DPC News

The curious case of a disinterested, suspicious, here-against-my-will, would-rather-be-somewhere-else, Patient.

What if … You removed EVERY possible obstacle from the path of the disinterested, suspicious, here-against-my-will, would-rather-be-somewhere-else, Patient?

By Michael Tetreault, Editor-in-Chief, The DPC Journal, Concierge Medicine Today, CMT CANADA, The DocPreneur Institute, Concierge Medicine FORUM | SEPTEMBER 2018

Define Exceptional.

Pause on those two words.

How do those two words apply to the way you run your medical practice, manage your staff or interact with your Patients?

It means something singularly different to every Doctor we talk to.


“Gain some customer service experience– try a service industry job as these skills are not taught in med school. Moving into Concierge Medicine is not solely about providing excellent medical care without the restraints of insurance industry mandates. You have to also appreciate the lost art of customer service so long ago forgotten when visiting a healthcare institution. Many times my clients (notice I do not use the word “Patients”) have noted why they refer their friends to my practice. It is the attention to detail, always delivering exactly what is promised and then some, and keeping their unique needs positioned first with a flexibility to offer new programs or meet needs as quickly as they are identified. This is the cornerstone of customer service.” ~ Dr. Carrie Bordinko, Consolaré, Paradise Valley, AZ

We’ve spent a lot of time, a LOT of time for more than the past decade now, interviewing, talking to and documenting the character qualities and habits of successful Concierge Medicine Physicians and the exceptionally trained and well-equipped staff who know precisely what it takes to make a lasting impression on subscription-based patients. Not only do their faces show their satisfaction, but so does their community. They understand that a Patient is a person. And, those subscribers are people who are voting with their pocketbooks and rewarding your hard work when its is deserved.

What do all of these Concierge Medicine Physicians have in common?

  1. They removed every possible obstacle from the path of the disinterested, suspicious, here-against-my-will, would-rather-be-somewhere-else, Patient.

    Cost to your medical practice: $0

  2. They’ve built systems, processes and redundancies inside their practice that has taken the level of patient service to an entirely new level. To say that many of these Concierge Medicine Clinics are providing exceptional care … is an understatement. What you might be surprised at is that it isn’t that difficult. It doesn’t take a lot of money and all it has really cost these doctors is their time.

“If you provide anything less than exceptional patient service for your Concierge Medicine patients, you’re wasting time, creating extra work for and frustrating your patients, staff, suppliers and yourself,” says one of Texas’ most well-known Concierge Physicians in a recent radio interview. “Smart businesses outside of healthcare have customers. So do we. We put in our time, our emotion and our mental strength into our customers and it’s about time we start operating like a business. We have every advantage now that we’re free from a lot of the administrative burdens most traditional medical practices have. There’s simply no reason why we cannot make the extra effort to serve our patients now.”

The basic premise of patient [customer] service training in many medical practices, whether they’re membership-based or not, comes with the best of intentions. The doctor has a staff meeting about patient service, and the service improves for a few days or weeks and then it drops to mediocre levels again. Consistent reminders don’t come because you’re a busy doctor and you have a lot of other responsibilities on your mind.

“Patients deserve to be involved in their care and receive the valuable service of planning for optimal health with the guidance of a family physician who is dedicated to the care of the patient.” ~Dr. Brian Nadolne, MD, Marietta, GA

So what can Doctors do to continually improve their patient care and customer service? At the end of the year, month or quarter (dependent on your billing cycle or patient contract), the patient will ultimately choose and deliver a clear message (think report card) to you and your staff and the business [i.e. practice] as to how they thought you did in the recent past. What do you think your patient retention will be in the coming year? 20% attrition? How about 10% attrition? Why not strive for 3% attrition? What if we took on that expectation? Is it even possible? The answer is yes, it is … !

Today we’ll provide you with three simple insights.

3. Be Mindful That The Experience Begins in the Parking Lot.

Guests coming to Disney World are excited about seeing Mickey Mouse, or a Princess. They can’t wait to be a part of the magic inside the parks. There’s only one problem…  Who is the first face Guests see at Disney World?

Believe it or not, parking matters. So does signage, nameplates and having a sense of respect and humor also. If there is a sign in the parking lot that gives the doctor the best spot … what/who does that tell curious patients who that Clinic is putting first?

I recently wrote and published a video blog and story about this topic, examining hospital hot-spots, car thefts inside medical office parking lots and the like. You can watch or read that story here …

Dr. Edward Espinosa [and Terry Bauer; CEO of Specialdocs behind at Table] speak to a crowd of Physicians at the 2017 CMT FORUM in Atlanta, Saturday, Oct. 28, 2017. LEARN MORE ABOUT our 2018 FORUM coming October 25-27, 2018 HERE …

“My vision is to cultivate a personal Patient – doctor relationship amidst a bustling urban community where impersonal professional relationships are the norm. Our practice strives to deliver quality medical care with an emphasis on evidence based medicine, open communication, easy accessibility, and a focus on customer service. These benefits can lead to an overall improvement in how healthcare is delivered and may ultimately improve outcomes.”  ~Dr. Edward Espinosa Buckhead Concierge Internal Medicine, Atlanta, GA

If you want to make a difference in your community and possibly the world, give your patients and the people you care about appropriate painted parking lot lines, updated handles on doors, updated paint, rails next to steps, and specific applications they can easily follow. You might not think these things matter … but they do, they really, really do!

To add to that, challenge them to do something. As we’ve all seen in healthcare, it’s not safe to assume that people automatically know what to do with what they’ve been taught. Why is it when you tell someone to take their medication or exercise and a few weeks later you follow up and find out your instructions haven’t been followed? The Patient-Physician relationship is a perfect example. How many people follow your advice 100% of the time every time. Their trust needs to be earned, regardless of how long you’ve been treating them. They need specific direction. This is hard. This requires an extra step in preparation. But this is how people grow. This is exactly what great physicians have shared with us that has taken their practice from ‘good to great.’

At the end of the day, it’s application that makes all the difference. Truth isn’t helpful if no one understands or remembers it. How many people do you think remember the parking lot?

4. De-clutter the Office, Fast!

*Each pre-conference workshop requires separate registration and is NOT INCLUDED in the general CMT 2018 FORUM registration fee. http://www.ConciergeMedicineFORUM.com

Settings create first impressions. Why is it that the phone is right next to the lobby? Move it to the back? No one wants to hear your staff leave voicemails for other patients. First impressions are REALLY important. For example, if you’re a Pediatric Concierge Physician (and many are), when parents see that you have created an appealing setting for their children, then they trust you with their child even more. Think of it as … ‘We value your kids like we value ours.’

Every physical environment communicates something. There aren’t any neutral ones. What do you do when people visit your home? You clean! When you have junk, that communicates that you are expecting the same old people. You don’t clean the house for family.

“A business that looks orderly says to your customer that your people know what they are doing.” E-Myth by Michael Gerber

If you don’t see a mess, if you aren’t bothered by clutter, you need to make sure there is someone around you who does see it and is bothered by it. An uncomfortable or distracting setting can derail the patient experience before it begins.

The messages your practice environment from the parking lot, shrubbery to the cleanliness of the bathroom and organization of the administrative area has the potential to trump your primary message, relationship-oriented patient care. This is exactly where you should shine. If your practice is over the price point of $2,500 per year, it’s even more important to get this right. If people are gonna say ‘Concierge Medicine provides exceptional and expensive care …’ your practice should be a walking, talking, amazing example of that and you should be proud of it, because your colleagues who’ve learned this already are.

“Every visit is on time; you are not waiting. If you are ill and come in the morning, you are always able to be seen the same day. And I don’t mean ‘squeezed in.’ I mean seen in a relaxing comfortable visit. You are not seen for five minutes with a practitioner saying, ‘Tell me your problem,’” but is rushed because five more people are waiting. When patients call at 10 o’clock on a Saturday night, they get their doctor on his cell phone — not an answering service, not a doctor who is covering for the weekend. It is their own doctor. He knows them. He doesn’t have to go back to a computer and say, ‘I see here that three years ago, you had pneumonia and we prescribed Cipro.’  When you have that number of patients,” says Roberta Greenspan of Specialdocs. ”You know your patients.”

Cost to your medical practice: $0

5. Train Your Team By Involving Patient Insight More.

Do not rely on the absence of patient complaints as the way you determine the level of service your practice provides. People will vote with their feet and their pocketbook. So, even in this new world of social media a large number of people who are disappointed with a doctor won’t complain to anyone, they just leave and never return. You have to define what “exceptional” means then train and remind your staff of the definition.

Customer service, as described by some physicians, is the number one way to grow [this type of] practice.

Satisfied patients are . . . satisfied. If someone else has a little better price or opens a medical practice that’s a bit more convenient, they’re gone. Especially the 25-45 age demographic. Just think of it, if your goal is a satisfied patient, even if you and your staff do everything perfectly, the best you’ll get is a satisfied patient — that’s your goal.

As a doctor, it’s your responsibility to offend people with the truth of medicine. That’s one reason many doctors have staff that work very hard NOT to offend them in the parking lot, the stairs, at the check-in window or lobby, or in the early minutes in the examination room.

You want people to come back in the following days, weeks or months for another round of offending. Present the truth of medicine in uncompromising terms, rally hard against couch potatoes, and tackle the most emotionally charged topics in their lives, while providing an “environment” where people feel cared for.

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.

Example of one Concierge Medicine Physician Office --

Example of one Concierge Medicine Physician Office — http://www.choicephysicianssfl.com/

Don’t keep your standards a secret. Ask for insight now, not later.

Don’t think that you show your commitment to exceptional customer service by making up slogans about it. Let your staff and patients know what your service expectations are.

“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

The key is that if you do ask for input from your patients while they’re still inside the walls of your practice, in the moment. You need to act when you get it. Whether it’s a good comment or a complaint, every patient/customer who gives you feedback needs to get a response.

One of the most important reasons for sharing your patient/customer service expectations with your patients while they are still inside the walls of your building is that it puts your staff on the “hot seat” … and, if they feel they haven’t gotten exceptional patient/customer service, now’s the time to ‘make it right.’ If you don’t, it’s likely they will “REVIEW” your practice on sites like YELP, GOOGLE, Vitals or HealthGrades.

When you have your entire team trained and you always remind them of your expectations, you need to make sure every new employee gets the same initial customer service training that your entire team received.

Your current template medical practice is perfectly designed to produce the results you are currently getting. But did you know that nearly 100% of every Membership Medicine Clinics say they need more patients?

Dr. Tiffany Sizemore-Ruiz, physician, author and blogger. Dr. T is known for giving a little tough love, but she cares immensely for her patients. She truly treats every patient as if they were a family member, and will always give advice based upon that ideal. Tel: 954.523.4141

Dr. Tiffany Sizemore-Ruiz, physician, author and blogger. Dr. T is known for giving a little tough love, but she cares immensely for her patients. She truly treats every patient as if they were a family member, and will always give advice based upon that ideal. Tel: 954.523.4141

The best thing you can do to show every new employee your commitment to patient/customer service is to train them about your patient/customer service expectations on Day 1. Any time your staff provides less than exceptional patient/customer service it’s your fault.

“Being a good physician is not just about knowing how to diagnose and treat disease. Honestly…that’s what books and studying is for. Being a good doctor entails earning the trust of your patients by being honest and forthcoming. It means knowing how to communicate effectively while still remaining sympathetic. It requires you, first and foremost, to be a human being. It honestly bothers me that young doctors feel like they have to “know everything” to be a great physician. Put down the damn book and go talk to your patient. Be a friggin human being. Be a friend. Its really that simple.” ~ Tiffany Sizemore-Ruiz, D.O. of Choice Physicians of South Florida.

How can this be? It’s simple, either you haven’t trained or reinforced this training properly.

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

When Concierge Medicine Doctors become committed to exceptional patient/customer service, you may stumble from time to time, but when you do, you’ll still be providing great patient/customer service. The added benefit to providing exceptional service is that when you or your staff do stumble, your patients will be much more likely to forgive you.

In summary, it is natural to assume that what worked in the past will always work. But, of course, that way of thinking is lethal. And the longer it goes unchallenged, the more difficult it is to identify and eradicate. Every innovation has an expiration date.

Cost to your medical practice: $0 (or, maybe just time and a half …)

6. Learn people’s names.

“I feel like I’m at a friend’s house.”

That is the true statement echoed by one of our readers when she explained her last visit to her Concierge Doctor’s office.

The staff at your medical practice and well, YOU, the DOCTOR, of course … should call people by their first names. If they bring their kids along, ask about them, talk to them. Make them smile.


EDITOR, Audio: “My Daughter, a Superhero named Sparkle Girl, has some advice for Doctors…”

People notice when you call for example, their daughter by her name five separate times.

“Not only should they call them by their first name,” says a Concierge Doctor in Nebraska who spoke at the Concierge Medicine FORUM, “If they are little kids, you should get on your knees and look them in the eye and welcome them to the Doctor’s Office. Then, tell him/her how much fun she is going to have. And, then, here’s the moment when you can ‘WOW’ them. Make sure you’re staff knows the family or Patient by their first name and is paying attention. When they leave after the visit, a staff member that Patient doesn’t even know should be standing at the door, look them in the eye and say something like “Casey & Johnny, I hope you guys had a great time. We’ll see you next time!”

Don’t treat people like a number. They are real people.

Cost to your medical practice: $0

7. Walk people where they need to go, don’t point.

This may go without saying, but if you’re in a larger medical facility, HIPAA concerns and compliance issues come into play here. You don’t want a Patient wandering your halls or inadvertently glancing at a file, opening a door or standing around. It happens, trust me. You’ve seen it. I’ve seen it. And, it’s especially bad when you have family members or even a busy practice with plenty of people around that suddenly don’t have anywhere to sit or know how to occupy themselves. A good example of this is, if someone asks where the bathroom is, walk them there. This simple task may seem pointless, but if it’s down the hall and the right, use that opportunity to ask them about their day. The minor little details matter.

You could say [with a smile I might add …] “Right this way.” You then walk them across the entire building. Or, maybe you take the long way and use it as a moment to ask them about their kids. So, don’t point, walk and talk.

Cost to your medical practice: $0

A Wide Array of Topics Will Be Uncovered In Precision Medicine; Genomics; PGX; Physician Independence; Policy; Legal Updates; Telehealth and More!


Categories: DPC News

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