that takes a burden off the practice. What about you? Do you believe you com- municate effectively with your patients, or do you feel challenged as to how (or if) you’re reaching them? Write to AMS with your com- ments at [email protected]. www.ArkMed.org