Insights from the Outside: Mastering the Initial Patient Contact and Pre-appointment Conversation

Insights from the Outside is a group of practicing clinician-owners. They are a diverse group from many medical specialties, including dentistry, veterinary medicine, cosmetic surgery, ophthalmology, audiology and optometry. Uniquely created by CareCredit, the groups’ purpose is to capture and share “best practices” to some of the common challenges all healthcare business owners face, such as attracting new patients, patient barriers to care, care acceptance, patient retention, social media, team training and empowerment and much more.

This article features ophthalmologist Dr. Ethan Sadri, owner of Atlantis Eyecare, dentist Dr. Howard Ong, owner of Seal Beach Dentistry, and Nola Aronson M.A., CCC-A, owner of Advanced Audiology.
Can you share your goals and desires when it comes to the patient experience in your practice?
Ms. Aronson: The overall goal of our patient experience is to make patients feel comfortable and understand that we are here to help in any way we can with their hearing concerns. Our patient experience starts with an introduction to our front office receptionist. Then the patient is escorted to our waiting room where they can read some literature and enjoy some coffee, candy and other treats. We have a video playing in the background that explains about hearing loss and new technology — hopefully educating the patient while entertaining them at the same time. When it’s time to see the provider, it’s our hope that they are comfortable and informed about hearing loss and what they can expect from their visit to our office.

Dr. Sadi: Like Ms. Aronson, we really focus on educating our patients about the latest updates and innovations in eye care. We also use video and written content to provide patients with as much relevant information as we can, prior to their exam, so that their visit with the doctor is as efficient and effective experience as possible.

Dr.Ong: Our patient experience is directly linked to our practice culture—which we define through our relationship-building skills. We feel the best way to gain initial trust and confidence is to take the time to simply speak to, visit and honestly connect with patients. Once that initial relationship is established, everything else follows—from educating patients and instilling confidence in our treatment recommendations to having patients accept and follow through with care. We personally go out and greet every patient and walk them into our practice. Little things like that are just part of our practice culture and goes back to treating patients like we would want to be treated.
Is the patient experience something that you and your team purposefully craft and continually update?
Dr. Sadi: Yes, we routinely craft and update our messaging to the patient. I think an informed patient is a powerful patient who can ask proper questions and understand and take part in their own care. Also, an informed patient is typically more motivated to move forward with their procedure or care goals. With the advent of the internet and all the different information that’s available today, patients are really savvy. While I definitely think it’s important that we as clinicians control the dialogue from a healthcare provider’s standpoint, as far as I’m concerned there’s no such thing as an over-informed patient.

Dr.Ong: Yeah, I would agree with that. Our major focus is relationship-building which can be hard to monitor but one of the things we do to stay up-to-date with what’s happening with our patient experience is have regular meetings. We divide our practice into different teams and we meet as a group at least once a month. During that time we talk about relationship-building. We make sure that every team member understands that this is the single most important tool we have to create a positive patient experience.

Ms. Aronson: Similar to what Dr. Ong said, we have clinic meetings where we go over what’s going on with each patient. If we’ve had any problems with a patient we try and determine why, what happened, what was said to the patient, what we can do to rectify the problem and what we can learn from it so that it doesn’t happen again.
What are your practice’s first points of contact with the patient?
Dr.Ong: These days it’s the internet or our social media platform. Patients are definitely checking us out online before contacting us. In fact, we had several new patients come in this past month, and when we asked how they heard about us, more than half said they found us on social media through Yelp or Facebook or some other form of digital media.

We actually have a review system that generates a request to patients automatically after their visit. Once they’ve completed a review we get their permission and then post it on our Facebook page and other social media platforms. That seems to be the primary way that many of our new patients are prompted to call or come by or make an appointment.

Ms. Aronson: I’m personally very involved in my community. Although it has 330,000 people, it’s very tight knit. My husband does all the marketing for our practice and he and I belong to several networking groups. I’m also on the board of directors of two non-profits here so when people see our ads and other marketing materials, I think they feel like they already know, like and trust us because of how much we’re out there in the community. You can’t just sit behind your desk. People work with people they know and trust and so that’s how we’ve built up our business by being out there. In addition to advertising in about four different papers, I’m also on a radio show on the senior hour once a month. So when people come to our practice, most of the time they say, “Oh, we see you everywhere. We feel like we know you already.”

Something we just started is a physician newsletter. We also have a patient newsletter that we email out. And of course we have our website which is continually evolving. We put open house events that we have once a month on the website for people to see and there’s a place for someone to sign up for a free hearing guide. We offer free hearing screenings to the whole entire community to get people into the door as well. We also recently started making videos. Most of them are informational because when somebody comes to your page, you want to look like the expert that knows everything so that they’re not looking around at different websites. So we have different short videos that say how to take care of your hearing aid, how to clean your hearing aid, what happens when you need a hearing aid, you know we have a video on tinnitus, just whatever we can think of that people would be interested in.

Dr. Sadi: Our initial point of contact with patients usually comes through the phone, internet, or a primary care or optometry referral. Typically the patient calls in for an appointment with the provider. Then my team sends them a packet of information to review and forms to fill out so that when they come in, they have a clear understanding of what to expect at their appointment.
As you said, Dr. Sadi, often the first point of contact is an incoming phone call. How critical a step is this first person-to-person contact in the patient’s journey?
Dr. Sadi: It’s extremely critical. If a patient calls in and has to deal with long wait times, dropped calls, a short or unmotivated team member it simply kills a patient’s confidence in the practice. On the other hand, if a patient experiences a pleasant greeting from a caring staff member with no wait or hold time, and they are able to schedule an appointment within a reasonable timeframe, they are far more likely to have a positive impression of your practice and keep their appointment. I think phone skills are like any other people skills; you have to be empathetic and come from a place of care and comfort for the patient.

Dr.Ong: I agree, and I’m happy to say our admin team is exceptional about welcoming patients over the phone. They take the time to walk new patients through our digital media — inputting their data online so when they come to our practice, they are ready. Our team also uses the initial phone call to really try and get to know the patient and determine their needs by asking questions that go beyond “How did you hear about us?” They ask about everything from the level of anxiety the patient may feel while undergoing treatment to the best time to schedule an appointment to eliminate conflicts. Those secondary or tertiary questions really help to set the patient up for success and limits disappointments. When it comes to phone skills I think a lot has to do with training. We meet and work on telephone training with our team every month. We discuss talking points, and if there’s been any feedback from patients — positive or negative.

We also use scripts. Although after hundreds of phone calls all of our admins know exactly what to say by now. But for those who are just beginning or looking to improve their telephone skills, I definitely recommend starting with a script because you don’t want to have a boring or meandering conversation with a patient that goes nowhere. You definitely want to be scripted and specific with those secondary, tertiary questions I was talking about so that you’re capturing all the relevant information and the admin knows what they’ve talked about with the patient when they meet them for the first time.

Ms. Aronson: That’s a great idea, Dr. Ong. One of the things we do to maintain our phone skills is have secret shoppers call our office and give us feedback on what happened during the call. I also work with a company that records our phone calls so that I listen to them — especially the missed opportunities — and see what’s happening and how the phone calls are being answered. We also do a lot of role-playing to make sure that first point of contact is really friendly on the phone. And we train our team to really listen to what the person is saying and we practice how to answer correctly. Because if you don’t answer the questions right or you try to give prices over the phone or things like that, then the patient’s going to go shopping around and looking around or if they don’t feel comfortable, they’re not going to make an appointment. So I think that first point of contact is one of the most important people in your office.
The next step in the patient journey is the pre-appointment communication. What do you do to continue the experience before the patient arrives at the practice?
Ms. Aronson: In our follow-up with the patient we have a patient input form that the front office fills out that has certain questions to ask the patient about their hearing and what they’re experiencing so that we can determine how to schedule the appointment appropriately and give enough time for the provider to be able to do things right. We also have our team member ask for a third-party to attend the appointment with the patient. They also use this conversation to ask the patient specific questions like, “What problems are you having?” “Do other people notice those problems, too?” “How long have you had those problems?”

Finally, to ensure that the patient shows up for their appointment, we do various things to confirm. We have a system that will email the patient a week before their scheduled appointment. Then we will email or text the patient to remind them a few days before and then our office staff will call the day before to confirm. We have a very low no show rate. In fact, the only time we have a no show is when it’s raining outside.

Dr. Sadi: After the initial contact we have patients go to our website and fill out the necessary forms. Then they have a conversation with a counselor and a front office person to see what they’re coming in for, how urgent it is and to provide them with educational materials up front. So if they are coming in for LASIK, we want to educate them about the procedure as much as possible up front. If they’re coming in for cataracts, we want to do the same thing.

How we present the information to our patients depends on the demographic and the age. If they prefer email, we will send them materials that way. A lot of our patients still like the traditional mail, especially older patients, so we often use that method. Once they get the materials we ask the patient to review them and contact us with any questions. We find that patients who have engaged with the information come in more educated and knowledgeable about the procedure and feel more comfortable. If they didn’t review the material, it’s pretty obvious. When that happens, the first appointment becomes an informational appointment and then they have to come back for a follow up —which is fine but it’s not as efficient as the patients who come in already having the basic knowledge about their treatment.

Dr.Ong: During our confirmation phone call, we always make sure that the patient knows which member of our team they are talking with. Then once they come in we make it a point to introduce them to the team member who initially had that phone conversation with them so they have a point of contact. That connection helps solidify and strengthen the patient experience. We also take the information we gathered in that initial conversation and we put it into their chart before we actually see the patient so the whole team, doctors and assistants are aware of some of the conversations we’ve had with the new patient. We leverage those notes when the patient comes, using them as bullet points during the chair-side conversation. You can literally see their eyes light up when they realize that someone was paying attention and as a result we now have a solid foundation on which to start a relationship.    

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