DPC JOURNAL | Top Stories, DPC Perspectives & Latest Interviews

Patients Must Park Further and Further Away. Really? Why Do Hospitals Get Away With Reserved Parking Spots?

“Direct Primary Care, Concierge Medicine and the like, is about doing something different, not doing the same things you’ve always done. If you’re too busy [in your practice] to not exercise good judgment when it concerns your staff, you will catch the shrapnel of their bad decisions. To which we say ‘as they go, you go …’ “

Why does your doctor have a reserved parking space? How does that statement of superiority make you feel? In today’s “DocPreneur Podcast” we examine what some Doctors are doing to help improve the patient care experience in their communities, doing away with things like “reserved parking spots for Doctors”, unnecessary “missed appointment fees” and more.

For hospitals: a bottom-line benefit

Hospitals offering valet parking services stand out as different and patient-centered, generating positive word-of-mouth from patients to their friends and family.

For hospitals, the many tangible benefits of offering a friendly, well-trained valet parking service makes it more an investment than cost. Partnering with a healthcare-dedicated valet parking company can increase patient loyalty and the bottom line by improving:

  • On-time arrival rates, avoiding that dreaded domino effect where one late patient delays subsequent appointments
  • Clinical staff productivity and efficiencies, due to lower downtime while waiting for late patients
  • Adherence to appointments, by making it easier and enjoyable to arrive
[Source; https://www.healthparkvalet.com/why-hospital-valet-parking/%5D

When hospital expansion planners allow medical services to take precedence over parking, the result can include significantly increasing parking costs, wasting valuable land, aggravating surrounding communities and inconveniencing or endangering patients and staff. [Source: http://www.parking-net.com/parking-news/skyline-parking-ag/hospital-parking-1%5D


Editor/Author – CMT/The DPC Journal/CMT Canada/AJRM – Join Michael & Others in Atlanta, OCTOBER 26-27, 2018 and learn more about the business of private medicine. — Register Here …

By Michael Tetreault, Editor-in-Chief

In the past month alone, I’ve had several conversations with about eight to ten Physicians in DPC and Concierge Medicine that were discussions primarily centered around staff.

Whether it was a ‘thank you!’ from a Physician about a recent story we published or a question, comment or a concern, the issue of staffing is one that plagues every medical office, every business and every employer. These membership medicine models are not exempt from these challenges as many Physician’s can attest and will relay this October in Atlanta at the 2018 CMT FORUM (Oct. 26-27, 2018) — click here to register/learn more/schedule >>.

As we unpack this complicated topic you should understand that you are not alone when wrestling with these issues inside your practice. The business of medicine isn’t easy. It is interesting to note that our culture in business today … more or less shames business owners for having these struggles inside a company. ‘You didn’t know this was happening in your business?’

It is even worse for Physicians on an ongoing basis.

This article today is about revisiting an important topic and exercising good judgment on a regular basis. It is not about drawing harsh conclusions about the daily delivery and operations of a complicated healthcare practice and what it should or could look like.

“Business is tough,” says Dr. Chris Ewin of 121MD in Fort Worth, TX. “If you are doing something just for the money, you are never going to enjoy it. You will be the hardest boss you have ever had. So, find something you love and pursue it. Follow this advice and you will set yourself up for an enjoyable future in medicine.”

We recently asked our Physician Readers the following question ‘How many business education hours [or #er of courses] did you take in medical school?’

  • 70% said … Less than 5 Business Edu. courses.
  • 25% said … Less than 20 hours of Business Edu.
  • Less than 5% said … 30+ hours of Business Edu.

concierge medicine top doctors 2018 2017 fordoctors“Two notable observations we encountered throughout our entire [Top Doctors at CMT of 2018] review process was related to patient comments received prior to transition and staff issues— which seem to plague most medical offices, even those inside the four walls of a Concierge Medicine practice,” said Tetreault. “A physicians reputation in the public and online is dramatically different from the patient reviews they may receive prior to a physicians entry into Membership Medicine vs. after the conversion. Many [physicians] go from zero to hero in the eyes of their patients in a matter of weeks or months. We have also noticed that the physicians staff and their individual attitudes towards patients still remains a sore spot among the doctor’s and patients concerns. Even post-transition, when physicians are well into managing their Membership Medicine customers … managing staff inappropriately can impact the clinic’s annual patient retention and ultimately, their bottom line. However, it is amazing what can be accomplished when Physicians walk this healthcare delivery process out and into their own communities. It is only now, that when we are able to look back and track these dramatic career moves of physicians that we see why so many patient experiences make so much sense.”

Here’s another true, anonymized example that we received this summer which I think provides a lens of clarity for our readers which is undeniable. It is a polarizing example that you may relate to and I hope many reading this, will learn from. After pondering, look inside the four walls of your own practice and see if this is happening to your patients.


“… she was going to a doctor who she loved, but did NOT like the staff as they were rude, lazy, etc. She had an appointment with her doctor and the Doctor was there [inside the office building]. But, she was sitting in her car. She just didn’t want to face or deal with the staff’s rudeness. Her doctor actually called her asking if she forgot about her appointment or was running late. She replied “I’m here, sitting in my car”. Then went on to say “I don’t want to come in because of your staff and how rude they are …” The Doctor replied “I will be right there.”

for doctors forum concierge medicine dpc event smallPause. Whoah. Are you kidding me?

Your Staff, whether you believe it or not, influences the direction and quality of your practice and can shape the experience(s) [for better or worse] that patients have in the practice/program. Whether you have a small, family-like atmosphere with friendly staff whom you’ve known for years or multiple new hires that come and go … all of these people are all moving the direction of your practice, your reputation with specialists and ultimately, your influence with patients along a certain path. The question for you is, is this the direction you want to go?

Patients are hesitant to complete surveys they receive from medical offices, even it is labeled anonymous. They are afraid it will impact the relationship with their Physician. They are afraid it will negatively impact the care they receive in the future. And, finally, they are afraid if they speak up, it will impact their bill. It is hard to find a good Physician these days who is accepting new patients, spends the time necessary to gather all the facts and has empathy for their Patients. Patients are afraid to speak up and tell their Physician that they are having an issue with a member of the staff. They fear that it will ultimately result in the Physician’s dislike of them personally and possible termination from practice.

This is what our healthcare marketplace today feels like for millions of patients every single day. That’s why what Membership Medicine and other free market healthcare delivery model variants are accomplishing with time … is so invaluable and critical to our ecosystem today. Membership Medicine is about doing something different, not doing the same things you’ve always done.

For example, a long-time patient of a medical practice (15-years +) walks into the same office one day and learns that the dental hygienist they’ve come to enjoy seeing has moved onto another position. Now, a new member of the staff is hired and the replacement is unfriendly, direct and derogatory towards the patient.

Does the patient say something? Will it impact the relationship with the practice? Will it impact billing? Worse, could speaking up impact the future of the care they need? Remember, the patient likes the doctor but dislikes the staff.

Let’s pick up where we left and see how the story ends.

He [the Physician] went outside to her [patient] car and personally escorted her into the office/practice. When he entered the office, he terminated his staff. He said “this one patient is worth more to me than my staff – you’re fired.”

This may sound extreme. And please note, this is an example of what one Physician did. This story is not intended to provide or render a recommendation or legal advice. You as the Physician or owner of the medical practice should exercise good judgment. That may mean you first consult with your business advisors and if necessary, your own legal counsel to deal with challenging staff circumstances.

With that disclaimer, if you don’t exercise judgment when it comes to your Staff, are they moving your practice in a direction you want it to go? Can you be yourself with your staff or do you have to pretend you are someone you’re not? Do you often feel pressure to give in to vacation demands or personal issues because of the family-like, office dynamic which exists in the practice? How often do they take advantage of you, your generosity or your forgiveness? Do you have an employee in mind that you wish now you’d never met? Do they get along with your husband or wife? Are they nice to other people’s children? What do they wear to work? Is it appropriate? What are they saying about you [or your practice] online?

We don’t hear enough input from Patient’s because they are telling us that they are afraid to speak up …. actions have consequences and they are frightened that the Doctor [or worse yet, staff] will somehow penalize them for it. Sadly, this is the reality of our healthcare marketplace today.

Now, we all know it is not all bad. In fact, I can show you more healthy staff environments in healthcare than I can find bad ones. But, maybe, it’s time to establish some clear boundaries with your staff. Don’t get me wrong, Staff can be useful. Staff should be helpful. But, if you’re not exercising good judgment, you will catch the shrapnel of their bad decisions. To which we say ‘as they go, you go …’

“If I’m paying any amount of a monthly [or annual] subscription to see my doctor, you better know my name when I arrive and I sure shouldn’t have to tap on the glass when I walk-in. And please, move the phone to the back of the office so I don’t have to hear your staff calling in prescriptions or making specialist referral calls.” ~M.C., True Story, Actual Patient, (C) Concierge Medicine Today, 2017

It’s quite possible that this Physician in the story above had no idea that his staff was so rude to Patients. It is important as a Manager and Physician Owner/Operator to listen to how your staff communicate by phone or in person with Patients. If a Staff member is talking about one patient, it most likely doesn’t begin and end there. It is probably a repeated pattern of talking about other Patient’s as well.

Where your staff are heading is a good barometer of where they are leading.

We’ve receive input from real Membership Medicine Patients each day. They share with us some of their experiences. For example, did you know that air quality inside their Doctor’s office is VERY important to them? Actually, it ranks at a whopping 4.5/5. When Physician’s were asked a similar question, they ranked the air quality in their office at a 2.3/5.


“Patients were skeptical and reluctant because of how accessible and convenient the service was. They expected to be kept waiting on hold. Some seemed puzzled by the fact that when they called I answered the phone and knew who they were. One patient even inquired as to how come they only had one form to fill out.” ~Raymond Zakhari, NP and CEO of Metro Medical Direct, New York

So what do Patients inside Concierge Medicine programs want to see from a Doctor’s staff?

One Patient writes … “Uniforms should be the same across the board and appropriate for the practice. Pediatric scrubs for Pediatric offices. Solid color for other offices. And, when it comes to Concierge Medicine offices who are more upscale, a dress code that is not wearing scrubs but uniformity is important. It communicates professionalism. Going to a Concierge Physician, is more laid back, casual and comfortable. That’s fine. But this isn’t summer vacation or a trip to Walmart. I want polished and respectful dress on staff. Who wouldn’t? Common sense. Make the effort. We’re [Patient’s] pay attention. I’d like to see a dress code at any Doctor’s office for that matter where the style of wearing dress pants and nice blouse (all uniformed) for staff is more professional, appropriate and appealing to Patients. If we’re going to refer our friends and Family to your Medical Office, impress them. Impress me. I matter. Patients are anxious when they go to the Doctor and scrubs usually are associated with unpleasant procedures such as lab draws or injections. Scrubs also give the impression that the people behind the scrubs are nurses who have a higher level of education and the reality of it is, these people are medical assistants not nurses.”

One Doctor in New Jersey said … “You either have a workload issue or a workforce issue? You don’t have both. If you’re not committed to providing exceptional patient/customer service for your patients, your practice will never achieve its full potential.”

Patient satisfaction isn’t good enough. Your patient/customer service expectations need to be exceptional, and you need to create not just satisfied customers, but happy, loyal patients.

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